Unintended pregnancy: worldwide levels, trends, and outcomes.
ABSTRACT 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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ABSTRACT: Unplanned pregnancy among the youth is a major public health concern because of the association with unsafe sexual practices. Young women, particularly in rural communities, continue to be most vulnerable to unplanned pregnancies which often end in induced abortion. In South Africa, circumstances influencing women who seek abortion are not thoroughly investigated. The study explored the circumstances shaping the women’s decision to seek termination of pregnancy and assessed the role of the male partner in the decision making process. The study used qualitative approach to conduct in-depth interviews with women seeking termination of pregnancy in a public rural hospital in Thulamela Municipality in Limpopo Province. A total of 30 in-depth interviews were conducted with women aged 15-40 years. Participants pointed to a number of related reasons that compelled them to seek termination of pregnancy. Being too young to have a baby, fear of parental reaction to unplanned pregnancy, and incomplete educational attainment were reasons raised by younger women who were still attending school. For older women, termination of pregnancy was a result of an unstable or weak relationship with partner and was related to financial difficulties. The decision to seek termination of pregnancy was influenced by life and social circumstances which are in relation to each other. Given that all pregnancies were unplanned, there is need to revisit programmes to provide appropriate and client-friendly family planning services to reach adolescents and young women who are at higher risk of seeking termination of pregnancy.African Journal for Physical Health Education, Recreation and Dance 09/2014; 20(September (Supplement 1)):58-73. · 4.03 Impact Factor
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ABSTRACT: Emergency contraception (EC), including both emergency contraceptive pills and the intrauterine device (IUD) used post-coitally, is a unique part of the contraceptive method mix. Clinicians still have an important role to play in making EC information and services available, even though one EC method is available without a prescription in the US and a number of other countries around the world. Women need accurate information about EC in general, and about the specific options that may be most effective for them, including ulipristal acetate and the IUD. Given confusing media messages about EC and weight and unclear clinical guidance, clinicians may wish to pro-actively raise EC in routine clinical encounters. They can also take part in ensuring that EC is offered to women who are receiving treatment after sexual assault.Current Obstetrics and Gynecology Reports. 06/2014; 3(2):150-154.
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ABSTRACT: To evaluate the effect of a digital dispenser's acoustic alarm function on adherence to ethinylestradiol (EE) 20 μg/drospirenone 3 mg in a flexible extended regimen (EE/drospirenoneFlex) among women in five European countries (France, Germany, Italy, Spain, UK) seeking oral contraception. Randomized, parallel-group open-label study. Women aged 18-35 years received EE/drospirenoneFlex administered in a regimen with cycle lengths of their choice with the aid of a digital pill dispenser over 1 year. In group A (N=250), the dispenser's acoustic alarm was activated (ie, acoustic alarm + visual reminder). In group B (N=249), the acoustic alarm was deactivated (ie, visual reminder only). In addition, the women recorded pill intake daily in diary cards. The primary efficacy variable was the mean delay of daily pill release after the dispenser reminded the woman to take a pill (reference time). Secondary efficacy variables included number of missed pills, contraceptive efficacy, bleeding pattern, tolerability, and user satisfaction. Dispenser data showed a mean (standard deviation [SD]) daily delay in pill release of 88 (126) minutes in group A vs 178 (140) minutes in group B (P<0.0001). Median (lower quartile, Q1; upper quartile, Q3) number of missed pills was 0 (0; 1) in group A vs 4 (1; 9) in group B (P<0.0001). Diary card results revealed similar trends; however, underreporting of missed pills was evident in both groups. No pregnancies were reported during 424 women-years of exposure. Across the two groups, the mean (SD) EE/drospirenoneFlex cycle length was 51.0 (31.8) days with strong regional differences, and the mean (SD) number of bleeding/spotting days was 50.4 (33.0) days. EE/drospirenoneFlex was well tolerated, and 80% of women were satisfied with treatment. The dispenser's activated acoustic alarm improved adherence with daily tablet intake of EE/drospirenoneFlex, reducing missed pills. EE/drospirenoneFlex provided effective contraception and a good tolerability profile.International Journal of Women's Health 01/2015; 7:19-29.