Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis

Roy, Tapan Kumar; Singh, Brijesh

doi:10.1371/journal.pone.0164007

Cited by 19 publications

(40 citation statements)

References 6 publications

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“…3%)(6)(7)(8). The proportion of unplanned pregnancy was higher in our study compared to the developed countries such as the Islamic Republic of Iran (11.1%), Belgium (2%), Kenya (18%), the United Kingdom (16.2%)(17,18,52,58).Although our results differ from previous Sri Lankan studies which have reported a higher prevalence of unplanned pregnancies, they are consistent with South Asian studies.…”

supporting

confidence: 70%

“…Lankan DHS in 2016 awareness on emergency contraceptives was 53.1% which was consistent with the current research findings (41). Studies in Pakistan, Bangladesh and, Nepal assessed the overall contraceptive knowledge and it showed that poor knowledge was significantly associated with unplanned pregnancy and reason is self-explanatory (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Of the global pregnancies, 40% were unplanned (2), of which 50% ended in abortion, 13% were miscarriages and 38% were live births (4,5). In low and middle-income countries, the incidence of unplanned pregnancies varies from 14% to 62% with Nepal having 41% (6), Pakistan 38.2% 7, Bangladesh 30.3% (8) and Sri Lanka 23.3% (9).…”

Section: Introductionmentioning

confidence: 99%

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Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka

Ranatunga¹,

Jayaratne²

2020

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Background Unplanned pregnancy is a significant public health issue in both low- and high-income countries. The burden of unplanned pregnancy is reflected in women opting for pregnancy terminations and it can be detrimental to the women and her family as well as the health system and society. Solid data on the proportion of unplanned pregnancies are using more specific tools such as the London Measure of Unplanned Pregnancy (LMUP) needed to address the issue in Sri Lankan contexts. The objective was to describe the proportion of unplanned pregnancies, their determinants and the health outcomes of women delivering at Colombo North Teaching Hospital-Ragama (CNTH).Methods A cross-sectional study was carried out among 494 consecutive pregnant women selected by non-probability consecutive sampling who were admitted for the confinement at CNTH. A pre-tested structured interviewer-administered questionnaire was used to collect data on antenatal women and intentionality measured by self-administered six-item LMUP. Maternal and newborn health outcomes were ascertained in each post-partum women before discharge. Data were analyzed with the Mann-Whitney U tests, Kruskal-Wallis tests and spearman rank correlation. We also evaluated the psychometric properties of the Sinhalese version of LMUP. Results The response rate was 97.8% and 17.2% of pregnancies ending at birth were unplanned, 12.7% were ambivalent and 70.1% were planned. Associated factor profile of women with unplanned pregnancies includes; not married women (p=0.001), educated up to the passing of GCE ordinary level by women (p<0.001) and spouse (p<0.001), primiparity (p=0.002) and inadequate knowledge on emergency contraceptives (p=0.037). Less planned pregnancies were also significantly associated with anemia (p=0.004), low mood for last two weeks (p<0.001), having a partner with problematic alcohol consumption (p<0.001), presence of Gender-Based Violence (GBV) (p<0.001), poor relationship satisfaction with partner (p<0.001) and family (p<0.001). Inadequate pre-pregnancy preparation and antenatal care were associated with an unplanned pregnancy. No differences were found in neonatal outcomes. Sinhalese version of the LMUP scale was found to be accepted, valid and reliable with the Cronbach's alpha of 0.936. Conclusions A sizeable proportion of pregnancies were unplanned. Teenage pregnancies, non-marital relationships and inadequate knowledge on emergency contraceptives, maternal anemia, low mood, and GBV were modifiable associated factors which could be prevented by evidence-based locally applicable approaches.

