Unintended pregnancy and abortion: what does it tell us about reproductive health and autonomy?

Kantorová, Vladimíra

doi:10.1016/s2214-109x(20)30342-9

Cited by 21 publications

(19 citation statements)

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“…Internationally comparable estimates of unintended pregnancy and abortion incidence can illuminate disparities in sexual and reproductive health and autonomy 1. Regional average model-based estimates have made global comparisons over time possible 2–8.…”

Section: Introductionmentioning

confidence: 99%

“…Regional average model-based estimates have made global comparisons over time possible 2–8. However, these studies have not provided the country-specific estimates that would allow country stakeholders to understand their own sexual and reproductive health context and to compare with other countries which may differ in policies and other factors which influence individuals’ ability to access care 1. This limits our understanding of these widespread phenomena which can substantially affect patterns of fertility and family formation.…”

Section: Introductionmentioning

confidence: 99%

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Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019

et al. 2022

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IntroductionInternationally comparable estimates of unintended pregnancy and abortion incidence can illuminate disparities in sexual and reproductive health and autonomy. Country-specific estimates are essential to enable international comparison, and to inform country-level policy and programming.MethodsWe developed a Bayesian model which jointly estimated unintended pregnancy and abortion rates using information on contraceptive needs and use, contraceptive method mix, birth rates, the proportions of births from unintended pregnancies and abortion incidence data. Main outcomes were the estimated rates of unintended pregnancy and abortion for 150 countries and territories, reported for the 5-year period 2015–2019, as annual averages per 1000 women aged 15–49 years.ResultsEstimated unintended pregnancy rates ranged from 11 (80% uncertainty interval: 9 to 13) in Montenegro to 145 (131 to 159) in Uganda per 1000 women aged 15–49 years. Between-country heterogeneity was substantial in all Sustainable Development Goal (SDG) regions, but was greatest in sub-Saharan Africa. Estimated abortion rates ranged from 5 (5 to 6) in Singapore to 80 (55 to 113) in Georgia. Variation between country estimates was similar in all SDG regions except for Europe and Northern America, where estimated abortion rates were generally lower.ConclusionThe estimates reflect variation in the degree to unintended pregnancy and abortion that are experienced in countries throughout the world. This evidence highlights the importance of investing in access to contraception and comprehensive abortion care, including in regions which may have lower rates of unintended pregnancy or abortion, respectively, as countries may differ substantially from regional averages.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019

et al. 2022

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“…1 Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. 2 In addition to abortion and its complications, 3 , 4 unintended pregnancy costs to health and social services impose significant emotional distress on women and their families. 5 Therefore, it is vital to prevent unintended pregnancy based on evidence to save the costs of abortion and its complications and reduce the morbidity and mortality of women and their children.…”

Section: Introductionmentioning

confidence: 99%

Unintended Pregnancy and Associated Factors Among Women Attending Antenatal Care in Public Hospitals During COVID-19 Pandemic, Southwest Ethiopia: A Cross-Sectional Study

Tenaw¹,

Chemir²,

Chekole³

et al. 2022

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Background COVID-19 pandemic directly or indirectly increases the burden of unintended pregnancy by limiting women’s access to family planning and other reproductive health services. COVID-19 results in extra 15 million unintended pregnancies over a year. Almost all previous studies conducted about unintended pregnancy were before COVID-19 pandemic in Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care in public hospitals of southwest Ethiopia. Methods This study was cross-sectional and conducted among women attending antenatal care at public hospitals of southwest Ethiopia from June 14 to July 14, 2021. Data were collected using a face-to-face interview. Factors associated with unintended pregnancy were analyzed using binary and multiple logistic regressions with an adjusted odds ratio and 95% confidence interval. Finally, the p-value was used as a graded measure of evidence to quantify the degree of significance. Results A total of 405 women participated in this study. The overall prevalence of unintended pregnancy was 19.5% (95% CI: 1.44–6.92) among women attending antenatal care during COVID-19 pandemic. Of which, 50.6% were mistimed and 49.4% unwanted. Urban residence (AOR: 3.1 95% CI: 1.44–6.92) and not being primary decision-maker (AOR: 2.85 95CI: 1.18–6.88) had high significance with unintended pregnancy. Not having ANC in a previous pregnancy (AOR: 3.40; 95% CI: 1.02–11.94) and not being exposed to community education about maternal health care (AOR: 2.36; 95% CI: 1.06–5.27) had medium significance with unintended pregnancy. Conclusion One-fifth of women attending antenatal care had unintended pregnancies during the COVID-19 pandemic. Efforts to scale up women’s decision-making power on family planning services and access to community education are needed to prevent unintended pregnancy.

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“…Diminished sexual autonomy among women also elevates the risks of adverse sexual and reproductive health outcomes such as sexually transmitted diseases [ 14 , 15 ], unintended pregnancies [ 16 , 17 ], unsafe abortions [ 18 ], and poor access to effective modern contraceptives [ 19 , 20 ]. There is also evidence that lack of sexual autonomy is a key source of mental health challenge among childbearing women [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Multi-level predictors of sexual autonomy among married women in Nigeria

et al. 2022

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Background Extant studies have established diverse individual-level and relational-level predictors of sexual autonomy among women in different countries. However, information remains scanty about the predictors beyond the individual and relational levels particularly at the community level. This study examined the multi-level predictors of sexual autonomy in Nigeria. This was done to shed more light on the progression toward attaining women-controlled safe sex in Nigeria. Methods This study adopted a cross-sectional design that utilised the 2018 Nigeria Demographic and Health Survey (NDHS) data. The study analysed responses from 8,558 women. The outcome variable was sexual autonomy, while the explanatory variables were individual-level (maternal age group, maternal education, nature of first marriage, parity, work status, religion, and media exposure), relational-level (spousal violence, type of marriage, spousal living arrangement, household wealth quintile, alcoholic consumption, family decision-making, and degree of marital control), and community-level characteristics (community residency type, geographic region, community literacy, female financial inclusion in community, female ownership of assets in community, and community rejection of wife-beating). Statistical analyses were performed using Stata version 14. The multilevel regression analysis was applied. Statistical significance was set at p < 0.05. Results Findings showed that parity, nature of first marriage, maternal education, media exposure, work status, and religion were significant individual-level predictors, while spousal violence, degree of marital control, type of marriage, family decision-making, and household wealth quintile were significant relational-level predictors of sexual autonomy. Results further showed that community-level characteristics also significantly predicted sexual autonomy. The likelihood of sexual autonomy was lower among rural women (aOR = 0.433; 95% CI 0.358–0.524), while the odds of sexual autonomy were higher among Southern women (aOR = 3.169; 95% CI 2.594–3.871), women who live in high literate communities (aOR = 3.446; 95% CI 3.047–3.897), women who reside in communities with high female financial inclusion (aOR = 3.821; 95% CI 3.002–4.864), and among women who live in communities with high female ownership of assets (aOR = 1.907; 95% CI 1.562–2.327). Conclusion Women’s sexual autonomy was predicted by factors operating beyond the individual and relational levels. Existing sexual health promotion strategies targeting individual and relational factors in the country should be modified to adequately incorporate community-level characteristics. This will enhance the prospect of women-controlled safe sex in Nigeria.

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Unintended pregnancy and abortion: what does it tell us about reproductive health and autonomy?

Cited by 21 publications

References 7 publications

Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019

Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019

Unintended Pregnancy and Associated Factors Among Women Attending Antenatal Care in Public Hospitals During COVID-19 Pandemic, Southwest Ethiopia: A Cross-Sectional Study

Multi-level predictors of sexual autonomy among married women in Nigeria

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