Abstract Introduction: Understanding the complexity of pregnancy intentions and resulting behaviors is essential to ensuring high quality, patient-centered reproductive health services that meet the needs of women and their partners. Community Health Centers (CHCs) play an important role in providing family planning care for traditionally underserved women, who may be at increased risk of experiencing unintended pregnancy. This study presents emerging findings on pregnancy intentions, ambivalence, and contraceptive behaviors among patients in CHC settings. Methods: This study employed a national survey (n=1,557) of women of reproductive age (18-44 years), sampled from 19 different CHC sites. The survey gathered information on patient characteristics, experiences with care, decision-making criteria and utilization of contraceptive services. Pregnancy intention was measured using the One Key Question®. Results: Approximately 12% of women reported that they wanted to become pregnant in the next year, while 88% were not actively seeking to become pregnant. Nearly 30% of those who did not desire a pregnancy reported not using contraception at the time of the survey. 1-in-4 women were pregnancy ambivalent and used contraception at approximately the same rates as women seeking to become pregnant. Conclusions: Women who express pregnancy ambivalence use contraception at similar rates to those who intend to become pregnant in the next year, potentially increasing their risk for unintended pregnancy. Understanding the characteristics and behaviors of underserved patients across different pregnancy intentions may help ensure that women receive the information, services, and support they need to achieve their reproductive health goals. Keywords: pregnancy intentions, family planning, community health centers, CHC, One Key Question®