Trends and predictors of unintended pregnancy in Canada: Results from a national survey

Abstract

<h3>Objectives</h3> (1) Determine the rates of unintended pregnancy (UP) in sexually active Canadian women; (2) Examine 10-year trends in UP in Canada; (3) Identify contraceptive practices and pregnancy outcomes in women experiencing UP. <h3>Methods</h3> A national cross-sectional Internet-based survey was administered to a nationally representative cohort of women and repeated 10 years later. Sexually active women aged 15–50 years were included in the analysis. Continuous variables were analysed with one-way ANOVA test, and categorical variables with chi-square test. Subanalysis and regression analyses were performed for all women who had experienced UP. <h3>Results</h3> 3284 females were included in the data analysis. 32.5% reported "ever" being pregnant; of these 61% were unintended, a decrease from 10 years prior (64.3%). In total, 19.7% had experienced an UP. Most commonly used contraceptive methods at time of UP were condoms (60%), OCPs (31.8%), and withdrawal (23.4%). Most common reasons for not using contraception at time of UP were "did not think I could get pregnant" and "I was not concerned about pregnancy." Of women experiencing UP, 43.4% completed the pregnancy, 14.7% miscarried, 32.6% terminated the pregnancy (surgical 17%, medical 15.6%), 2.1% utilized adoption services. Odds of UP were significantly higher in 20–29 year olds, those in long-term relationships, and those reporting "never use" of contraception. Odds of pregnancy termination were higher in 20–29 year olds. <h3>Conclusions</h3> UP remains an important public health issue that has significant impacts on the individual and society. These results emphassize the need for ongoing education and support for contraceptive provision and utilization.