Rice Whitney S, Turan Bulent, Stringer Kristi L, Helova Anna, White Kari, Cockrill Kate, Turan Janet M
Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, United States of America.
Department of Medical Sociology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, United States of America.
PLoS One. 2017 Mar 22;12(3):e0174210. doi: 10.1371/journal.pone.0174210. eCollection 2017.
Norms and stigma regarding pregnancy decisions (parenting, adoption, and abortion) are salient to maternal well-being, particularly for groups disproportionately affected by unintended pregnancy. However, there are few validated measures of individual-level perceptions of norms and stigma around pregnancy decisions. Additionally, little is known about variation in the content of norms regarding pregnancy decisions, and in stigma related to violations of these norms, across socio-demographic groups.
To create measures of perceived norms and stigma around pregnancy decisions, we developed and pre-tested 97 survey items using a mixed methods approach. The resulting survey was administered to 642 young adult women recruited from health department clinics and a public university campus in Birmingham, Alabama. Principal components factor analyses, reliability analyses, independent t-tests, and correlation analyses were conducted to establish the reliability and validity of scales. Additionally, multiple linear regression was used to identify demographic predictors of higher scale scores.
Factor analyses revealed four subscales for each pregnancy decision: conditional acceptability, anticipated reactions, stereotypes/misperceptions, and attitudes. The total scales and their subscales demonstrated good internal reliability (alpha coefficients 0.72-0.94). The mean scores for each scale were significantly associated with each other, with related measures, and differed by sociodemographic characteristics. Specifically, in adjusted analyses, women in the university setting and White women expressed more negative attitudes and stigma around parenting. Minority women endorsed more negative norms and stigma around adoption. Finally, women from the health department, White women, and religious women expressed more negative norms and stigma around abortion.
Findings suggest that our multidimensional measures have good psychometric properties in our sample of young women in the U.S. South, and highlight the importance of conceptualizing and measuring norms and stigmas around all pregnancy decisions. These scales may be of use in research on pregnancy decision-making and evaluation of stigma-reduction interventions.
关于妊娠决定（生育、领养和堕胎）的规范与污名对孕产妇福祉至关重要，尤其是对于那些意外怀孕影响尤为严重的群体。然而，针对妊娠决定中个体层面规范和污名认知的有效测量方法却很少。此外，对于不同社会人口群体在妊娠决定规范内容以及违反这些规范相关污名方面的差异，我们知之甚少。
为了创建关于妊娠决定的感知规范和污名的测量方法，我们采用混合方法开发并预先测试了97个调查项目。随后，对从阿拉巴马州伯明翰市卫生部门诊所和一所公立大学校园招募的642名年轻成年女性进行了该调查。进行了主成分因子分析、信度分析、独立样本t检验和相关分析，以确定量表的信度和效度。此外，使用多元线性回归来识别量表得分较高的人口统计学预测因素。
因子分析显示，每个妊娠决定都有四个子量表：条件可接受性、预期反应、刻板印象/误解和态度。总量表及其子量表显示出良好的内部信度（α系数为0.72 - 0.94）。每个量表的平均得分彼此之间、与相关测量指标均显著相关，并且因社会人口特征而异。具体而言，在调整分析中，大学环境中的女性和白人女性对生育表达了更多负面态度和污名。少数族裔女性对领养认可了更多负面规范和污名。最后，来自卫生部门的女性、白人女性和宗教女性对堕胎表达了更多负面规范和污名。
研究结果表明，我们的多维测量方法在美国南部年轻女性样本中具有良好的心理测量特性，并强调了对所有妊娠决定的规范和污名进行概念化和测量的重要性。这些量表可用于妊娠决策研究和减少污名干预措施的评估。
