Unintended Pregnancy: Worldwide Levels, Trends, and Outcomes

Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, USA.
Studies in Family Planning (Impact Factor: 1.28). 12/2010; 41(4):241-50. DOI: 10.2307/27896274
Source: PubMed


Unintended pregnancy can carry serious consequences for women and their families. We estimate the incidence of pregnancy by intention status and outcome at worldwide, regional, and subregional levels for 2008, and we assess recent trends since 1995. Numbers of births are based on United Nations estimates. Induced abortions are estimated by projecting from recent trends. A model-based approach is used to estimate miscarriages. The planning status of births is estimated using nationally representative and small-scale surveys of 80 countries. Of the 208 million pregnancies that occurred in 2008, we estimate that 41 percent were unintended. The unintended pregnancy rate fell by 29 percent in developed regions and by 20 percent in developing regions. The highest unintended pregnancy rates were found for Eastern and Middle Africa and the lowest for Southern and Western Europe and Eastern Asia. North America is the only region in which overall and unintended pregnancy rates have not declined. We conclude with a brief discussion of global and regional program and policy implications.

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    • "In 2008, 41% of the 208 million pregnancies estimated worldwide were unintended (Singh et al., 2010). Among women aged 15–44 years in low-and middle-income countries, the rates of unintended pregnancies declined by 20% from 71 to 57 per 1000 from 1995 to 2008 (Singh et al., 2010). However, the figures are still high. "
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    ABSTRACT: This paper assesses the factors influencing mistimed and unwanted pregnancies in Nepal separately using data from the 2011 Nepal Demographic and Health Survey. Women who had given birth within the five years before the survey were interviewed about the intendedness of their last pregnancy. The data were analysed with a chi-squared test, followed by multiple logistic regression analysis. Among the total 5391 participants, 11.29% and 13.13% reported their last pregnancy as mistimed and unwanted respectively. Logistic regression analysis showed that women from the hill region were more likely to report mistimed pregnancy, while women from the Western and Far-Western development regions were less likely to report mistimed pregnancy. Education status was positively correlated with the reporting of mistimed pregnancy. Women involved in agriculture, with full autonomy on household decision, with some exposure to mass media, belonging to higher age group and having third or higher parity were less likely to report mistimed pregnancy. Similarly, women from the Western development region had relatively higher odds of reporting unwanted pregnancy. Women with husbands involved in a paid job had lower odds of unwanted pregnancy. Women's autonomy was also positively correlated with unwanted pregnancy. Women with the intention to use contraceptive had lower odds of unwanted pregnancy. Interventions targeting the factors identified by this study could be useful in reduction of mistimed and unwanted pregnancies among Nepali women.
    Journal of Biosocial Science 05/2015; -1:1-18. DOI:10.1017/S0021932015000073 · 0.98 Impact Factor
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    • "Data from the United States indicate that roughly one-half of all pregnancies were unintended at the time of conception, with mistimed more common than unwanted pregnancies (Finer & Henshaw, 2006; Forrest, 1994; Gazmararian et al., 1995; Korenman, Kaestner, & Joyce, 2002; Marsiglio & Mott, 1988; Pulley, Klerman, Tang, & Baker, 2002). Estimates of levels of unintended pregnancies in developing countries rely heavily on Demographic and Health Survey (DHS) data (Singh, Sedgh, & Hussain, 2010). "
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    ABSTRACT: Sex ratios in India have become increasingly imbalanced over the past decades. We hypothesize that when sex ratios become very uneven, the shortage of girls will increase girls' future value, leading sex ratios to self-correct. Using data on children under 5 from the last four Indian censuses, we examine the relationship between the sex ratio at one point in time and the change in sex ratio over the next 10 years by district. Fixed-effects models show that when accounting for unobserved district-level characteristics-including total fertility rate, infant mortality rate, percentage literate, percentage rural, percentage scheduled caste, percentage scheduled tribe, and a time trend variable-sex ratios are significantly negatively correlated with the change in sex ratio in the successive 10-year period. This suggests that self-corrective forces are at work on imbalanced sex ratios in India.
    Demography 12/2014; 52(2). DOI:10.1007/s13524-014-0356-z · 1.93 Impact Factor
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    • "However, the percentages of pregnancies that are unintended vary geographically ; 38%, 39%, 44%, 48% and 58% in Asia, Africa, Europe and North America (US and Canada combined) and Latin America/Caribbean, respectively. Within Europe, the percentages of pregnancies that are unintended range from 39% in Southern Europe to 48% in Eastern Europe [1]. Up to 50% of unintended pregnancies can be attributed to contraceptive failure or non-compliance [2]. "
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    ABSTRACT: Objectives: To evaluate healthcare providers' (HCPs') knowledge, attitudes and beliefs regarding intrauterine contraception (IUC). Study design: HCPs in eight European countries and Canada who saw at least 20 women per month for contraception completed an online questionnaire. Responses were evaluated by country. Results: In total, 1103 HCPs completed the survey: 633 obstetrician-gynecologists, 335 general practitioners and 135 family planning clinicians (physician, midwife or nurse). When respondents in different countries were asked to report their three main barriers to considering IUC, predominant concerns were nulliparity (34-69%) and pelvic inflammatory disease (PID; 14-83%) for women in general, and insertion difficulty (25-83%), PID (17-83%), insertion pain (7-60%) and infertility (6-55%) for nulliparous women. In addition, 4-59% of HCPs reported that they never proactively include IUC in contraceptive counseling for a nulliparous woman, regardless of her age. Furthermore, only 30-61% of respondents correctly identified that, in the World Health Organization medical eligibility criteria for IUC, nulliparity is category 2 (benefits outweigh risks). Conclusions: HCPs in Europe and Canada have clear gaps in their knowledge regarding IUC and misplaced concerns persist, particularly regarding use of IUC in nulliparous women; the predominant misconceptions are about PID, insertion difficulty and insertion pain. Further education on the evidence is needed so that IUC is recognized as being suitable for young and nulliparous women and is included in contraceptive counseling.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 10/2014; 183. DOI:10.1016/j.ejogrb.2014.10.020 · 1.70 Impact Factor
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