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Attitudes & Decision-Making After Pregnancy Testing

Nearly half of pregnancies in the United States are considered “unintended,” and at least half of these pregnancies are carried to term. Although accidental pregnancies are common, evidence about how women make decisions about their pregnancies and the health care they want and are able to obtain is surprisingly limited. Furthermore, we know relatively little about how the experience of more and less intended pregnancy affects women’s lives and well-being during and after pregnancy.

The Attitudes and Decision-making After Pregnancy Testing (ADAPT) Study is using innovative methods to address the following research questions:

Research Questions

What are women’s preferences about becoming pregnant, and how and why do their preferences change over time?
What factors influence women’s decisions about their pregnancies and the types of services they seek and receive?
What prevents women who seek an abortion from getting one?
How does having a less intended pregnancy, compared to a more intended pregnancy, affect women’s well-being, health, and socioeconomics?
How do these outcomes differ for women who have an abortion, women who want but cannot get an abortion, and women who choose to carry an unintended pregnancy to term?

Study Design

This longitudinal cohort study is recruiting about 2,200 women from reproductive and primary care health centers in four states. All study participants will be followed for at least one year. Women who become pregnant, as well as a subset of women who do not become pregnant, will be surveyed over two-three years.


ADAPT’s unique prospective study design and use of a robust new pregnancy preference measure, the Desire to Avoid Pregnancy measure, will enable our researchers to document women’s pregnancy attitudes, decision-making processes, and experiences seeking prenatal or abortion care over time. By including women from several states, our researchers will be able to observe how diverse social and political environments affect women’s pregnancy decision-making and ability to get the health care they seek. Comparing the health and well-being of women who have more and less intended pregnancies, as well as women who avoided unintended pregnancies, will illuminate the effects of unintended pregnancy on women’s lives.