Effects Of Unintended Pregnancy Research Articles

Unintended pregnancy and antenatal care behavior in Indonesia

<p><strong><em>Background: </em></strong><em>One in four mothers experience u</em><em>nwanted pregnancy. It causes great risks for mothers and children, such as malnutrition, neglected, violence and even death. During pregnancy, a woman is expected to take the initiative and change her behavior by taking adequate care. Antenatal care is a part of maternal and child health services that are vital in early detection and monitoring of fetal well-being as an efforts to improve the health of mothers and babies during pregnancy, childbirth and postpartum. The mother's intention towards her pregnancy, whether desired or not, is related to the mother's behavior during pregnancy. Unintended pregnancy can obstruct the achievement of adequate antenatal care.</em><em>.</em></p><p><strong><em>Objectives: </em></strong><em>This study aims to determine the relationship between unintended pregnancy and antenatal care behavior</em></p><p><strong><em>Methods: </em></strong><em>This study used a cross-sectional design with the secondary data from 2017 Indonesian Demographic Health Survey. The dependent variable in this study was antenatal care behavior which is a composite of the first antenatal visit, frequency of antenatal visit and iron consumption. There were 14.223 women of childbearing age 15-49 years which eligible for this study’s criteria. The collected data was analyzed with chi square and logistic regression models of risk factors test</em><em></em></p><p><strong><em>Results:</em></strong><em> Mothers with unintended pregnancies have a bigger opportunity to do unhealthy antenatal care behavior (OR = 2.338: 95% CI 1.707- 3.203) compared to intended pregnancies. The effect of unintended pregnancy on antenatal care behavior varies according to maternal age (OR- 1.267: 95% CI 1.034-1.553), parity (OR= 0.579: 95% CI 0.430-0.780) and residency (OR= 1.490: 95% CI 1.226- 1.811).</em><em></em></p><p><strong><em>Conclusions: </em></strong><em>There is a relationship between unintended pregnancy and antenatal care behavior. Mothers with unintended pregnancies is 2.338 times more likely to have unhealthy antenatal behavior care. We also found that this effect differs according to the maternal age, parity and residency.</em><em> </em><em></em></p>

Effect of unintended pregnancy on skilled antenatal care uptake in Bangladesh: analysis of national survey data

BackgroundAround 48% of all pregnancies in low- and middle-income countries are unintended. Unintended pregnancy may contribute to lower use of antenatal care (ANC); however, current research in the area is largely inconclusive due to the methodological approaches applied.MethodsResponses from 4493 women extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) were used to assess the association between unintended pregnancy and subsequent uptake of at least one and at least four skilled ANC visits. For this, Bayesian multilevel logistic regression models with informative priors (representing a range of values within which the researcher is certain the true effect of the parameters included lies) were used, adjusting for other factors that affect ANC uptake. Informative priors were selected from the BDHS data collected in 2004, 2007, and 2011.ResultsAround 64% of women in Bangladesh who had at least one pregnancy within 3 years prior to the survey (that ended in a live birth) received ANC at least once, and of these around 32% used ANC at least four times. Mistimed (aOR, 0.73, 95% Cred I, 0.66–0.81) and unwanted (aOR, 0.69, 95% Cred I, 0.64–0.75) pregnancy were associated with reduced odds of attending the recommended minimum of four skilled ANC visits compared with wanted pregnancy. These likelihoods were even lower for at least one skilled ANC visit among women with a mistimed (aOR, 0.59, 95% Cred I, 0.53–0.65) or an unwanted pregnancy (aOR, 0.67, 95% Cred I, 0.61–0.74) than women with a wanted pregnancy.ConclusionsIn Bangladesh, more than one-quarter of women who report an unintended pregnancy at conception and do not terminate the pregnancy are at high risk of not using ANC. It is important for policies to include women with unintended pregnancy in mainstream healthcare services. This will increase the use of ANC and reduce associated adverse consequences.

