The London Measure of Unplanned Pregnancy (LMUP)            
 

Studies using the LMUP
A number of researchers and academics are using the LMUP (see below for details). Where publications are available from these studies they are listed below:


Dr Jenny Hall (UCL) carried out a study in Malawi examining the relationship between pregnancy intention and key maternal and neonatal outcomes. The LMUP was used to assess pregnancy intention. The evaluation of the LMUP in translation was published in 2013 Further information. The findings from the main study are now being published, including the first comparisons of the LMUP with the DHS in Stephenson et al (2018) and Hall et al (2018):

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 Ė 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

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

Hall JA, Barrett G, Phiri T, Copas A, Malata A, Stephenson J. 2016 Prevalence and determinants of unintended pregnancy in Mchinji District, Malawi: Using a conceptual hierarchy to inform analysis PlosOne 11(10): e0165621. doi:10.1371/journal.pone.0165621 Abstract and full pdf

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

 

Dr Sara Yeatman and colleagues carried out a study of child and parental health in Malawi, using the LMUP. They presented their findings at the Society of Family Planning conference, the abstract of which has been published:

Yeatman S, Smith-Greenaway E. 2018 Birth planning and womenís and menís health in Malawi Studies in Family Planning Online first Abstract

Yeatman S, and Smith-Greenaway E. 2016 The relationship between pregnancy plannedness and parental and child health in Malawi Contraception 94(4):424 Abstract

 

Dr Joline Goossens and colleagues used the LMUP in a study of postpartum women in Flanders, Belgium. The psychometric properties of the Dutch LMUP have been published. (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

Goossens J, Beeckman D, Van Hecke A, Delbaere I, Verhaeghe S. 2018 Preconception lifestyle changes in women with planned pregnancies Midwifery 356:112-120 Abstract

Goossens J, Van Den Branden Y, Van der Sluys L, Delbaere I, Van Hecke A, Verhaeghe S, Beeckman D. 2016 The prevalence of unplanned pregnancy ending in birth, associated factors and health outcomes Human Reproduction 31;12: 2821-2833 Abstract

 

Dr Victoria Lyun, Prof Landon Myer and colleagues used the LMUP in a study of pregnant women in Cape Town, South Africa:

Lyun V, Brittain K, Phillips TK, Le Roux S, McINtyre JA, Zerbe Z, Petro G, Abrams EJ, Myer L. 2018 Prevalence and determinants of unplanned pregnancy in HIV-positive and HIV-negative women in Cape Town, South Africa: a cross-sectional study BMJ Open 8;4:e019979. Abstract and full text

 

Dr Jonathan Bearak (Guttmacher Institute) and colleagues assessed global trends in unintended pregnancy. Six studies using the LMUP were included in the analysis:

Bearak J, Popinchalk A, Alkema L, Sedgh G. 2018 Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model Lancet Global Health 6;4:e380-e389 Abstract and full text

 

Dr Hannah Kluckow, Prof Kirsten Black and colleagues assessed pregnancy intention among women attending antenatal care in the Solomon Islands:

Kluckow H, Panisis L, Lauri J, Jatubatu, Kim D, Hodges L, Black K. 2018 Socio-demographic predictors of unintended pregnancy and late antenatal booking in Honiara, Solomon Islands Australian and New Zealand Journal of Obstetrics and Gynaecology doi:10.1111/ajo.12782 Abstract

 

Dr Gariepy and colleagues used the LMUP in a study of pregnant women recruited via abortion and pregnancy testing services:

Kemet S, Lundsberg LS, Gariepy AM. 2018 Race and ethnicity may not be associated with risk of unintended pregnancy Contraception Online first Abstract

Gariepy A, Lundsberg LS, Vilardo N, Stanwood N, Yonkers K, Schwarz EB. 2017 Pregnancy context and women's health related quality of life Contraception Contraception 95;5:491-499 Abstract

 

The Turnaway Study. The LMUP was used in the UCSF ‘Turnaway Study’, a prospective, longitudinal study of women who underwent or were denied an abortion. Further information: Papers reporting LMUP findings include:

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

Aztlan EA, Foster DG, Upadhyay U. 2018 Subsequent unintended pregnancy among US women who receive or are denied a wanted abortion Journal of Midwifery and Women's Health 63;1:45-52 Abstract

Roberts SCM, Subbaraman MS, Delucchi KL, Wilsnack SC, Foster DG. 2016 Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking Drug and Alcohol Dependence 159:117-24 Abstract

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

Rocca et al. 2015 Decision rightness and emotional responses to abortion in the United States: a Longitudinal Study PloS ONE 10(7): e0128832. doi:10.1371/journal.pone.0128832 Abstract

