Examining the relationship between intolerance of uncertainty and pregnancy avoidance after an earthquake

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This uncertainty may influence major life decisions, such as pregnancy planning. This study aimed to examine the relationship between intolerance of uncertainty and pregnancy avoidance in women affected by the February 6, 2023, Kahramanmaraş earthquake in Turkey. Methods A descriptive and cross-sectional study was conducted with 246 women aged 18–40 who experienced the earthquake. Data were collected via an online survey between December 1, 2023, and January 1, 2024, using snowball sampling. Tools included a Participant Introduction Form, the Intolerance of Uncertainty Scale (IUS-12), and the Desire to Avoid Pregnancy Scale (DAPS). Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression, adjusting for sociodemographic and reproductive variables. Results Participants had a mean IUS score of 38.52 (± 10.38) and a DAPS score of 2.25 (± 0.92). A significant positive correlation was found between intolerance of uncertainty and pregnancy avoidance (r = 0.222, p = 0.001). Regression analysis showed that intolerance of uncertainty significantly predicted pregnancy avoidance (β = 0.019, p = 0.001), explaining 16% of the variance in DAPS scores after adjusting for covariates. Conclusions Increased intolerance of uncertainty following the earthquake was significantly associated with a greater tendency to postpone or avoid pregnancy. This highlights the psychological impact of post-disaster uncertainty on reproductive decisions and emphasizes the need for integrated mental and reproductive health support in disaster-affected populations. Intolerance of uncertainty earthquake pregnancy avoidance Introduction Disasters are inevitable events that have always existed in human history. Among these events, earthquakes are of special importance as they risk completely changing human life and social structure regarding their effects and consequences [ 1 ]. The earthquakes, called the 'disaster of the century,' with a magnitude of 7.7 and 7.6 on the Richter scale and epicenter in Pazarcık and Elbistan districts of Kahramanmaraş on February 6, 2023, affected 11 provinces of Turkey and caused great destruction [ 2 ]. Approximately 13.5 million people were directly affected. This corresponds to 16% of Turkey's population. It was also reported that more than 50,000 people lost their lives, hundreds of thousands were injured, and millions were left homeless [ 3 ]. The earthquake caused significant trauma to individuals, as many negative factors such as human and economic losses, aftershocks, homelessness, having to live in tents and containers, and evacuations from earthquake zones to other regions came together in the aftermath of the disaster of the century [ 4 ], [ 5 ]. This trauma can lead to uncertainty about the future [ 6 ], [ 7 ]. The lack of knowledge about how to proceed in the face of a situation beyond one's control and how to cope with this uncertainty can lead to fear and anxiety [ 8 ]. Intolerance of uncertainty is anxiety, emotional distress, ineffective problem solving, and uncertainty avoidance due to uncertainty about the future [ 9 ]. After traumatic events where the future is uncertain, individuals often tend to postpone their plans. Having children, which is one of the important plans for the future, is often postponed after traumatic events [ 10 ]. Parents tend to prefer to have children when they are in the best physical, mental, economic, and social condition. However, after traumatic events such as earthquakes, which can lead to the loss of loved ones, individuals may also prefer to have children with the idea of filling the place of loss. Alternatively, unwanted pregnancies may occur due to inadequate access to family planning methods [ 11 ], [ 12 ]. From this point of view, this study was planned to examine the relationship between intolerance of uncertainty experienced by women after an earthquake and pregnancy planning. Material and Method Type, place, and time of the research This descriptive and cross-sectional study used Google Forms with women of childbearing age who experienced the February 6, 2023, Kahramanmaraş earthquake through social networks (WhatsApp, Instagram, Facebook, etc.). Population and sample of the study The population of the study consisted of women who experienced the February 6, 2023, Kahramanmaraş earthquake and continue to live in the earthquake zone, actively use social media (WhatsApp, Instagram, Facebook, etc.), are between the ages of 18–40 and voluntarily accepted to participate in the study. The sample size of the study was calculated using the G*Power 3.1.9.7 program. The mean score of the "Intolerance of Uncertainty Scale" obtained by Geçgin et al. (2017) was used to calculate the study's sample size (Geçgin and Sahranç, 2017). As a result, the power analysis was calculated as 234 women with a 5% bias level, an effect size of 0.20, and a 92% ability to represent the universe (power). Considering that there would be losses, the study was completed with 246 volunteer women. The inclusion criteria were that the woman was between 18 and 40, could read and understand Turkish, and planned to have a child within the following year. The exclusion criteria were being pregnant, having problems that prevent future pregnancy and childbirth (infertility, surgical menopause), and answering the research questions inconsistently. Data collection and data collection tools Research data were collected using an online survey between December 1, 2023, and January 1, 2024. The online survey was created through Google Forms. The research data was collected by reaching women in 11 earthquake-affected provinces (Adana, Adıyaman, Diyarbakır, Elazığ, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye, Şanlıurfa) through