Faculty Proceedings, Presentations, Speeches and Lectures


Assessing the Need for Family Planning Education in a Low-income Help-seeking Sample for Relationship Distress

Event Title

Association for Behavioral and Cognitive Therapies (ABCT) 2021 Virtual Convention

Event Location


Document Type


Presentation Date


Date Range

2021-11-16 to 2021-11-21


Having children places significant stress on romantic relationships (Doss et al., 2009; O’Reilly Treter et al., 2020); this stress is moderated by pregnancy intention, that is—whether the pregnancy is planned (Li et al., 2019). Indeed, unintended pregnancy is associated with increases in mental health symptoms and relationship conflict compared to couples whose pregnancies were intended.

While the impacts of the transition to parenthood are prevalent across income level, low-income couples tend to have less access to family planning education compared to higher-income couples (Frost, Frohwirth, & Zolna, 2014). Moreover, the rates of unintended pregnancy in the United States are nearly threefold for women < 100% of the federal poverty line and twofold for women within 100-200% of the federal poverty line compared to those >200% (Finer & Zolna, 2016). As such, low-income couples are at a substantially increased risk of experiencing stress related to unintended pregnancy.

To determine whether family planning education should be incorporated into the curriculum of a relationship-focused online program, the current study examined levels of family planning education among four groups of women (not pregnant, pregnant-intended, pregnant-unintended, pregnant-no preference) from a help-seeking sample of 1,159 mixed-gender, relationally-distressed low-income couples who completed the OurRelationship Program.

Overall, 48.1% of women (n = 539) reported that they were “not at all likely” to get pregnant if they engaged in sexual intercourse without contraception, indicating that nearly half of women in the sample had low contraception knowledge. During the two-month program, 3.1% (n = 36) reported getting pregnant. More than half (54.3%) of these women reported that the pregnancy was intended, 28.3% reported the pregnancy was unintended, and 17.4% reported that they had no preference. A series of chi-square analyses was conducted to assess for differences in contraception knowledge and pregnancy risk. Of note, pregnancy intention varied to the extent women were regularly engaging in sex without contraception at initial assessment. Specifically, 84.6% of unintentionally pregnant women were engaging in sex without contraception compared to 75.0% of no preference pregnant women, 60.0% of intentionally pregnant women, and 47.2% of non-pregnant participants, X2 (9, 1121) = 30.920, p < 0.001.

In conjunction with the high frequency of sexual risk behavior (i.e., sex without contraception) and low contraception knowledge in this help-seeking, low-income sample, the relationship between sexual risk behavior and unwanted pregnancy suggests that it may be helpful to include family planning resources in relationship education targeting low-income couples.