Table 3 Selected quotations illustrating subthemes

Desire for motherhood and children

The feeling of the baby move is beautiful. From the second that I felt him move, I felt more in love with him than I have anything [crying]. (Participant 16)

I love children. I feel like children just put you in a happy space. I love being around them. I love molding them, and helping them grow, and just seeing their personalities. (Participant 13)

Pregnancy as empowering

I’m just strugglin’, but God has stepped in. Now I have a housin’ voucher. I was rentin’ right now, cash money. I have a voucher now. I’m tryin’ to find a house to move into. God has given me a chance to have a new baby. By me gettin’ pregnant is gonna change my whole life. (Participant 27)

No. Everybody always said they don't think I will be able to carry kids because of the bone disease that I have and stuff like that, but I'm proving them wrong. (Participant 11)

Pregnancy and birth experiences

Because my last two pregnancies have been high-risk. I’m restricted on everything. I can’t do anything. I mean, for me personally, I don’t like to be pregnant. (Participant 3)

Influence of pregnancy on medical conditions

No, but I do feel like oftentimes I feel like people do take the whole high risk and pregnancy thing. When I first learned about it, it was really scary. Now that I’m so far along, and I’m getting ready to deliver, I feel like with the proper planning and with the proper medical attention, it’s definitely possible to have a, I guess, I wanna say like an ease of mind, like a better fit of mind going into a high-risk pregnancy. (Participant 24)

As you know, diabetes and pregnancy is a full-time job. It went from being something that I fit into my life when I could, to becoming the main focus of everything that I did—every bite of food that I ate, every time my blood sugar was high, every time, like I said, just the constant anxiety of trying to do what was best. A lot of the fear that I had for the first trimester—holding my breath all the time wondering if I was gonna lose the baby. Especially with my first because I just figured, “I’m high risk. It’s not gonna work out the way I want it to. (Participant 22)

Perceived susceptibility to pregnancy

I just felt like it wasn't such a big deal just because it wasn't as easy for me to get pregnant, so I didn't have to force myself to get on [birth control] or anything like that. (Participant 21)

Effects of birth control

Then, I know when I had the Implanon, I—it was just spotting all the time, so I was like, "Nah, it's not worth it for me. (Participant 7)

I noticed that it can help with mood and stuff like that, like changing people mood and that I’ve noticed being in the field I am and having improved some people moods and stuff being on birth control. I've seen that happen. I've seen it mess with their mood. Honestly, I think it shapes women different. I don't know. Their body shape, to me, I can tell, “Oh, she took birth control.” (Participant 30)

Influence of contraception on medical conditions

I guess it’s just about me having health conditions. It was rejectin’. It started to reject my liver. That’s why I feel the way I feel. (Participant 4)

I knew after I got off and my blood pressure had started getting controlled, and it went down, so I—based on that, I just figured I was going to stop and not take any additional hormones or anything. (Participant 29)

Reasons to use birth control

I think just obviously my husband and I don’t want back-to-back children right away. Especially, revisiting it after this pregnancy would be something to discuss. (Participant 26)

Partner Influence

Really other than hubby being ready, no one really 'cause for me it's always been a very personal decision, and it's personal between the two people who are creating a baby. (Participant 7)

There’s nothing that has really made me want to be pregnant. I mean, kind of—with this baby’s father, I wanted to share it with him. I wasn’t preventing, and it happened. (Participant 3)

Family support

I have my partner, and he was onboard. We were trying. Then you have my family who had actually even told him,’cause I did have a previous accident, and they told him, “Don’t get her pregnant. Don’t do it.” I’m thinking, how do you tell two adults who live in their own place [laughter] and who take care of things not to do something? (Participant 5)

I know my mom changed a lot since she found out that I got pregnant. She's more excited than I am. It's basically like I'm carrying her child. (Participant 11)

Social influences

Then seeing all the family and the friends that I had around to help support me and all that actually helped me out a lot. Other than that, it wasn't such a big problem of being pregnant or anything. (Participant 21)

Kinda sad because the people that I expected to be happy for me were not happy for me. I had more friends and colleagues. Well, colleagues were about 50–50 that were happy, and then they were like, “Well, why would you do that?” (Participant 5)

Physician counseling

Who would not really want to listen to their doctor, someone that’s paid millions of dollars for this education, works’round the clock nonstop? As humans, I feel like we always look for a go-to answer, whether it’s just us being lazy, or just because we don’t know. I think that the doctors play a huge part into it, but it’s still your choice. (Participant 5)

Yeah. We had the thought, if we get pregnant, we get pregnant. If we don’t, we don’t. We talked to the doctors, who told me it should be a safe pregnancy. (Participant 29)

Birth control and healthcare access

Yeah. Any hospital I go into, I’ll be able to get on birth control if I wanted to or not—or my actual OB/GYN. If I go into his office and say, “Hey, Dr. so and so, I think I wanna go ahead and try this birth control right after I have my child,” they’ll be ready to give me the shot, give me the pill, give me the patch, give me the implant, give me whatever I need. I be able to get it. (Participant 28)

It is, it’s offered—I mean, even at Planned Parenthood, it’s offered. I mean, there’s places where you don’t have insurance and they still help you. (Participant 3)

Financial stability

I'm not too concerned about financial. I'm not saying I make a lot of money, but I think I make enough to be able to take care of my baby. (Participant 30)

My job and whether or not I had finances 'cause back when I was working jobs that I was making minimum wage, there's no way, no way. Now, being a little more financially stable, still not great but a little more financial stable, way more comfortable with the idea. (Participant 7)

Perceived need for planning

For me, it really just came down to feeling prepared, not that you can ever really be prepared, but feeling semi-prepared and not like I was totally just throwing a wrench into my whole life… (Participant 7)

It really wasn't a thought, but I enjoyed the pregnancy and it wasn't a thought about, it wasn't planned or anything, but, yeah. (Participant 18)

Perceived sense of control of pregnancy

I think we all try to put this emphasis, “Well, it’s my body.” It’s the control. It’s control. It’s control. You’ve got women out there who want it more than anything, and they can’t do it. Then you have women who that’s the last thing they wanted on their mind, and now they have three or four kids. (Participant 5)

It's everybody's own choice to use it or not to use it. I feel like when a baby is supposed to be here, they're gonna come whether you're on birth control or not. (Participant 12)

If it happens, it happens

I had regular menses that came every month after that, but you know you’ve gotta plan, and then you’ve gotta get the romance on. Then, at that time, I feel like my body was so stressed-out, and then I was getting sick all the time. I was getting low. I was getting low. I was like, there’s no way my body is going to be able to sustain a pregnancy right now, and lo and behold, I was wrong. (Participant 5)

If it happens, it happens during whatever time. (Participant 30)

Birth control Failure

They did give me some pills without the hormones, without estrogen. That was pretty good. Then when I went to go get my tubes tied, I couldn’t get my tubes tied ‘cause I was pregnant. (Participant 19)

Yeah, I was already—yeah, I got pregnant on birth control. Come to find out, my mother was, too, when she got pregnant with me. (Participant 16)

My body, my choice

Because you can pretty much control you. You just hear what other people have to say, but at the end of the day, you make your own decisions. (Participant 1)

It’s my choice. If they refuse to wanna continue to treat me, I’ll go find another doctor. (Participant 28)

Birth control is easy to get

I think if you—it's fairly easy to use it once you get it. I feel like with all the different insurances and the different options, I feel like it's easy to get because now, I mean, you can order birth control on Facebook (Participant 12)

I've never had any issues, because I've always had insurance. I've just always known where to go. I mean, you can go to the health department and get your sack of 50 condoms. (Participant 2)