Roberts, S. C. M., Wilsnack, S. C., Foster, D. G. and Delucchi, K. L. (2014), Alcohol Use Before and During Unwanted Pregnancy Alcoholism: Clinical and Experimental Research 38:2844-2852. Abstract

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

Biggs A, Gould H, Greene Foster D. 2013 Understanding why women seek abortions in the US BMC Women's Health 13:29 Abstract and full text

Robert SCM, Avalos LA, Sinkford D, Greene Foster D. 2012 Alcohol, tobacco and drug use as reasons for abortion Alcohol and Alcoholism 47;6:640-684 Abstract

 

Dr Ana Borges and colleagues used the LMUP with a cohort of pregnant women, following them into the postpartum period, and assessed their postpartum use of contraception:

Borges ALV, dos Santos OA, Fujimori E. 2018 Concordance between intention to use and current use of contraceptives among six-month postpartum women in Brazil: the role of unplanned pregnancy Midwifery 56:94-101 Abstract

 

Dr Ahmed Abdulwahab and colleagues (King Saud University) used the LMUP in a study of women attending antenatal services:

Abdulwahab A, Almotairi A, Alkhamis W, Almutiari A. 2018 Prevalence of unplanned pregnancy and its psychological effect among pregnant patients in King Khalid University Hospitals The Egyptian Journal of Hospital Medicine 70(6):943-947 Abstract and full pdf

 

Dr Eman Almaghaslah, Prof Roger Rochat, and Dr Ghada N. Farhat (Emory University) evaluated the LMUP in Arabic in Saudi Arabia:

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

 

The LMUP will be used in an RCT of sexual health and nutritional interventions among sex workers in Kenya. The trial protocol has been published:

Ampt et al. 2017 WHISPER or SHOUT study: protocol of a cluster-randomised controlled trial assessing mHealth sexual reproductive health and nutrition interventions among female sex workers in Mombasa, Kenya BMJ Open 7(8): e017388 Abstract and full pdf

 

Dr Kinga Om and colleagues used the LMUP with women attending the antenatal clinic of the Jigme Dorji Wangchuk National Referral Hospital in Bhutan, Thailand:

Om K, Deoisres W, Suppaseemanont W. 2017 Preconception health behaviors and associated factors of Bhutanese pregnant women attending antenatal care clinic of National Referral Hospital. Thai Pharmaceutical and Health Science Journal 12;2:45-56 Abstract and full pdf

 

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

 

The UK's third National Survey of Sexual Attitudes and Lifestyles, carried out by Prof Anne Johnson (UCL), Dr Cath Mercer (UCL), Dr Pam Sonneneberg (UCL), Dr Andrew Copas (UCL), Prof Kaye Wellings (LSHTM), Wendy MacDowall (LSHTM), Bob Erens (NatCen), Healther Wardle (NatCen), Prof Catherine Ison (Health Protection Agency), Prof Frederick Wu (University of Manchester), used the LMUP in its data collection in relation to all pregnancies reported in the last year. Further information about Natsal The papers reporting LMUP findings include:

Paquette R, Tanton C, Burns F, Prah P, Shahmanesh M, Field N, Macdowall W, Gravningen K, Sonnerberg P, Mercer CH. 2017 Illicit drug use and its association with key sexual risk behaviours and outcomes: Findings from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) PlosONE 12(5):e0177922 Abstract

Palmer MJ, Clarke L, Ploubidis GB, Mercer CH, Gibson LJ, Johnson AM, Copas AJ, Wellings K. 2016 Is "sexual competence" at first heterosexual intercourse associated with subsequent sexual health status The Journal of Sex Research Abstract

Wellings et al. 2013 The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) Lancet 382(9907):1807-16 Abstract

 

Dr Ana Borges and colleagues evaluated the LMUP in Brazilian Portuguese translation:

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

 

Dr Paula Castano and Prof Carolyn Westhoff, Colombia University, used the LMUP in US-English and Spanish translation in 2005 in a study of women seeking pregnancy testing at a family planning clinic. Dr Aiken led an analysis of these data 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

 

Major Ryan J. Heitmann and colleagues used the LMUP in a survey of U.S. female service members and military health care beneficiaries aged 18-42 across three tertiary military health centres:

Heitmann RJ, Batig AL, Levy G, Novotney J, Grubbs C, Batig TS, Gobem JM, Hemman E, Christy AY, Hill MJ. 2016 Unintended pregnancy in the military health care system: who is really at risk? Military Medicine 181;10:1370-1374 Abstract

 

Dr Liauw and colleagues carried out a study examining the contraceptive needs of women in a correctional facility in Ontario, Canada. They used the LMUP to assess the intention status of women's most recent pregnancy:

Liauw J, Foran J, Dineley B, Costescu D, Kouyoumdjian FG. 2016 The unmet contraceptive need of incarcerated women in Ontario Journal of Obstetrics and Gynaecology Canada 38;9820-826 Abstract

 

Dr Cheney and colleagues used the LMUP in with women attending an Early Pregnancy Assessment Service (EPAS) in Australia. The EPAS reviews women who present in the first 20 weeks of pregnancy with bleeding and/or pain or with other concerns.