Pregnancy Intention and Associated Maternal Behaviors during Pregnancy among Pregnant Women in Gamo-Goffa Zone, Southern Ethiopia

Introduction: Pregnancy is a happy event for women when it is intended. Instead, an unintended pregnancy leads the mother to unhealthy behaviors which in turn causes maternal mortality and morbidity. But limited evidence exists on the effects of unintended pregnancy on maternal behaviors during pregnancy in Ethiopia particularly in the study area. Therefore, this study aimed to identify the effect of pregnancy intention on maternal behaviors during pregnancy among pregnant women in Gamo-Goffa Zone, Southern Ethiopia. Methods: Community-based cross-sectional study design employed in Gamo-Goffa Zone from March, 13 to April 13, 2017. Using multi-stage stratified sampling technique 770 pregnant women were selected and enrolled in the study. The logistic regression was performed to identify the independent effect of pregnancy intention on maternal behaviors. Results: More than one-third (36.2%) study participants experienced an unintended pregnancy. Women with unintended pregnancy were 69% times less likely to receive antenatal care (AOR = 0.31, 95% CI (0.21 – 0.46)); four times more likely to initiation antenatal care late (AOR = 4.40, 95% CI (1.70 – 11.40)) and three times more likely to use the substance (AOR = 3.01, 95% CI (1.81 – 5.02)) during pregnancy. Conclusion: Women with unintended pregnancy are less likely to receive recommended antenatal care and more likely to engage in risky behaviors. Therefore, besides promotion on the utilization of effective contraception to prevent unintended pregnancy, behavioral change communications directed toward increasing utilization of antenatal care and minimization of risky behaviors are recommended to attain healthy behaviors during any type of pregnancy.

The Effect of Unintended Pregnancy Among Married Women on the Length of Breastfeeding in Indonesia

The coverage of exclusive breastfeeding in Indonesia in 2017 is 35%, far below the recommendations of WHO (World Health Organization) of 50%. This rate is getting lower in unwanted pregnancies. Every year there is13.3% incidence of unwanted pregnancy in women aged 15-44 years. It has an impact on the mental, psychological condition of the mother in the process of child care and nutrition from birth. This study aims to determine the prevalence and relationship of unwanted pregnancy among married women on the duration of breastfeeding in Indonesia. This research wa a quantitative study using cross -sectional study design, a sample of 5,163 married women, and aged 15-49 years. Data were analyzed using univariate descriptive statistics on complex sample analysis, bivariate analysis using Chi-Square, and multivariate using logistic regression tests of risk factor models. This study showed that 1,267 mothers who breastfed <6 months and there was a relationship between the unwanted pregnancy with the duration of breastfeeding (p-value: 0.007 with PR: 1.349; 95% CI: 1.085-1.676) after been controlled by the use of contraception. The support of husband and health workers during pregnancy, childbirth until child care is needed to support breastfeeding

The Role of Father Involvement and Intimate Partner Violence on Postnatal Depression Among Women With Unintended Pregnancy.

This study set out to fill the research gap by including various aspects of father involvement and intimate partner violence (IPV) in the examination of the association between unintended pregnancy and maternal postnatal depression (PND). This study aimed to examine the effect of father involvement and IPV on the association between unintended pregnancy and PND. A sample of 1,083 pregnant women who attended antenatal clinic at selected hospitals in Hong Kong completed two surveys to report on their pregnancy intention, antenatal depression, PND, IPV during pregnancy, their partner's (i.e., father's) involvement during pregnancy and after childbirth, and perceived social support. Comparisons were made between women with unintended pregnancy and those with intended pregnancy, and the effects of unintended pregnancy, father involvement, IPV, and other factors on maternal PND were examined. Results show that women with unintended pregnancy were more likely to report PND, IPV, fear, postnatal stress, lower degree of father involvement, and lower level of social support. Unintended pregnancy independently increased the risk of PND by 1.95 times (95% confidence interval [CI] = [1.15, 3.28]), after adjustment for all other variables. When father involvement was included in the regression model, the negative effects of IPV and the related fear on PND became nonsignificant. The positive association between unintended pregnancy and PND was robust. Father involvement might help promote maternal health by reducing the negative effects of IPV on PND.

Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis

To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries. A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics. A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25-39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted). Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.

