The London Measure of Unplanned Pregnancy (LMUP)            

Publications
PUBLICATIONS (METHODS)

This page provides methodological information relating to the LMUP. It lists publications that relate to the original development study, to the evaluation of the LMUP in new contexts, and/or provide insights into the performance of the LMUP as a psychometric measure.


Key publications from the original LMUP development and evaluation study

Barrett G, and Wellings K. 2002 What is a “planned” pregnancy? Empirical data from a British study Social Science and Medicine 55; 545-557 Abstract Abstract and full text

Barrett G, Smith SC, Wellings K. 2004 Conceptualisation, development and evaluation of a measure of unplanned pregnancy Journal of Epidemiology and Community Health 58:426-433 Abstract Full text

See all publications from the LMUP development and evaluation study


Publications relating to the psychometric evaluations of the LMUP in translation and/or new populations

Rocca CH, Krishnan S, Barrett G, and Wilson M. 2010 Measuring pregnancy planning: an assessment of the London Measure of Unplanned Pregnancy among urban, south Indian women. Demographic Research 23(11):293-334 Abstract and full pdf Further Information

Morof D, Steinauer J, Haider S, Liu S, Darney P, Barrett G. 2009 Evaluation of the reliability and validity of the London Measure of Unplanned Pregnancy in a U.S. population of women. International Journal of Gynecology and Obstetrics Vol.107 Supplement 2 p.S275 journal page Further Information

Morof D, Steinauer J, Haider S, Liu S, Darney P, Barrett G. 2012 Evaluation of the London Measure of Unplanned Pregnancy in the a United States population of women. PloS One 7(4) Article number e35381 Abstract and full pdf Further Information

Hall J, Barrett G, Mbwana N, Copas A, Malata A, Stephenson J. 2013 Understanding pregnancy planning in a low-income country setting: validation of the London measure of unplanned pregnancy in Malawi BMC Pregnancy and Childbirth 13:200 Abstract and full pdf Further Information

Roshanaei S, Shaghaghi A, Jafarabadi MA, and Kousha A. 2015 Measuring unintended pregnancies in postpartum Iranian women: validation of the London Measure of Unplanned Pregnancy Eastern Mediterranean Health Journal 21(8):572-578 Abstract and full text Further information

Borges ALV, Barrett G, dos Santos OA, Nascimento NC, Cavalhieri FB, Fujimori E. 2016 Evaluation of the psychometric properties of the London Measure of Unplanned Pregnancy in Brazilian Portuguese BMC Pregnancy and Childbirth 16:244 Abstract and full pdf Further information

Habib MA, Raynes-Greenow C, Nausheen S, Soofi SB, Sajid M, Bhutta ZA, Black K. 2017 Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan BMC Pregnancy and Childbirth 17:156 Abstract and full pdf Further information

Almaghaslah E, Rochat R, Farhat G. 2017 Validation of a pregnancy planning measure for Arabic-speaking women PloS ONE 12(10): e0185433 Abstract and full pdf Further information

Goossens J, Verhaeghe S, Van Hecke A, Barrett G, Delbaere I, Beeckman D. 2018 Psychometric properties of the Dutch version of the London Measure of Unplanned Pregnancy in women with pregnancies ending in birth PloS ONE 13(4): e0194033 Abstract and full pdf   Further information

For evaluations of the LMUP currently underway but as yet unpublished, please see the LMUP Versions


Recommendations for analysis using the LMUP

Hall JA, Barrett G, Copas A, Stephenson J. 2017 London Measure of Unplanned Pregnancy: guidance for its use as an outcome measure Patient Related Outcome Measures 8:43-56 Abstract and full pdf


Publications that provide insight into the validity of the LMUP

Insights can be gained into the validity (in particular the "construct validity") of a measure from its use in research studies. The following studies (incidentally) provide information about the performance of the LMUP in relation to the construct of pregnancy planning/intention.

Rocca CH, Kimport K, Gould H, Foster DG. 2013 Women's Emotions One Week After Receiving or Being Denied an Abortion in the United States. Perspectives on Sexual and Reproductive Health 45: 122–131. Abstract
This is an extremely interesting paper. In relation to the LMUP it shows that women with higher LMUP scores who go on to have an abortion experience more negative emotions one week post-abortion. This finding makes sense. In terms of the performance of the LMUP, it suggests that LMUP scores are providing a fairly high degree of discrimination of the construct of pregnancy planning/intention, particularly in the lower/mid range.