social networks (WhatsApp, Facebook, Twitter and Instagram). The snowball sampling method was used to reach the targeted sample size. The women reached this way were asked to forward the research links to other women who met the research criteria and invite them to the study. Participant Introduction Form The participant introduction form, prepared by the researcher in accordance with the literature, consisted of 11 questions to determine women's identifying characteristics (age, education level, income status, marriage type, etc.), obstetric characteristics (number of pregnancies, number of births, etc.), family planning use status, and family planning method used [ 13 ]. Intolerance of Uncertainty Scale (IUS-12) The scale was developed by Carleton et al. (2007) [ 14 ]. Sarıçam et al. (2014) conducted a Turkish validity and reliability study. The scale consists of 12 items and 2 sub-dimensions. The scale is a 5-point Likert scale (1- Not suitable for me,..., 5- Completely suitable for me). The lowest score that can be obtained from the scale is 12, and the highest score is 60. Cronbach's alpha coefficient of the scale was found to be .88. In this study, Cronbach's alpha coefficient was 0.89. Psychometric evaluation of an instrument to measure prospective pregnancy preferences: the desire to avoid pregnancy scale (DAPS) The scale was developed by Corinne Rocca et al. (2019) [ 15 ]. A Turkish validity and reliability study was conducted by İrem (2022). The scale consists of 14 items and 3 sub-dimensions. The highest score to be obtained from the scale is 56/14 = 4, and the lowest score is 0/14 = 0. The high score obtained from the scale indicates an increased desire to avoid pregnancy, while the low score obtained from the scale indicates a decreased desire to avoid pregnancy. Cronbach's alpha coefficient of the scale was found to be 0.95. In this study, Cronbach's alpha value on the scale was determined to be 0.92. Evaluation of the Data The data to be obtained in the study were analyzed using SPSS (Statistical Package for Social Sciences) for the Windows 25.0 program. Descriptive statistical methods (number, percentage, mean, and standard deviation) were used to evaluate the data. The suitability of the scales used for normal distribution was evaluated by examining the skewness and kurtosis values (within ± 2) with the Kolmogorov-Smirnov test. As a result of the analysis, it was determined that all scales were normally distributed. Pearson's correlation analysis examined the relationship between the IUS and the DAPS. Multiple regression was performed to determine the explanatory status of the independent variable (IUS mean score) for the dependent variable (DAPS mean score). In multiple regression analysis, age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use status were adjusted according to these variables. Fındıngs In this study, the mean age of the women was 31.63 ± 7.44 years. It was found that 69.9% of the women were married through arranged marriages, and 45.1% had a university education level or higher. It was determined that 63.8% of the participants were not employed, 46.7% had an income equal to their expenses, 31.3% had 2 pregnancies, and 31.3% had 2 births. It was also determined that 69.5% of the women had never had a miscarriage, 91.1% had never had a stillbirth, 70.7% used a family planning method, and 22.8% used withdrawal as a family planning method ( Table 1 ). Table 1 Distribution of women according to their descriptive characteristics Variables N (%)/Mean ± SD Age 31.63 ± 7.44 Form of Marriage By agreement 74 (30.1) By arranged marriage 172 (69.9) Education Level Literate 12 (4.9) Primary School 28 (11.4) Middle School 32 (13.0) High School 63 (25.6) University and above 111 (45.1) Employment status Working 89 (36.2) Not working 157 (63.8) Income status Income matches expenditure 79 (32.1) Income equal to expenditure 115 (46.7) Income more than expenditure 52 (21.1) Number of pregnancies None 45 (18.3) 1 46 (18.7) 2 77 (31.3) 3 52 (21.1) 4 and above 26 (10.6) Number of births None 49 (19.9) 1 58 (23.6) 2 77 (31.3) 3 37 (15.0) 4 and above 25 (10.2) Number of miscarriages None 171 (69.5) 1 59 (24.0) 2 and above 16 (6.5) Number of stillbirths None 224 (91.1) 1 19 (7.7) 2 and above 3 (1.2) Use of family planning methods Yes 174 (70.7) No. 72 (29.3) Type of method used Condom 48 (19.5) RIA 34 (13.8) Pill 17 (6.9) Withdrawal 56 (22.8) Calendar 19 (7.7) The mean scores of the scales used in the study were determined as 38.52 ± 10.38 and 2.25 ± 0.92. Pearson correlation was used to test the relationship between the scales used in the study. As a result of the test, a statistically significant and positive correlation between IUS and DAPS was observed (r = 0.222, p = 0.001). Multiple linear regression analysis was performed to examine the relationship between intolerance of uncertainty and pregnancy avoidance. The analysis controlled age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use. According to the results of the regression analysis, when the beta coefficient value, t value, and significance level of the independent variable are analyzed, it is seen that there is a statistically significant effect between intolerance of uncertainty and pregnancy avoidance (t = 3.621, p = 0.001). An increase of 1 unit in the pregnancy avoidance variable causes an increase of 0.019 in intolerance of uncertainty (β = 0.019, p = 0.001). The intolerance of uncertainty variable explains 16% of the total pregnancy avoidance score. Dependent variable: Pregnancy avoidance (R² = 0.16; Table 2 ). Table 2 Relationship between intolerance of uncertainty and pregnancy avoidance: Multiple linear regression analysis Independent Variable B a Standard Error Beta b p 95% Confidence Interval IUS 0.019 0.005 0.217 0.001 0.009–0.030 Dependent variable: Pregnancy avoidance (DAPS), IUS: Intolerance of Uncertainty Scale, aBeta coefficient, b Standardized beta coefficient, Model Adjusted R 2 = 0.16 Adjusted for age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use Dıscussıon This study examined the relationship between intolerance of uncertainty and pregnancy avoidance after the earthquake. It found a significant relationship (β = 0.019, p = 0.001). There is a decrease in population after disasters [ 12 ]. The main reasons for this are death or disability of the population of reproductive age, postponement, or a decrease in the desire for pregnancy. When fertility rates were examined all over the world after the COVID-19 pandemic, it was seen that the statistics decreased [ 16 ].When the data in Turkey were analyzed, it was determined that while the fertility rate was 1.99 in 2018, this rate decreased to 1.76 during the pandemic. In a study conducted by Angela et al., it was reported that women postponed their pregnancy plans during COVID-19 [ 17 ]. In the study by Sienicka et al. (2021), most of the women reported that they postponed their pregnancy plans during the pandemic because access to prenatal and delivery services may be limited (86.6%) [ 18 ]. More than half (51.9%) reported that they postponed their pregnancy plans because they were afraid of losing their income. Especially after disasters, disruptions in health services, inability to carry out transfer stages effectively, inability to meet basic needs such as nutrition and shelter, and not knowing how long the negativities will last create uncertainty. When the results of our study are analyzed, it is seen that women postponed their pregnancy plans after the earthquake (β = 0.019, p = 0.001). Crisis periods that occur after disasters prevent individuals from planning for the future. In a meta-analysis, it was determined that after the earthquake in Haiti (2010), rates of unintended pregnancies increased, and rates of desired pregnancies decreased significantly due to unaffordable family planning services [ 19 ]. Anxiety experienced after natural disasters such as earthquakes can have significant effects on pregnancy planning. Effects such as physical and psychological trauma and environmental exposures experienced after natural disasters cause unwanted pregnancies or women to change their pregnancy plans [ 20 ]. Studies have shown that disasters cause individuals to change or postpone their plans (work or education) [ 21 ], [ 22 ]. Another study determined that those who changed their plans after the earthquake and those who experienced uncertainty about the future avoided pregnancy (Özşahin, 2024). In a study by Mitrovic et al., it was determined that women whose invitro fertilization treatment was postponed during the COVID-19 pandemic period perceived the intolerance of uncertainty as a threat and tended to avoid pregnancy [ 24 ]. In a study conducted after the McMurray fire (2016), women's stress levels increased due to the suddenly emerging uncertain environment, which caused some women to reconsider their pregnancy plans [ 25 ]. In a study conducted in Japan, it was determined that the mental preparation processes of women who experienced natural disasters were impaired, and they did not consider pregnancy before the conditions improved [ 26 ]. In the study of Flink et al. (2023), it was determined that intolerance to uncertainty after the disaster increased pregnancy avoidance behavior in women planning pregnancy for the first time [ 27 ]. Conditions such as anxiety, fear, worry, and uncertainty experienced after a disaster may cause women to experience indecision about having a child [ 28 ]. In conclusion, natural disasters and crisis periods significantly affect women's pregnancy plans; pregnancy is often postponed or completely canceled during these processes. Factors such as uncertainty, anxiety, and difficulties in accessing basic needs may cause individuals to reconsider their reproductive decisions. Therefore, planning reproductive health services after a disaster is of great importance in terms of protecting women's physical and psychological well-being. However, this study has some limitations. Its descriptive and cross-sectional design makes it difficult to establish a causal relationship between intolerance of uncertainty and pregnancy avoidance. In addition, the study did not include a control group that had not experienced an earthquake, and the reasons for women's pregnancy avoidance were not addressed in depth. Conclusion As a result of study, it was observed that as the level of intolerance of uncertainly increased among women after the eartquake, the tendency to postpone pregnacy planning also increased. This higlight the significant impact of post-disaster psychological on reproducetive health Recommendations for Future Research In future studies, comparative and longitudinal research should be conducted to examine changes in women’s reproductive plans following different types of disasters. Interventions aimed at strengthening psychogial resilience and coping with post–disaster uncertainty shoul be prioritized, and mental health support services sahould be expanded accordingly. Health policies should be developed to ensure the uninterrupted provision of reproductive health services in post-disaster periods. The reasons why women avoid pregnacy shouls be explored in grater depth through qualitative methods, and preventive health services spesific to the post- disaster context be diversified. Limitation The cross- sectional desing of the study limitation. Declarations Dısclosure Statement No potential conflict of interest was reported by author. Corresponding author 's e-mail [email protected] Ethics approval and Consent to participate Ethics committee approval for the study was received from the Bingol University Health Sciences Scientific Research and Publication Ethics