Cheney K, Sim KA, D'Souza M, Pelosi M, Black KI. 2016 Unintended pregnancy amongst an early pregnancy clinic cohort: identifying opportunities for preventative health interventions Australian and New Zealand Journal of Obstetrics and Gynaecology 56(4):426-31 Abstract

 

A UK Department of Health funded study on pre-pregnancy health and care, led by Prof. Judith Stephenson at Institute for Women's Health, UCL, used the LMUP with pregnant women and their partners:

Bye A, Shawe J, Stephenson J, Bick D, Brima N, Micali N. 2016 Differences in pre-conception and pregnancy healthy lifestyle advice by maternal BMI: Findings from a cross sectional survey Midwifery 42:38-45 Abstract

Stephenson et al. 2014 How do women prepare for pregnancy? Preconception experiences of women attending antenatal services and views of health professionals PlosOne 9(7): e103085. doi:10.1371/journal.pone.0103085 Abstract

 

Prof. James Trussell and colleagues assessed pregnancy intention among women attending antenatal clinics and abortion services:

Bexhell H, Guthrie K, Cleland K, Trussell J. 2016 Unplanned pregnancy and contraceptive use in Hull and East Yorkshire Contraception 93:233-235 Abstract

 

Dr Abdolreza Shaghaghi and colleagues evaluated the LMUP in Persian translation in Iran as part of a wider study assessing unmet need for family planning:

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 pdf

 

Dr Ana Luiza Vilea Borges used the LMUP in a study of contraceptive use by women following an induced or spontaneous abortion:

Borges ALV, OlaOlorun F, Fujimori E, Akiko L, Hoga K, Tsui AO. 2015 Contrceptive use following spontaneous and induced abortion and its association with family planning services in primary health care: results from a Brazilian longitudinal study Reproductive Health 12:94 Abstract and full pdf

 

Dr Ginger Poulton and colleagues used the LMUP with women attending methodone clinics in a study assessing their reproductive health and choices:

Poulton G, Parlier AB, Scott KR, Fagan EB, Galvin SL. 2015 Contraceptive choices for reproductive age women at methadone clinics in Western North Carolina MAHEC Online Journal of Research 2:2 Abstract and full pdf

 

The LMUP was used in the Life Study, the UK's ambitious new cohort study which aimed to recruit 80,000 pregnant women. The study, led by Prof. Carol Dezateux at Institute of Child Health, UCL closed early due to difficulties in recruitment of participants. Further information

 

The UK ‘Contessa’ study, a longitudinal study of women's contraceptive use, used the LMUP in its data collection:

Wellings et al. 2015 Stopping and switching contraceptive methods: findings from Contessa, a prospective longitudinal study of women of reproductive age in England Contraception 91:57-66 Abstract

 

A Swedish study of antenatal clinic attenders used the LMUP in its data collection:

Bodin et al. 2015 Coherence of pregnancy planning within couples expecting a child Midwifery Abstract

 

An Argentinian study of women with and without bipolar disorder used the LMUP in its data collection:

Marengo et al. 2015 Unplanned pregnancies and reproductive health among women with bipolar disorder Journal of Affective Disorders 178:201-205 Abstract

 

A U.S. study of pregnancy intention among HIV-positive women used the LMUP in their data collection:

Rahangdale et al. 2014 Pregnancy intentions among women living with HIV in the United States Journal of Acquired Immune Deficiency Syndrome 65(3):306-311 Abstract

 

The LMUP was used in a study of antenatal clinic attenders in Papua New Ginuea. (The full LMUP was used in the pilot study then item 6 was dropped in the main study because of low endorsement. Technically, this invalidates the LMUP, but score patterns can be seen.)

