What if I had been asked One Key Question®?


What if I had been asked One Key Question®?

by Becky Griesse
October 8, 2018
A woman standing next to a giant question mark

Over the last year, I have been immersed in the world of pregnancy intention screening and specifically One Key Question®. A world that starts with a simple question – “Would you like to become pregnant in the next year?” – and leads to a conversation centered on contraception and/or preconception care. I wondered, how would I have responded over the years? In my 20s, I’m sure my answer would’ve been “No.” But as I’ve gotten older, become more stable, and developed my career, I bet my answer would’ve changed. I remember being asked if I wanted children and saying to friends or family, “if it happens, it happens.” If I found myself in the right relationship or in the right financial circumstances, I would be “ok either way” if I got pregnant. While I can look back and imagine my response at various doctor visits, I was never asked.  

What is One Key Question®?

One Key Question® supports women’s power to decide by helping to transform their health care experience. One Key Question® is a pregnancy intention screening tool for clinicians and other providers who serve women ages 18-50 years old. It’s a question that gets a conversation started about what the patient wants related to her own desires about pregnancy and her reproductive health. 

Developed in 2011, One Key Question® was originally intended for use in primary care settings where often, reproductive health and birth control were not addressed. Why? Because providers thought a different doctor (OB/GYN) was handling those health issues. However, they were missing a large opportunity to support women’s reproductive health desires, by not asking the right questions. 

Why this question?

The original phrasing of One Key Question® was a bit different than the current one. After testing out a question with the wording “planning to get pregnant” and with no time frame, developers soon realized they needed a new prompt. Women wanted to tell providers what they wanted – something they were never asked. They also wanted it to have a more specific time frame. Hence, the birth of “Would you like to become pregnant in the next year?”

They also learned that this was not a Yes or No question. There are women all along the continuum between Yes and No. Therefore, four optional response categories go along with One Key Question®

Yes, No, Unsure, or Ok Either Way. 

What comes next?

While One Key Question® seems simple enough, it’s not just a checkbox on an electronic health record or health history form. The question and answer lead to a conversation about contraception and/or preconception care. That can include conversations about current contraception use and what women liked or didn’t like about their method. It can include a prescription for folic acid and follow-up visits for any chronic conditions that may impact a healthy pregnancy. Ultimately, One Key Question® is designed to provide support for ALL women, regardless of their answer, to have healthy pregnancies or to prevent pregnancies women themselves say they are not ready for.  

Imagine your next visit to the doctor. What would you say if they asked you, “Would you like to become pregnant in the next year?”