Future directions in performance measures for contraceptive care: a proposed framework

In the United States, almost half (45%) of the approximately 6 million pregnancies each year are unintended [ [1] Finer L.B. Zolna M.R. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016; 374: 843-852 Crossref PubMed Scopus (1269) Google Scholar ]. These statistics indicate that many women experience barriers to achieving their desired reproductive outcomes, which has potential adverse consequences for women, children and society at large, such as higher rates of preterm birth, lower rates of breastfeeding and lower educational attainment [ 2 Conde-Agudelo A. Rosas-Bermudez A. Kafury-Goeta A.C. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006; 295: 1809-1823 Crossref PubMed Scopus (765) Google Scholar , 3 DeFranco E.A. Seske L.M. Greenberg J.M. Muglia L.J. Influence of interpregnancy interval on neonatal morbidity. Am J Obstet Gynecol. 2015; 212: 386.e381-386.e389 Abstract Full Text Full Text PDF Scopus (38) Google Scholar , 4 Gipson J.D. Koenig M.A. Hindin M.J. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plan. 2008; 39: 18-38 Crossref PubMed Scopus (601) Google Scholar , 5 Sawhill I. Karpilow Q. Venator J. Families CoCa The impact of unintended childbearing on future generations. Brookings Institution, Washington, DC2014 Google Scholar , 6 Tsui A.O. McDonald-Mosley R. Burke A.E. Family planning and the burden of unintended pregnancies. Epidemiol Rev. 2010; 32: 152-174 Crossref PubMed Scopus (240) Google Scholar ]. Contraceptive care is a highly effective clinical intervention that can substantially reduce those adverse outcomes, help individuals and couples achieve their desired number and spacing of children, and save money [ 7 Foster D.G. Biggs M.A. Malvin J. Bradsberry M. Darney P. Brindis C.D. Cost-savings from the provision of specific contraceptive methods in 2009. Womens Health Issues. 2013; 23: e265-e271 Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar , 8 Frost J. Finer L. Tapales A. The impact of publicly funded family planning clinic services on unintended pregnancies and government cost savings. J Health Care Poor Underserved. 2008; 19: 778-796 Crossref PubMed Scopus (57) Google Scholar , 9 Frost J.J. Sonfield A. Zolna M.R. Finer L.B. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program. Milbank Q. 2014; 92: 696-749 Crossref PubMed Scopus (61) Google Scholar , 10 Sonfield A. Kost K. Institute TG Public costs from unintended pregnancies and the role of public insurance programs in paying for pregnancy and infant care: estimates for 2010. The Guttmacher Institute, New York, NY2015 Google Scholar , 11 Trussell J. Contraceptive failure in the United States. Contraception. 2011; 83: 397-404 Abstract Full Text Full Text PDF PubMed Scopus (982) Google Scholar ]. However, many women at risk of unintended pregnancy do not use contraception or use it incorrectly or inconsistently [ 12 Daniels K. Daugherty J. Jones J. Mosher W. Current contraceptive use and variation by selected characteristics among women aged 15–44: United States, 2011–2013. US National Center for Health Statistics, Hyattsville, MD2015 Google Scholar , 13 Jones R. Tapales A. Lindberg L. Frost J. Using longitudinal data to understand changes in consistent contraceptive use. Perspect Sex Reprod Health. 2015; 47: 131-139 Crossref PubMed Scopus (36) Google Scholar ], and there are documented barriers in access to and quality of contraceptive care services available [ [14] Obstet Gynecol. 2015; 125: 250-255 Crossref PubMed Google Scholar ].

Comparison of unintended and intended pregnancy outcomes

Comparison of unintended and intended pregnancy outcomes

Preconception Women’s Health and Pediatrics: An Opportunity to Address Infant Mortality and Family Health

THE U.S. INFANT mortality rate remains unacceptably high, with large disparities found by race. Increasingly, research has demonstrated that interventions must go beyond ensuring access to care and prenatal focus to address the preconception health of women. Critical fetal development occurs in the earliest weeks after conception, often before a woman is aware of her pregnancy. The Maternal Child Health Bureau’s life course initiatives and the Centers for Disease Control’s preconception health initiatives are placing infant mortality and child health in a life course context, that is, uniting the reproductive health and pediatric longitudinal perspectives. In the recent report “Clinical Preventive Services forWomen”, the Institute ofMedicine recommended annual well-women visits incorporating preconception care, and Healthy People 2020 includes a section of objectives on preconception health and behaviors. With growing scientific recognition that early antecedents of child and adult health start prenatally and even preconceptionally, women’s health is key. Pediatric clinicians have been leaders in the efforts to reduce infant mortality and in family-centered care, but how can pediatrics further contribute? A golden opportunity exists to serve as preconception care (PCC) clinicians for preconceptional adolescents and interconceptional mothers seen in practice.