Committee (E-33117789-044-129878). Before starting the survey, information about the purpose and content of the study and a consent tab stating that participation was voluntary were included. The consent of those who accepted after reading the informed consent was obtained before the survey by clicking the “I have read and agree to participate in the study” tab. Consent for publication Not applicable. Competing interests There is no personal or financial conflict of interest between the authors of the article Funding Declaration NONE Author Contribution Conceptualion : EABY, GN Data curation : GN, EABY Formal analysis: GN , FKT Funding acquisition : GN, EABY; Investigaiton : GN, EABY; Methodology :EABY; Project administration : EABY, FKT; Software: FKT, EABY; Resources : GN, EABY; Supervision : GN, EABY; Validation : FKT GN; Visualization : EABY; Writing Original draft :EABY,GN,FKT; Writing-review-editing : EABT, GN. Acknowledgement The authors would like to thank the patients who agreed to participate in the study voluntarily. Data Availability The data that support the findings of this study were not openly available due to reasons of sensitivity. If reasonably requested, it could be obtained from the corresponding author. References Duruel -M. Being a migrant in disasters: The February 6 earthquake in Hatay example. 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13:48:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":785684,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7732357/v1/39b5eec4-1567-40fc-bacc-16bf963bde45.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Examining the relationship between intolerance of uncertainty and pregnancy avoidance after an earthquake","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDisasters are inevitable events that have always existed in human history. Among these events, earthquakes are of special importance as they risk completely changing human life and social structure regarding their effects and consequences [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The earthquakes, called the 'disaster of the century,' with a magnitude of 7.7 and 7.6 on the Richter scale and epicenter in Pazarcık and Elbistan districts of Kahramanmaraş on February 6, 2023, affected 11 provinces of Turkey and caused great destruction [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Approximately 13.5\u0026nbsp;million people were directly affected. This corresponds to 16% of Turkey's population. It was also reported that more than 50,000 people lost their lives, hundreds of thousands were injured, and millions were left homeless [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The earthquake caused significant trauma to individuals, as many negative factors such as human and economic losses, aftershocks, homelessness, having to live in tents and containers, and evacuations from earthquake zones to other regions came together in the aftermath of the disaster of the century [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This trauma can lead to uncertainty about the future [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The lack of knowledge about how to proceed in the face of a situation beyond one's control and how to cope with this uncertainty can lead to fear and anxiety [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Intolerance of uncertainty is anxiety, emotional distress, ineffective problem solving, and uncertainty avoidance due to uncertainty about the future [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. After traumatic events where the future is uncertain, individuals often tend to postpone their plans. Having children, which is one of the important plans for the future, is often postponed after traumatic events [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Parents tend to prefer to have children when they are in the best physical, mental, economic, and social condition. However, after traumatic events such as earthquakes, which can lead to the loss of loved ones, individuals may also prefer to have children with the idea of filling the place of loss. Alternatively, unwanted pregnancies may occur due to inadequate access to family planning methods [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. From this point of view, this study was planned to examine the relationship between intolerance of uncertainty experienced by women after an earthquake and pregnancy planning.\u003c/p\u003e"},{"header":"Material and Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eType, place, and time of the research\u003c/h2\u003e\u003cp\u003eThis descriptive and cross-sectional study used Google Forms with women of childbearing age who experienced the February 6, 2023, Kahramanmaraş earthquake through social networks (WhatsApp, Instagram, Facebook, etc.).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePopulation and sample of the study\u003c/h3\u003e\n\u003cp\u003eThe population of the study consisted of women who experienced the February 6, 2023, Kahramanmaraş earthquake and continue to live in the earthquake zone, actively use social media (WhatsApp, Instagram, Facebook, etc.), are between the ages of 18\u0026ndash;40 and voluntarily accepted to participate in the study. The sample size of the study was calculated using the G*Power 3.1.9.7 program. The mean score of the \"Intolerance of Uncertainty Scale\" obtained by Ge\u0026ccedil;gin et al. (2017) was used to calculate the study's sample size (Ge\u0026ccedil;gin and Sahran\u0026ccedil;, 2017). As a result, the power analysis was calculated as 234 women with a 5% bias level, an effect size of 0.20, and a 92% ability to represent the universe (power). Considering that there would be losses, the study was completed with 246 volunteer women. The inclusion criteria were that the woman was between 18 and 40, could read and understand Turkish, and planned to have a child within the following year. The exclusion criteria were being pregnant, having problems that prevent future pregnancy and childbirth (infertility, surgical menopause), and answering the research questions inconsistently.