Pregnancy Recognition Trajectories: A novel conceptual framework

Joe Strong, London School of Economics and Political Science (LSE)
Emily Freeman, London School of Economics and Political Science (LSE)
Ernestina Coast, London School of Economics and Political Science (LSE)
Ann M. Moore, Guttmacher Institute

How and in what ways a person comes to recognise they are pregnant can have significant implications for their health and wellbeing. The field lacks theoretical and empirical work that interrogates the time-bound, varied processes that lead to a person knowing they are pregnant. We have developed a novel conceptual framework – pregnancy recognition trajectories (PRT) - for researchers and practitioners to better understand myriad, sometimes-complex, non-linear pathways to pregnancy recognition. We use three intersecting methods; an inductive saturation approach to review literature published between 2000 and 2023, expert workshops and research seminars, and authorial experiences of pregnancy recognition. Our framework comprises three intersecting domains: assessing the likelihood of a pregnancy; interpreting signs and symptoms of a pregnancy, and; opportunities for pregnancy confirmation. The framework centres recognition of a (non-)pregnancy, including non-recognition, and is sensitive to the diverse conceptualisations of what constitutes a pregnancy. Intersecting across each domain are socio-ecological levels – micro, meso, and macro – which make visible the connections between individuals, communities, systems and structures. While pregnancy age can be linear, time manifests in different ways across a trajectory. Our framework centres individual experiences and desires for how, when, and in what ways pregnancy recognition occurs.

Keywords: Sexual and Reproductive Health and Rights

See extended abstract.