# Pregnancy, Birth, Neonatal, and Mental Health Outcomes Are Minimally Associated with Pregnancy Ambivalence

## TL;DR

This study finds that pregnancy ambivalence is minimally linked to poor birth or neonatal outcomes but is associated with mental health issues and harmful behaviors during pregnancy.

## Contribution

The study introduces the London Measure of Unplanned Pregnancy (LMUP) as a comprehensive tool for measuring pregnancy ambivalence.

## Key findings

- Ambivalence was not associated with birth or neonatal outcomes.
- Ambivalence linked to delayed prenatal care, harmful behaviors, and increased depression and anxiety.
- Mental health screening may be more beneficial than screening for pregnancy ambivalence.

## Abstract

Pregnancy ambivalence is increasingly recognized and studied in sexual and reproductive health research, yet its associations with adverse outcomes remain unclear. The purpose of this paper was to explore different measures of ambivalence and whether any were associated with poor pregnancy, birth, social or mental health outcomes. A cross‐sectional survey was conducted with 1941 individuals assigned female at birth, ages 18–45, who had been pregnant in the past 2 years. Ambivalence measures included the London Measure of Unplanned Pregnancy (LMUP) and additional questions exploring mixed feelings, uncertainty, incongruent feelings, and fatalistic beliefs about pregnancy planning. No associations were observed between ambivalence and birth/neonatal outcomes, though ambivalence measures were linked to delayed prenatal care, exposure to harmful behaviors during pregnancy, and increased odds of depression, anxiety, and intimate partner violence. Mental health assessments and intimate partner violence screening could improve care delivery and outcomes more than screening for pregnancy ambivalence. The LMUP, which captures multiple dimensions of ambivalence as well as addresses the deficiencies with traditional measures of behavior, may be the strongest measure to use when needing to comprehensively measure pregnancy ambivalence.