\u003c/p\u003e\n\u003ch3\u003eData collection and data collection tools\u003c/h3\u003e\n\u003cp\u003eResearch data were collected using an online survey between December 1, 2023, and January 1, 2024. The online survey was created through Google Forms. The research data was collected by reaching women in 11 earthquake-affected provinces (Adana, Adıyaman, Diyarbakır, Elazığ, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye, Şanlıurfa) through social networks (WhatsApp, Facebook, Twitter and Instagram). The snowball sampling method was used to reach the targeted sample size. The women reached this way were asked to forward the research links to other women who met the research criteria and invite them to the study.\u003c/p\u003e\n\u003ch3\u003eParticipant Introduction Form\u003c/h3\u003e\n\u003cp\u003eThe participant introduction form, prepared by the researcher in accordance with the literature, consisted of 11 questions to determine women's identifying characteristics (age, education level, income status, marriage type, etc.), obstetric characteristics (number of pregnancies, number of births, etc.), family planning use status, and family planning method used [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eIntolerance of Uncertainty Scale (IUS-12)\u003c/h3\u003e\n\u003cp\u003eThe scale was developed by Carleton et al. (2007) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Sarı\u0026ccedil;am et al. (2014) conducted a Turkish validity and reliability study. The scale consists of 12 items and 2 sub-dimensions. The scale is a 5-point Likert scale (1- Not suitable for me,..., 5- Completely suitable for me). The lowest score that can be obtained from the scale is 12, and the highest score is 60. Cronbach's alpha coefficient of the scale was found to be .88. In this study, Cronbach's alpha coefficient was 0.89.\u003c/p\u003e\u003cp\u003e\u003cb\u003ePsychometric evaluation of an instrument to measure prospective pregnancy preferences: the desire to avoid pregnancy scale (DAPS)\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe scale was developed by Corinne Rocca et al. (2019) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. A Turkish validity and reliability study was conducted by İrem (2022). The scale consists of 14 items and 3 sub-dimensions. The highest score to be obtained from the scale is 56/14\u0026thinsp;=\u0026thinsp;4, and the lowest score is 0/14\u0026thinsp;=\u0026thinsp;0. The high score obtained from the scale indicates an increased desire to avoid pregnancy, while the low score obtained from the scale indicates a decreased desire to avoid pregnancy. Cronbach's alpha coefficient of the scale was found to be 0.95. In this study, Cronbach's alpha value on the scale was determined to be 0.92.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eEvaluation of the Data\u003c/h2\u003e\u003cp\u003eThe data to be obtained in the study were analyzed using SPSS (Statistical Package for Social Sciences) for the Windows 25.0 program. Descriptive statistical methods (number, percentage, mean, and standard deviation) were used to evaluate the data. The suitability of the scales used for normal distribution was evaluated by examining the skewness and kurtosis values (within \u0026plusmn;\u0026thinsp;2) with the Kolmogorov-Smirnov test. As a result of the analysis, it was determined that all scales were normally distributed. Pearson's correlation analysis examined the relationship between the IUS and the DAPS. Multiple regression was performed to determine the explanatory status of the independent variable (IUS mean score) for the dependent variable (DAPS mean score). In multiple regression analysis, age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use status were adjusted according to these variables.\u003c/p\u003e\u003c/div\u003e"},{"header":"Fındıngs","content":"\u003cp\u003eIn this study, the mean age of the women was 31.63\u0026thinsp;\u0026plusmn;\u0026thinsp;7.44 years. It was found that 69.9% of the women were married through arranged marriages, and 45.1% had a university education level or higher. It was determined that 63.8% of the participants were not employed, 46.7% had an income equal to their expenses, 31.3% had 2 pregnancies, and 31.3% had 2 births. It was also determined that 69.5% of the women had never had a miscarriage, 91.1% had never had a stillbirth, 70.7% used a family planning method, and 22.8% used withdrawal as a family planning method \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of women according to their descriptive characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (%)/Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31.63\u0026thinsp;\u0026plusmn;\u0026thinsp;7.44\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eForm of Marriage\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBy agreement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74 (30.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBy arranged marriage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e172 (69.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation Level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (4.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (11.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (13.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (25.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111 (45.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWorking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e89 (36.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot working\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e157 (63.