The stability of pregnancy intentions and pregnancy-related maternal behaviors.
ABSTRACT Our objectives were to characterize the stability of pregnancy intention and to examine whether stability is associated with the timing of prenatal care initiation, smoking during pregnancy, and breastfeeding.
We use a sample of women from the National Longitudinal Survey of Youth (NLSY) for whom information on pregnancy intention was collected both during pregnancy and after delivery. In bivariate analyses we compare outcomes and characteristics of women whose pregnancy intention changed between the prenatal and postpartum periods. With multivariate methods, we analyze the correlates of switching pregnancy intention as well as the association between switching and maternal behaviors.
Women whose pregnancy intention changes between the two assessments are similar in marital status and socioeconomic background to those who report both during pregnancy and after delivery that the pregnancy is unintended. Disagreement during pregnancy between the parents' pregnancy intentions is the most important predictor of instability in the mother's pregnancy intention. Effects of unintended pregnancy on the timing of initiation of prenatal care, smoking during pregnancy, and breastfeeding based on reports after delivery are smaller than those based on reports during pregnancy, although differences are not statistically significant. Adverse effects of unintended pregnancy are greater when pregnancies reported by the mother to be unintended at either assessment are combined into a single category for unintended pregnancy.
Unstable pregnancy intention may be a marker for adverse maternal behaviors related to infant health.
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ABSTRACT: Adolescent pregnancy is a major health problem in many developing countries. To assess contraceptive practices and pregnancy intendedness in pregnant adolescents. This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR) and 95% confidence interval (CI) of independent predictors. Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0%) were currently in school. Seventy-five (37.5%) participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%). Only two participants (1.0%) had ever used an intrauterine device or implant. Participants' age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94-14.04). Of the 200 participants, 132 (66.0%) declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27-13.75) and participants' age (aOR, 5.76; 95% CI, 2.42-13.70). Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants' age was an independent factor predicting non-use of contraceptives. Educational status and age of the participants were significant factors predicting unintended pregnancy.International Journal of Women's Health 01/2015; 7:315-20. DOI:10.2147/IJWH.S77077
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ABSTRACT: A thorough understanding of the health implications of unwanted and unintended pregnancies is constrained by our ability to accurately identify them. Commonly used techniques for measuring such pregnancies are subject to two main sources of error: the ex post revision of preferences after a pregnancy and the difficulty of identifying preferences at the time of conception. This study examines the implications of retrospective and prospective measurement approaches, which are vulnerable to different sources of error, on estimates of unwanted and unintended pregnancies. We use eight waves of closely-spaced panel data from young women in southern Malawi to generate estimates of unwanted and unintended pregnancies based on fertility preferences measured at various points in time. We then compare estimates using traditional retrospective and prospective approaches to estimates obtained when fertility preferences are measured prospectively within months of conception. The 1,062 young Malawian women in the sample frequently changed their fertility preferences. The retrospective measures slightly underestimated unwanted and unintended pregnancies compared to the time-varying prospective approach; in contrast the fixed prospective measures overestimated them. Nonetheless, most estimates were similar in aggregate, suggesting that frequent changes in fertility preferences need not lead to dramatically different estimates of unwanted and unintended pregnancy. Greater disagreement among measures emerged when classifying individual pregnancies. Carefully designed retrospective measures are not necessarily more problematic for measuring unintended and unwanted fertility than are more expensive fixed prospective ones.
Journal of Policy Practice 08/2014; 13(4):258-275. DOI:10.1080/15588742.2014.929072