Abstract
BackgroundUnintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. In countries like Pakistan where data for the unintended pregnancies is scarce, studies are required to estimate its accurate prevalence and predictors using more specific tools such as the London Measure of Unplanned Pregnancies (LMUP).MethodsWe conducted a hospital based cross sectional survey in two tertiary care hospitals in Pakistan. We used a pre tested structured questionnaire to collect the data on socio-demographic characteristics, reproductive history, awareness and past experience with contraceptives and unintended pregnancies using six item the LMUP. We used Univariate and multivariate analysis to explore the association between unintended pregnancies and predictor variables and presented the association as adjusted odds ratios. We also evaluated the psychometric properties of the Urdu version of the LMUP.ResultsAmongst 3010 pregnant women, 1150 (38.2%) pregnancies were reported as unintended. In the multivariate analysis age < 20 years (AOR 3.5 1.1-6.5), being illiterate (AOR 1.9 1.1-3.4), living in a rural setting (1.7 1.2-2.3), having a pregnancy interval of = < 12 months (AOR 1.7 1.4-2.2), having a parity of >2 (AOR 1.4 1.2-1.8), having no knowledge about contraceptive methods (AOR 3.0 1.7-5.4) and never use of contraceptive methods (AOR 2.3 1.4-5.1) remained significantly associated with unintended pregnancy. The Urdu version of the LMUP scale was found to be acceptable, valid and reliable with the Cronbach's alpha of 0.85.ConclusionsThis study explores a high prevalence of unintended pregnancies and important factors especially those related to family planning. Integrated national family program that provides contraceptive services especially the modern methods to women during pre-conception and post-partum would be beneficial in averting unintended pregnancies and their related adverse outcomes in Pakistan
Highlights
Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality
Given the adverse impact of unintended pregnancies on maternal and neonatal morbidity and mortality, and the lack of available data, our aim was to investigate the prevalence of unintended pregnancy using the London Measure of Unplanned Pregnancies (LMUP) and examine the socio-demographic predictors in Pakistan
This is consistent with the Papua New Guinean, Kenyan and Tanzanian data [20, 33, 37] and makes sense given that younger women have higher fertility, higher frequency of sexual intercourse, lower knowledge of contraceptive methods and higher rates of
Summary
Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. Most of the unintended pregnancies occur in developing countries largely due to poor literacy and lack of knowledge and access to contraceptive methods [3, 4]. In these settings unintended pregnancies contribute significantly to adverse health, social and economic outcomes [4,5,6,7,8] and increase the risks of maternal death and neonatal, infant and child mortality [9]. Unsafe abortion contributes to maternal mortality in Pakistan [14,15,16]
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