Attitudes toward unprotected intercourse and risk of pregnancy among women seeking abortion

Despite the high prevalence of unintended pregnancies caused by lack of contraceptive use, little is known about women's reasons for or attitudes toward unprotected intercourse (UI).

We included 562 women seeking pregnancy termination at six U.S. abortion clinics who completed surveys on their experiences and attitudes about UI, knowledge of the risk of conception, and willingness to engage in UI in the future.

Respondents reported an average of 18 acts of UI leading up to conception. The most commonly reported reasons for UI were thinking one could not get pregnant (42%), difficulties procuring a contraceptive method (40%), and not planning to have sex (38%). When asked about attitudes toward UI, 48% reported that UI feels better or more natural, 36% said it is okay to have UI once in a while or at certain times of the month, and 28% cited partner or relationship benefits as a reason to engage in UI. In addition, 23% said they were somewhat or extremely likely to engage in UI in the next 3 months. Younger women (<20 years), women who named partner or relationship benefits to UI, and women who underestimated the risk of conception were significantly more willing to engage in UI in the next 3 months.

Given the prevalence of risk taking and the perceived benefits of UI, contraceptives, particularly long-acting methods, need to be made easy to procure and use. The success of coital specific methods may be limited by women underestimating the risk of conception.