Maternal adverse childhood experiences and pregnancy intentions

Purpose: The current study investigates the association between maternal adverse childhood experiences (ACEs) and having an unwanted (i.e., a pregnancy that was undesired) or mistimed pregnancy (i.e., a pregnancy that occurred sooner than wanted). Methods: Data are from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS) ( N = 1897). Multinomial logistic regression analyses are used to assess the association between levels of ACE exposure and having an unwanted or mistimed pregnancy relative to an intended pregnancy. Results: Findings demonstrated that women with three ACEs (Relative Risk Ratio [RRR] = 2.157, 95% con-fidence interval [CI], 1.121-4.151) and four or more ACEs (RRR = 1.836, 95% CI, 1.181-2.854) had approx-imately twice the relative risk of having an unwanted pregnancy (vs. an intended pregnancy) compared to women with 0 ACEs. There was no association between ACEs and reporting a mistimed pregnancy. Conclusions: These findings add to a burgeoning literature detailing how accumulating ACEs can create challenges for family planning by increasing the likelihood of having an unintended pregnancy. Study re-sults suggest the need to devote greater resources to the prevention of ACEs and unintended pregnancies. (c) 2021 Elsevier Inc. All rights reserved.