Abstract

BackgroundAddressing women’s inaccurate perceptions of their risk of pregnancy is crucial to improve contraceptive uptake and adherence. Few studies, though, have evaluated the factors associated with underestimation of pregnancy risk among women at risk of unintended pregnancy.MethodsWe assessed the association between demographic and behavioral characteristics and underestimating pregnancy risk among reproductive-age, sexually-active women in Hanoi, Vietnam who did not desire pregnancy and yet were not using highly-effective contraception (N = 237). We dichotomized women into those who underestimated pregnancy likelihood (i.e., ‘very unlikely’ they would become pregnant in the next year), and those who did not underestimate pregnancy likelihood (i.e., ‘somewhat unlikely,’ ‘somewhat likely’ or ‘very likely’). We used bivariable and multivariable logistic regression models to identify correlates of underestimating pregnancy risk.ResultsOverall, 67.9% (n = 166) of women underestimated their pregnancy risk. In bivariable analysis, underestimation of pregnancy risk was greater among women who were older (> 30 years), who lived in a town or rural area, and who reported that it was “very important” or “important” to them to not become pregnant in the next year. In multivariable analysis, importance of avoiding pregnancy was the sole factor that remained statistically significantly associated with underestimating pregnancy risk (odds ratio [OR]: 0.11; 95% confidence interval [CI], 0.05–0.25). In contrast, pregnancy risk underestimation did appear to vary by marital status, ethnicity, education or other behaviors and beliefs relating to contraceptive use.ConclusionsFindings reinforce the need to address inaccurate perceptions of pregnancy risk among women at risk of experiencing an unintended pregnancy.

Highlights

  • Addressing women’s inaccurate perceptions of their risk of pregnancy is crucial to improve contraceptive uptake and adherence

  • The analysis is based on 237 women who were susceptible to unintended pregnancy

  • Women living in a town or rural area had four-fold greater odds of pregnancy risk underestimation relative to women living in a city (OR, 4.0; 95% Confidence interval (CI), 1.0–15.9)

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Summary

Introduction

Addressing women’s inaccurate perceptions of their risk of pregnancy is crucial to improve contraceptive uptake and adherence. Unintended pregnancies, defined as pregnancies that are unwanted or mistimed at the time of conception, pose a substantial social and economic burden for women and their families. Consequences of these pregnancies include poor birth outcomes [2], increased levels of pregnancy-related morbidity and mortality [3, 4], as well as mental health. In another study of women attending reproductive healthcare clinics in the United States, Biggs et al found that 27% of women planning to use no method or a low-efficacy contraceptive method (i.e., natural family planning, withdrawal, diaphragm, or sponge) underestimated their risk of pregnancy from engaging in 1 year of unprotected intercourse [15]

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