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confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka

Ranatunga¹,

Jayaratne²

2020

Preprint

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“…Studies that analysed unwanted childbearing in Bangladesh show that women's current age, marriage at an younger age, religion, low educational attainment by women, exposure to mass-media, husband's desire for more children, and unmet need for FP exerts signi cant in uence on unwanted childbearing [16,17].…”

Section: Studies On Unintended Childbearing In Different Countries Exmentioning

confidence: 99%

“…Main reasons for this non-use of birth control can be child replacement (because of child mortality), sex preferences, lack of access to FP services, inability of women to implement their reproductive preferences because of the opposition of husband or others, and unavailability of birth control [27]. Besides these, unwanted birth may also result from contraceptive failure that largely depends upon the quality of FP programmes [11,17].…”

Section: Analytical Framework For Analysing Unwanted Childbearingmentioning

confidence: 99%

Drivers of unwanted births in Bangladesh (2004 ̶ 2014): A decomposition analysis

Mahfuzur

Tasnim

2020

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BackgroundIn Bangladesh, about 30 percent of the total births a woman on average have (2.3 births) are unwanted. Reduction in unwanted births is very important for family wellbeing, and control of rapid population growth. This reduction requires in-depth knowledge about the factors associated with the change in unwanted childbearing. This study examines the contributions of population structure, external factors that is family planning programmes, and their interaction to the change in the proportion of women having unwanted birth during MethodsThis study uses the notion of standardization approach for measuring the effects of family planning programmes and non-programme factors on unwanted childbearing. Using Bangladesh Demographic and Health Survey data, we employ both aggregate and detailed three-fold decomposition technique to decompose the changes in the proportion having unwanted birth into the contributions of the three different factors. In decomposing the changes, we use logistic regression estimates. ResultsAbout 10.3 percent women are found to have unwanted birth in 2014. This percentage remains almost unchanged during 2004−2007, but declines significantly during 2007−2011 and 2011−2014. Population structure exerts significant reducing effect on proportion having unwanted birth during all the study periods, while external factors exerts significant negative effect only during 2011−2014.Interaction effect is found non-significant during all the study periods. All the factors found significantly associated with unwanted childbearing in logistic regression analysis do not show significant effect on its changes in detailed decomposition analysis. Structural effects of respondent's age at marriage and education are found significantly negative during all the study periods. ConclusionsIn Bangladesh, significant reducing effect of population structure amid non-declining family planning programmes reduces the proportion having unwanted birth, while simultaneous reducing effects of structure and family planning programmes during a period result in a more pronounced decline.

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Does unintended pregnancy have an impact on skilled delivery care use in Bangladesh? A nationally representative cross-sectional study using Demography and Health Survey data

Khan

Harris

2020

J. Biosoc. Sci.

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Skilled delivery care has been targeted in the Sustainable Development Goals to reduce preventable maternal and newborn deaths, which mostly occur because of birthing complications. Birthing complications are more frequent in women with unintended than intended pregnancies, and around 43% of total pregnancies in low- and middle-income countries are unintended. This study quantified the impact of unintended pregnancy on skilled birth attendance and delivery in health care facilities in Bangladesh. Data from 4493 women participating in the cross-sectional 2014 Bangladesh Demographic and Health Survey were analysed. Multilevel logistic regression models were used to assess the association of unintended pregnancy with skilled birth attendance and delivery in a health care facility through skilled providers while adjusting for individual-, household- and community-level factors identified using a directed acyclic graph. Around 26% of women reported that their last pregnancy (occurring within the previous 3 years) that ended with a live birth was unintended at conception. Only 42% reported having a skilled birth attendant present at their last birth and 38% gave birth in a health care facility. Significant differences were found across pregnancy intention. Lower odds of skilled birth attendance (OR, 0.70, 95% CI, 0.52–0.93) and delivery in a health care facility through skilled providers (OR, 0.65, 95% CI, 0.48–0.89) were found among women who had an unwanted pregnancy relative to women who had a wanted pregnancy. However, a mistimed pregnancy was not found to be associated with skilled birth attendance or delivery in health care facility through skilled providers. Increased availability of health care facilities at the community level is required in Bangladesh to ensure skilled delivery care for women with an unwanted pregnancy. Policies are also required to integrate women with an unwanted pregnancy into mainstream health care services through earlier detection and increased awareness in order to reduce the adverse maternal and fetal outcomes associated with lack of quality birthing care.

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Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis

Cited by 19 publications

References 6 publications

Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka

Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka

Drivers of unwanted births in Bangladesh (2004 ̶ 2014): A decomposition analysis

Does unintended pregnancy have an impact on skilled delivery care use in Bangladesh? A nationally representative cross-sectional study using Demography and Health Survey data

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