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome matches expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79 (32.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome equal to expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e115 (46.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome more than expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52 (21.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of pregnancies\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45 (18.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46 (18.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (31.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52 (21.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (10.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of births\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49 (19.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58 (23.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (31.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37 (15.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25 (10.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of miscarriages\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e171 (69.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (24.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (6.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of stillbirths\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e224 (91.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (7.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (1.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eUse of family planning methods\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e174 (70.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (29.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of method used\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCondom\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48 (19.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRIA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34 (13.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePill\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (6.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWithdrawal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56 (22.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCalendar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (7.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mean scores of the scales used in the study were determined as 38.52\u0026thinsp;\u0026plusmn;\u0026thinsp;10.38 and 2.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92. Pearson correlation was used to test the relationship between the scales used in the study. As a result of the test, a statistically significant and positive correlation between IUS and DAPS was observed (r\u0026thinsp;=\u0026thinsp;0.222, p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eMultiple linear regression analysis was performed to examine the relationship between intolerance of uncertainty and pregnancy avoidance. The analysis controlled age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use. According to the results of the regression analysis, when the beta coefficient value, t value, and significance level of the independent variable are analyzed, it is seen that there is a statistically significant effect between intolerance of uncertainty and pregnancy avoidance (t\u0026thinsp;=\u0026thinsp;3.621, p\u0026thinsp;=\u0026thinsp;0.001). An increase of 1 unit in the pregnancy avoidance variable causes an increase of 0.019 in intolerance of uncertainty (β\u0026thinsp;=\u0026thinsp;0.019, p\u0026thinsp;=\u0026thinsp;0.001). The intolerance of uncertainty variable explains 16% of the total pregnancy avoidance score. Dependent variable: Pregnancy avoidance (R\u0026sup2; = 0.16; Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eRelationship between intolerance of uncertainty and pregnancy avoidance: Multiple linear regression analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndependent\u003c/p\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eB\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStandard Error\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBeta\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e95% Confidence Interval\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIUS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.009\u0026ndash;0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eDependent variable: Pregnancy avoidance (DAPS), IUS: Intolerance of Uncertainty Scale, aBeta coefficient, \u003csup\u003eb\u003c/sup\u003eStandardized beta coefficient, Model Adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.16\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAdjusted for age, educational status, employment status, income status, marriage type, number of pregnancies, and family planning use\u003c/p\u003e"},{"header":"Dıscussıon","content":"\u003cp\u003eThis study examined the relationship between intolerance of uncertainty and pregnancy avoidance after the earthquake. It found a significant relationship (β\u0026thinsp;=\u0026thinsp;0.019, p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eThere is a decrease in population after disasters [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The main reasons for this are death or disability of the population of reproductive age, postponement, or a decrease in the desire for pregnancy. When fertility rates were examined all over the world after the COVID-19 pandemic, it was seen that the statistics decreased [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].When the data in Turkey were analyzed, it was determined that while the fertility rate was 1.99 in 2018, this rate decreased to 1.76 during the pandemic. In