A Third of Women Do Not Confirm They Are Pregnant Until 6 Weeks or Later

By Linda Carroll

November 15, 2021

NEW YORK (Reuters Health) - More than a third of women and girls do not confirm they are pregnant until they are six weeks or further along and one in five don't know until they are at seven weeks or later, a U.S. study finds.

An analysis of data from 259 pregnant individuals who were participating in a cross-sectional survey, revealed that the quickest route to confirming a pregnancy is an at home test, but teens are less likely than others to use those tests, researchers report in Contraception.

"Recently we have seen the Supreme Court is more willing to allow enforcement of gestation-based restrictions on abortion, for example, the Texas six-week ban currently in effect there," said first author Dr. Lauren Ralph of the University of California, San Francisco. "So, it's become increasingly important to understand when people discover they are pregnant and who is more likely to make the discovery later and to be impacted by these laws."

"We found a wide range of experiences," Dr. Ralph told Reuters Health by phone. "One in three first discovered their pregnancy after six weeks' gestation. That means when they knew for the first time, they were already beyond six weeks and that is higher among certain subgroups, such as those between 15 and 19, those living in food-insecure households where financial instability is higher and among those who identified as Latinx or Latina."

"In particular," Dr. Ralph said, "the majority of young people - over 50% - were beyond six weeks when the pregnancy was confirmed. This study clearly highlights these groups as being disproportionately impacted by restrictions like those in Texas that ban abortion early in pregnancy."

One barrier for young people was difficulty obtaining home pregnancy tests, Dr. Ralph said.

To take a closer look at women and girls' behaviors related to pregnancy suspicion and confirmation, Dr. Ralph and her colleagues conducted a cross-sectional study. The researchers recruited women and girls from eight reproductive and primary healthcare facilities, including one abortion facility, in Arizona, New Jersey, New Mexico, South Carolina and Texas in 2016 and 2017.

The researchers included in their analysis patients who were aged 15 to 45, who identified as female, who were sexually active in the last year, who were not sterilized and who were able to speak and read English or Spanish. Patients who said they were interested in participating in the study were asked to fill out a 30-minute anonymous survey while still in the waiting room.

Those who reported a current or suspected pregnancy were asked when they first suspected they might be pregnant, if and how they had confirmed the pregnancy and what kinds of healthcare they had sought. The researchers asked patients if they took a home pregnancy test "before going to any doctor's office or clinic" and what factors, if any, made them "put off or delay taking a home pregnancy test after (they) first suspected (they) were pregnant."

Among the 259 participants, mean age 26, 198 indicated they were pregnant and 61, that they might be pregnant. Many (42%) reported receiving public assistance, 34% said they were seeking abortion care or a pregnancy test (31%) and 25% said they were seeking prenatal care.

Nearly three-quarters (74%) took a home pregnancy test as the first step to confirm a suspected pregnancy, before going to a health care facility. Teens were less likely to have taken a home pregnancy test than young adults aged 20 to 24 before seeking medical care (65% vs. 81%, p=0.05).

The most common reasons for delaying taking a test were: waiting to see if a period would come (52%), fear of what the result would be (35%) and wanting to spend some time figuring out what to do if they were pregnant (16%).

The new findings weren't a surprise to Dr. Ashley Turner, an assistant professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine and a physician at Northwestern Medicine, who wasn't involved in the study.

"Honestly it seems very consistent with what I see in my practice," Dr. Turner said. "I feel like people who take a pregnancy test the day after they miss a period in general are those trying to become pregnant."

Those who confirmed pregnancy late were younger people, people of color and those who were poor, Dr. Turner noted. "This is exactly what I would anticipate," she added. "So, the Texas law is mostly not affecting people with planned pregnancies."

SOURCE: https://bit.ly/3C7jjxv Contraception, online November 5, 2021.