One Key Question: Putting Women First


One Key Question: Putting Women First

by Colleen Crittenden Murray, MPH, DPH
February 22, 2019

For most women, deciding if, when, and under what circumstances to get pregnant and have a child is a highly personal and complex decision. For many, the decision is not a binary yes or no answer. Instead, the answer often falls on a spectrum ranging from absolutely not, to not sure, maybe one day, or to yes. While some women ache to become mothers, others wait for the perfect time as they juggle competing priorities, such as their career and other factors, including relationship status, professional aspirations, and financial security. Health providers should approach women’s reproductive health with the understanding that the desire to become pregnant does not always have a clean, neat, check-the-box, yes or no answer.

Enter One Key Question®.

Power to Decide’s One Key Question has an audacious goal: nothing short of transforming women’s health care. One Key Question is a tool for health and social service providers that helps start a conversation about if and when women want to get pregnant and have a child. The notion behind One Key Question is simple: it provides a framework for health providers, social service providers, and champions who support women, age 18-50, to routinely ask, “Would you like to become pregnant in the next year?” By dividing patients’ answers into four categories (yes, no, ok either way, and unsure) rather than only two (yes or no), providers can better focus on what women want to do regarding pregnancy. One Key Question is non-judgmental and equally supports women who want to become pregnant, those who do not, and those who are ambivalent.

As outlined in a recent New York Times article, pregnancy planning is not a practice that resonates with all ages, cultures, and backgrounds. Moreover, an appreciable proportion of women are ambivalent about pregnancy (our own research suggests it could be as high as 40%). One Key Question meets women where they are by focusing on understanding their goals and providing follow-up care based on the response. That care can take many forms, such as a new prescription for birth control, preconception health, prenatal care, or referral to other services.

One Key Question is used by thousands of healthcare and social service providers in approximately 30 states. To that end, Power to Decide is the exclusive national trainer for One Key Question® and offers a full complement of capacity building and licensing options for One Key Question, including:

  • One day, in-person certification training and consultation package for clinics, community-based organizations, public health departments, and other organizations.
  • Train the trainer certification training and consultation package.
  • Systems integration and licensing packages.

At Power to Decide, we believe that all women regardless of who they are or where they live should have the opportunity to pursue the future they want and decide if, when, and under what circumstances to get pregnant and have a child. We recognize that 90 percent of young people say they do not intend to get pregnant at this point in their lives. With One Key Question health providers will be better equipped to understand their patient’s desires and to provide the care and referrals that are necessary.