a study conducted by Angela et al., it was reported that women postponed their pregnancy plans during COVID-19 [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. In the study by Sienicka et al. (2021), most of the women reported that they postponed their pregnancy plans during the pandemic because access to prenatal and delivery services may be limited (86.6%) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. More than half (51.9%) reported that they postponed their pregnancy plans because they were afraid of losing their income. Especially after disasters, disruptions in health services, inability to carry out transfer stages effectively, inability to meet basic needs such as nutrition and shelter, and not knowing how long the negativities will last create uncertainty. When the results of our study are analyzed, it is seen that women postponed their pregnancy plans after the earthquake (β\u0026thinsp;=\u0026thinsp;0.019, p\u0026thinsp;=\u0026thinsp;0.001). Crisis periods that occur after disasters prevent individuals from planning for the future. In a meta-analysis, it was determined that after the earthquake in Haiti (2010), rates of unintended pregnancies increased, and rates of desired pregnancies decreased significantly due to unaffordable family planning services [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Anxiety experienced after natural disasters such as earthquakes can have significant effects on pregnancy planning. Effects such as physical and psychological trauma and environmental exposures experienced after natural disasters cause unwanted pregnancies or women to change their pregnancy plans [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Studies have shown that disasters cause individuals to change or postpone their plans (work or education) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Another study determined that those who changed their plans after the earthquake and those who experienced uncertainty about the future avoided pregnancy (\u0026Ouml;zşahin, 2024). In a study by Mitrovic et al., it was determined that women whose invitro fertilization treatment was postponed during the COVID-19 pandemic period perceived the intolerance of uncertainty as a threat and tended to avoid pregnancy [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In a study conducted after the McMurray fire (2016), women's stress levels increased due to the suddenly emerging uncertain environment, which caused some women to reconsider their pregnancy plans [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In a study conducted in Japan, it was determined that the mental preparation processes of women who experienced natural disasters were impaired, and they did not consider pregnancy before the conditions improved [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In the study of Flink et al. (2023), it was determined that intolerance to uncertainty after the disaster increased pregnancy avoidance behavior in women planning pregnancy for the first time [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Conditions such as anxiety, fear, worry, and uncertainty experienced after a disaster may cause women to experience indecision about having a child [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In conclusion, natural disasters and crisis periods significantly affect women's pregnancy plans; pregnancy is often postponed or completely canceled during these processes. Factors such as uncertainty, anxiety, and difficulties in accessing basic needs may cause individuals to reconsider their reproductive decisions. Therefore, planning reproductive health services after a disaster is of great importance in terms of protecting women's physical and psychological well-being.\u003c/p\u003e\u003cp\u003eHowever, this study has some limitations. Its descriptive and cross-sectional design makes it difficult to establish a causal relationship between intolerance of uncertainty and pregnancy avoidance. In addition, the study did not include a control group that had not experienced an earthquake, and the reasons for women's pregnancy avoidance were not addressed in depth.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAs a result of study, it was observed that as the level of intolerance of uncertainly increased among women after the eartquake, the tendency to postpone pregnacy planning also increased. This higlight the significant impact of post-disaster psychological on reproducetive health\u003c/p\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eRecommendations for Future Research\u003c/h2\u003e\u003cp\u003eIn future studies, comparative and longitudinal research should be conducted to examine changes in women\u0026rsquo;s reproductive plans following different types of disasters. Interventions aimed at strengthening psychogial resilience and coping with post\u0026ndash;disaster uncertainty shoul be prioritized, and mental health support services sahould be expanded accordingly. Health policies should be developed to ensure the uninterrupted provision of reproductive health services in post-disaster periods. The reasons why women avoid pregnacy shouls be explored in grater depth through qualitative methods, and preventive health services spesific to the post- disaster context be diversified.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eLimitation\u003c/h2\u003e\u003cp\u003eThe cross- sectional desing of the study limitation.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eDısclosure Statement\u003c/h2\u003e\u003cp\u003eNo potential conflict of interest was reported by author.