Pregnancy ambivalence: Expectations, preferences and contraceptive choice

We utilize novel probabilistic expectations data related to contraception, such as the perceived chances of pregnancy or contracting a sexually transmitted disease, to investigate the underlying factors contributing to the differences in contraceptive choices across various demographic groups in the United States. Women from groups with disproportionately higher rates of unintended pregnancies, such as Black women and those with lower income, exhibit relatively accurate perceptions about contraceptive effectiveness. This finding suggests that systematic misperceptions about contraceptive efficacy play a limited role in explaining the variation in contraceptive choice across different groups. We then combine data on contraception choice with the expectations data to make inference on women’s preferences for birth control methods’ attributes. We find heterogeneity in preferences for becoming pregnant: non-Black women with a college degree would be willing to pay $260 per month to avoid a pregnancy, while Black women without a degree and low income women exhibit a willingness to pay to avoid pregnancy not statistically different from zero, suggesting an ambivalence toward pregnancy. These results highlight that differences in contraceptive choices and outcomes are primarily driven by varying preferences for pregnancy, with limited disutility among groups experiencing higher rates of unintended pregnancies.