A cross-sectional study on alcohol and contraception use among sexually active women of childbearing age: Implications for preventing alcohol-exposed pregnancies.

Abstract

A high proportion of unwanted or unplanned pregnancies may be alcohol-exposed due to contraception failure or non-use. Nevertheless, data on contraception and alcohol use in the context of the risk of alcohol-exposed pregnancies are sparse. To describe contraception use and alcohol consumption in sexually active non-pregnant women and investigate the factors associated with less effective contraception methods. A cross-sectional national survey of women aged 18-35 years. Data from non-pregnant women who were sexually active (n = 517) were analysed. Descriptive statistics were used to report demographics, consumption, and contraception measures. Logistic regression was used to investigate the factors associated with less effective contraception among drinkers. The majority of participants were younger (46%), of NZ European ethnicity (78%), not in a permanent relationship (54%), with some or completed tertiary education (79%), employed (81%) and not users of the community services card (82%). Twenty-five percent of women were smokers, 94% consumed alcohol, and 72% binged at least 'monthly or less'. Most women used the pill (56%), and 20% of drinking women were using a contraception method with a 10% or more annual failure rate after 1 year of use. Women who binged 'weekly or more often' had similar odds of using less effective contraception as women who 'never' binged (p > 0.05). Younger Māori or Pacific women (odds ratio = 5.99; 95% confidence interval of odds 1.15-31.2; p = 0.033) and women who had no tertiary education (odds ratio = 1.75; 95% confidence interval of odds 0.00-3.06; p = 0.052) had higher odds of using less effective contraception. With 20% of women at risk of an alcohol-exposed pregnancy, public health measures to address alcohol consumption and the effective use of contraception are critical to reducing the risk for alcohol-exposed pregnancies in NZ.