#2-14E. Addressing Reproductive Inequity: How Sociodemographics Impact Pregnancy Attainment (JAMA Netw Open, 2025)

How accurately do our patients achieve their pregnancy and childbearing preferences? This prospective cohort study, leveraging longitudinal data from reproductive-aged women across nine US states, utilized the rigorously developed Desire to Avoid Pregnancy (DAP) scale to assess the association between preferences and incident pregnancy. The results confirm a strong association between preferences and outcomes, yet reveal that even among those with a high desire to avoid pregnancy (High DAP scores), an estimated 3% became pregnant annually. Crucially, the study found that the attainment of these preferences—both avoiding and achieving pregnancy—varied significantly by sociodemographic characteristics. This highlights substantial reproductive inequities influenced by factors like racial/ethnic identity and education level. For clinicians, it is important to note that the primary outcome relied on self-reported incident pregnancy, which likely results in an underestimation of pregnancy rates, particularly those ending in abortion. These findings are vital, demonstrating the urgent need for individualized, equitable interventions in contraception, preconception counseling, abortion, and fertility care to better support patients in achieving their reproductive goals.

Citation: Bullington BW, Muñoz I, Boscardin WJ, Rocca CH. Pregnancy Preferences and Incident Pregnancy in the US. JAMA Network Open. 2025. DOI: 10.1001/jamanetworkopen.2025.36697.

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