Cameron ST, Glasier A. 2013 Identifying women in need of further discussion about the decision to have an abortion and eventual outcome Contraception 88;1:128-132. Abstract
This is also an interesting paper. It shows that, at a group level, LMUP scores are associated with the likelihood of abortion (lower scores mean abortion is more likely; higher scores mean abortion less likely) in a fairly homogeneous group (i.e. women attending a clinic for assessment for abortion). The strength of this study is the separation in time between completion of the LMUP (at clinic assessment for abortion) and the outcome (whether the woman had an abortion).


Comparing the LMUP with other ways of assessing pregnancy planning/intention

LMUP versus a single question

There have been various instances where the LMUP has been compared to a single question that asks about pregnancy planning:

The LMUP was compared to the single question, “Was your pregnancy planned?” among a small sample of teenagers who were surveyed as part of the Evaluation of the Teenage Pregnancy Strategy. This analysis is reported in Geraldine Barrett’s PhD:

Barrett G. 2002 Developing a measure of unplanned pregnancy. London School of Hygiene and Tropical Medicine, University of London. PhD Thesis. (PhD, see pages 280-2)

The LMUP was compared to the single question, “Did you plan on becoming pregnant now?” in an analysis by Aiken et al in 2016. Barrett et al commented on the analysis in 2017:

Aiken ARA, Westhoff CL, Trussell J, Castano PM. 2016 Comparison of a timing-based measure of unintended pregnancy and the London Measure of Unplanned Pregnancy Perspectives on Sexual and Reproductive Health 48;3:139-146 Abstract

Barrett G, Hall JA, Stephenson J. 2017 Measuring unintended pregnancy: the complexity of comparison Perspectives on Sexual and Reproductive Health 49;1:69-70 Letter

The LMUP in Swedish was compared to the single question, “How planned was your current pregnancy?” in an analysis by Drevin et al in 2017. Barrett et al commented on the analysis in 2018:

Drevin J, Kristiansson P, Stern J, Rosenblad A. 2017 Measuring pregnancy planning: a psychometric evaluation comparison of two scales. Journal of Advanced Nursing 73:2765-2775 Abstract

Barrett G, Hall JA, Borges ALV, Rocca C, Almaghaslah E, Stephenson J. 2018 Commentary on Drevin et al. (2017) Measuring pregnancy planning: a psychometric evaluation comparison of two scales. JAN Interactive Commentary

LMUP and the Demographic and Health Surveys

The first comparison of the LMUP with the DHS (Demographic and Health Surveys) question on pregnancy intention can be found here:

Hall J, Stephenson J, Barrett G. 2018 Comparing the order of the London Measure of Unplanned Pregnancy and the Demographic and Health Survey question on pregnancy intention in a single group of postnatal women in Malawi ‐ the effect of question order on assessment of pregnancy intention BMC Research Notes 11:487 Abstract and full pdf

Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M, Kumaran K, Yajnik CS, Baird J, Mishra GD. 2018 Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health Lancet 391(10132):1830-41 Abstract and full pdf

Further analyses comparing the LMUP to the DHS and NSFG questions are currently being carried out.


Stability over time in reporting pregnancy intention: LMUP data

The stability of women's reports of pregnancy over time (i.e. the further away they get from conception) has been investigated in the past with other ways of measuring pregnancy intention. The contributions of LMUP data to this question are listed here:

Rocca C, Foster D. 2016 Changes over time in retrospective reporting of pregnancy intentions among women who sought an abortion in the United States Population Association of America Annual Meeting, Washington D.C. April 2016 Abstract

Ralph L, Greene Foster D, Rocca C. 2018 Comparing prospective versus retrospective pregnancy intention reporting on incident pregnancies in a longitudinal study of U.S. women Population Association of America Annual Meeting, Denver, April 2018 Abstract


Recommendations for use of the LMUP

The LMUP is recommended as an outcome measure in relation to preconception care in the U.S.:

Frayne et al. 2016 Health care system measures to advance preconception wellness: Consensus recommendations of the clinical workgroup of the National Preconception Health and Health Care Initiative Obstetrics and Gynecology 127(5):863-872 Abstract and full text

The LMUP is recommended for national surveys to allow comparisons of rates of unintended births:

ESHRE Capri Workshop Group 2014 Simultaneous prevention of unintended pregnancy and STIs: a challenging compromise Human Reproduction Update 20(6):952-963 Abstract and full text


              copyright © Dr Geraldine Barrett