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003ch2\u003eCorresponding author 's e-mail\u003c/h2\u003e\u003cp\[email protected]\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eEthics approval and Consent to participate\u003c/h2\u003e\u003cp\u003e Ethics committee approval for the study was received from the Bingol University Health Sciences Scientific Research and Publication Ethics Committee (E-33117789-044-129878). Before starting the survey, information about the purpose and content of the study and a consent tab stating that participation was voluntary were included. The consent of those who accepted after reading the informed consent was obtained before the survey by clicking the \u0026ldquo;I have read and agree to participate in the study\u0026rdquo; tab.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThere is no personal or financial conflict of interest between the authors of the article\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eDeclaration\u003c/p\u003e\u003cp\u003eNONE\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualion : EABY, GN Data curation : GN, EABY Formal analysis: GN , FKT Funding acquisition : GN, EABY; Investigaiton : GN, EABY; Methodology :EABY; Project administration : EABY, FKT; Software: FKT, EABY; Resources : GN, EABY; Supervision : GN, EABY; Validation : FKT GN; Visualization : EABY; Writing Original draft :EABY,GN,FKT; Writing-review-editing : EABT, GN.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank the patients who agreed to participate in the study voluntarily.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study were not openly available due to reasons of sensitivity. If reasonably requested, it could be obtained from the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDuruel -M. Being a migrant in disasters: The February 6 earthquake in Hatay example. \u003cem\u003eIntroduction\u003c/em\u003e, vol. 14, no. 2, pp. 227\u0026ndash;255, Nov. 2023, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.19059/mukaddime.1381750\u003c/span\u003e\u003cspan address=\"10.19059/mukaddime.1381750\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eErdoğan -B. Sociology of earthquake: Social and cultural dimensions of the February 6 disaster. TRT Acad. 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Jul. 2024;21(1):96. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12978-024-01836-8\u003c/span\u003e\u003cspan address=\"10.1186/s12978-024-01836-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Intolerance of uncertainty, earthquake, pregnancy avoidance","lastPublishedDoi":"10.21203/rs.3.rs-7732357/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7732357/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eNatural disasters such as earthquakes can cause severe psychological distress, including uncertainty about the future. This uncertainty may influence major life decisions, such as pregnancy planning. This study aimed to examine the relationship between intolerance of uncertainty and pregnancy avoidance in women affected by the February 6, 2023, Kahramanmaraş earthquake in Turkey.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA descriptive and cross-sectional study was conducted with 246 women aged 18\u0026ndash;40 who experienced the earthquake. Data were collected via an online survey between December 1, 2023, and January 1, 2024, using snowball sampling. Tools included a Participant Introduction Form, the Intolerance of Uncertainty Scale (IUS-12), and the Desire to Avoid Pregnancy Scale (DAPS). Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression, adjusting for sociodemographic and reproductive variables.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eParticipants had a mean IUS score of 38.52 (\u0026plusmn;\u0026thinsp;10.38) and a DAPS score of 2.25 (\u0026plusmn;\u0026thinsp;0.92). A significant positive correlation was found between intolerance of uncertainty and pregnancy avoidance (r\u0026thinsp;=\u0026thinsp;0.222, p\u0026thinsp;=\u0026thinsp;0.001). Regression analysis showed that intolerance of uncertainty significantly predicted pregnancy avoidance (β\u0026thinsp;=\u0026thinsp;0.019, p\u0026thinsp;=\u0026thinsp;0.001), explaining 16% of the variance in DAPS scores after adjusting for covariates.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eIncreased intolerance of uncertainty following the earthquake was significantly associated with a greater tendency to postpone or avoid pregnancy. This highlights the psychological impact of post-disaster uncertainty on reproductive decisions and emphasizes the need for integrated mental and reproductive health support in disaster-affected populations.\u003c/p\u003e","manuscriptTitle":"Examining the relationship between intolerance of uncertainty and pregnancy avoidance after an earthquake","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-21 12:29:15","doi":"10.21203/rs.3.rs-7732357/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-04T20:02:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9287711002682743752930068028351603456","date":"2025-11-24T11:12:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"4592633351669788630198106655446900918","date":"2025-11-19T11:12:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"59688048315187214555146638129169992314","date":"2025-11-12T06:46:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-11T12:45:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-05T10:33:51+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-15T04:51:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-14T18:04:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Women's Health","date":"2025-10-14T18:01:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"faa1a762-a96a-4368-92a9-5d1676ed1b59","owner":[],"postedDate":"November 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-21T12:29:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-21 12:29:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7732357","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7732357","identity":"rs-7732357","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}