Perceptions of susceptibility to pregnancy among U.S. women obtaining abortions

More than half (52%) of unintended pregnancies in the United States (U.S.) occur among the 10.7% of women using no contraceptive method. We interviewed a sample of women obtaining abortions in the U.S. in 2008 (n = 49) and explored their attitudes toward and beliefs about their risk of pregnancy. We found that most respondents perceived themselves to have a low likelihood of becoming pregnant at the time that the index pregnancy occurred. Respondents' reasons for this perceived low likelihood fell into four categories: perceived invulnerability to pregnancy without contraceptive use, perceptions of subfecundity, self-described inattention to the possibility of conception and perceived protection from their current use of contraception (although the majority in this subgroup were using contraception inconsistently or incorrectly). About half of the women discussed more than one reason when explaining why they perceived themselves to have a low risk of pregnancy at that time. We propose a modified Health Belief Model to account for women's low perceived susceptibility to pregnancy based on our results. Further research is needed to quantify the proportion of women who are at risk of pregnancy who do not believe they are at risk and their reasons why, so as to be able to better address women's misconceptions about fecundity and conception with the goal of preventing unintended pregnancy.