Date of Conferral

12-5-2025

Date of Award

December 2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Stacy-ann Christian

Abstract

More than half of all pregnancies are unintended (mistimed or unwanted), and women with unplanned pregnancies may face economic hardships for families and additional health consequences if they have pre-existing medical conditions. This quantitative study was conducted to examine the relationship between pregnancy intention levels and severe acute maternal morbidity, specifically chorioamnionitis, among women who gave birth in Oklahoma and Mississippi in 2022. Using secondary data (N=1939) from the Pregnancy Risk Assessment Monitoring System Automated Research Files and state-level abortion policy data from the Guttmacher Institute, this study employed Bronfenbrenner’s social ecological model framework to investigate the relationship between pregnancy intention levels and chorioamnionitis, while controlling for race, ethnicity, age, poverty level, marital status, pre-pregnancy care, and adequacy of prenatal care, as well as moderating effects caused by abortion restriction policies. Binary logistic regression models were used for data analysis. Unintended pregnancies were most prevalent (55%); inadequate prenatal care (Wald =5.129 p=0.024 Exp(B)=4.501 CI(1.224,16.546); marital status (Wald =5.812 p=0.016 Exp(B)=0.369 CI(0.164-0.830); and FPL (Wald =6.835 p=0.009 Exp(B)=0.272 CI(0.102, 0.722) each had positive association with chorioamnionitis. Chorioamnionitis incidence was very low (<1%), therefore evidence was insufficient to demonstrate statistically significant association with pregnancy intention or moderation effects by abortion restriction policies. However, data from this study was used to inform a policy memo, public health intervention plan, and infographic aimed to reduce rates of unplanned pregnancies, which may promote positive social change.

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