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Ambivalence Toward Pregnancy as an Indicator for Contraceptive Nonuse: A Systematic Review and Meta‐Analysis
Author(s) -
LaCross Allison,
Smaldone Arlene,
Angelson Jessica
Publication year - 2019
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12969
Subject(s) - meta analysis , pregnancy , ambivalence , medicine , observational study , systematic review , family planning , odds ratio , fertility , family medicine , demography , population , medline , psychology , environmental health , social psychology , genetics , pathology , sociology , political science , law , research methodology , biology
This systematic review and meta‐analysis examines the association between contraceptive nonuse and ambivalence toward pregnancy. Methods Following an a priori protocol, 4 databases were searched, and results were reported using the Meta‐Analysis of Observational Studies in Epidemiology guidelines. Studies were appraised for quality using the Appraisal Tool for Cross‐Sectional Studies, and those reporting results as frequencies or odds ratio (OR) were included in random effects meta‐analytic models. Results Of 209 identified studies, 6 met criteria for systematic review and meta‐analysis. Pooled data from 8360 women in 6 studies demonstrated a significant association (OR, 2.41; 95% CI, 1.4‐4.15; P < .0001) between ambivalence toward pregnancy and nonuse of contraception. Pooled data from 735 men (2 studies) demonstrated no significant differences (OR, 1.96; 95% CI, 0.7‐5.47; P = .20) between ambivalence toward pregnancy and male contraceptive nonuse. Discussion Women with ambivalent pregnancy attitudes are more likely to forgo contraception compared with women with anti‐natal (strong desire to avoid pregnancy) attitudes, which has not been validated to date in a systematic review and meta‐analysis. There was no significant association between men's pregnancy attitudes and their contraceptive nonuse, however. Although a cohesive theoretical definition of ambivalence is lacking, health care providers are advised to help guide people who have either conflicting or absent attitudes toward pregnancy to formulate a concrete opinion about their family planning goals.