Sanga et al. 2014 Unintended pregnancy amongst women attending antenatal clinics at the Port Moresby General Hospital Australian and New Zealand Journal of Obstetrics and Gynaecology 54(4):360-365 Abstract

 

A pilot randomized trial of an intervention to prevent HIV in young women in Zimbabwe used the LMUP. Little information is given about how the LMUP was adapted for use in the study:

Dunbar et al. 2014 The SHAZ! Project: Results from a pilot randomized trial of a structural intervention to prevent HIV among adolescent women in Zimbabwe PloS ONE 9(11) : e113621. doi:10.1371/journal.pone.0113621 Abstract

 

A Danish study of pre-pregnancy health and care used the LMUP in their data collection:

Backhausen et al. 2013 Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women European Journal of Contraception and Reproductive Health Care Abstract

 

An Australian study of women attending an antenatal clinic used the LMUP in their data collection:

Rassi A, Wattimena J, Black K. 2013 Pregnancy intention in an urban Australian antenatal population Australian and New Zealand Journal of Public Health 37:568-73 Abstract

 

A UK study of women attending for abortion used the LMUP:

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

 

A Brazilian study, led by Dr Ana Luiza Vilela Borges, has used the LMUP:

Borges et al. 2011 Pregnancy planning: prevalence and associated aspects Revista da Escola de Enfermagem da USP 45:2 Abstract

 

Corinne Rocca MPH PhD of University of California, San Francisco led an evaluation of the LMUP in Tamil and Kannada translation in Bangalore, India Further information:

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

 

Diane Morof MD MSc, Centers for Disease Control and University of California, San Francisco, has led an evaluation of the LMUP in US English and Spanish 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

 

Skinner R, Doherty D, and Lewis L, of the University of Western Australia, carried out a longitudinal study in Perth, Australia, called, "Why do teenage mothers fall pregnant so quickly? Exploring the bio-psychosocial antecedents of repeat teenage pregnancy". The LMUP was used in data collection with mothers during pregnancy.

Lewis et al. 2010 Predictors of sexual intercourse and rapid-repeat pregnancy among teenage mothers: an Australian prospective longitudinal study Medical Journal of Australia 193(6):338-42 Abstract

 

A Canadian study of couples expecting their first child use the LMUP in their data collection:

Lachance-Grzela M and Bouchard G. 2009 The well-being of cohabiting and married couples during pregnancy: Does pregnancy planning matter? Journal of Social and Personal Relationships 26(2-3):141-159 Abstract

Bouchard G. 2011 The role of psychosocial variables in prenatal attachment: an examination of moderational effects Journal of Reproductive and Infant Psychology 29(3):197-207 Abstract

 

Shallimar Jones, of Michigan State University, used the LMUP in her doctoral research on stress during pregnancy, completed in 2007.

 

Fatim Lakha and Prof Anna Glasier MD FRCOG used the LMUP in a study looking at unplanned pregnancy and emergency contraception use among pregnant women in Edinburgh, Scotland.

Lakha F, Glasier A. 2006 Unintended pregnancy and use of emergency contraception among a large cohort of women attending for antenatal care or abortion in Scotland Lancet 368:1782-87 Abstract

 

Suzanne Cater and Lester Coleman PhD of the Trust for the Study of Adolescence carried out a study, funded by the Joseph Rowntree Foundation, of 'planned' pregnancy among teenagers. The LMUP was used as a screening questionnaire to identify potential interviewees. The report presents the LMUP data and provides a rich qualitative account of the reasons for teenage 'planned' pregnancies:

Cater S, Coleman L. 2006 'Planned' Teenage Pregnancy: Perspectives of young parents from disadvantaged backgrounds. Bristol: Policy Press Abstract and full pdf

Coleman L, Cater S. 2006 ‘Planned’ teenage pregnancy: perspectives of young women from disadvantaged backgrounds in England Journal of Youth Studies 9(5):593-614 Abstract

 

Catherine Schünmann MD, and Prof Anna Glasier MD FRCOG, Edinburgh, used a modified version of the LMUP in a randomised controlled trial of contraceptive advice at the time of abortion. G Barrett's comment on the unevaluated modified measure and the author's response were published in January 2007.

Schünmann C, and Glasier A. 2006 Measuring pregnancy intention and its relationship with contraceptive use among women undergoing therapeutic abortion Contraception 73:520-524. Abstract

Barrett G. 2007 Letter to the Editor Contraception 75:79 Letter

Schünmann C. 2007 Response to Letter to the Editor Contraception 75:79

 

Prof Kaye Wellings, London School of Hygiene and Tropical Medicine, and colleagues used the LMUP in a survey component of the Teenage Pregnancy Strategy Evaluation. The LMUP findings are presented on page 63 and 64 of the final report and in corresponding sections in the earlier annual reports.

Wellings K et al. 2005 Teenage Pregnancy Strategy Evaluation: Final Report Synthesis. London: LSHTM Report


Routine data collection

The LMUP was used by the U.S. California Maternal and Infant Health Assessement (MIHA) survey in 2008 and 2009. Further information