Impact Of Unintended Pregnancy Research Articles

Knowledge, attitudes, and practices of community pharmacists providing over-the-counter emergency hormonal contraception: a scoping review.

Reducing the rate and impact of unintended pregnancy through effective contraception is a public health goal. Since deregulation, globally, ease of access to community pharmacists has enabled them to play a key role in the provision of emergency hormonal contraceptive pills (ECP). The aim of this scoping review is to explore pharmacists' overall knowledge of and attitudes and practices towards the provision of emergency contraception. A systematic literature search for the period from 1999 to 2023 was conducted using Scopus, Medline (Ovid), CINAHL, Emcare, Web of Science, and Google Scholar. Keywords such as emergency contraception, emergency contraceptive, morning after pill, plan B, pharmacist, community pharmacist, and pharmacy were applied. Articles published only in English that described the knowledge, attitudes, and practices of community pharmacists providing emergency contraception were included in this review. Twenty studies met the inclusion criteria. Despite positive attitudes towards the provision of ECP, there is a clear deficit in both the knowledge and counselling practices of pharmacists, with some pharmacists lacking an open attitude towards the supply of ECP to adolescents and third parties. Usage of a private counselling area ranged from 0% to 90% highlighting privacy for patients seeking ECPs is lacking during consultations. In countries where practice guidelines are available, these are often not being optimally utilized. This review has highlighted gaps in pharmacists' knowledge and counselling practices, demonstrating shortcomings in pharmacists' education, training, and application of professional practice guidelines. Future research on ECP guidelines is recommended to improve implementation and usability in practice.

Experiences and life circumstances of unintentionally pregnant women affected by intimate partner violence-stress factors, resources, healthcare structures and needs: a scoping review protocol.

Open Science Framework: https://doi.org/10.17605/OSF.IO/ZMVPE.

Perception of contraceptive counseling and contraceptive use among systemic lupus erythematosus patients

Objectives(1) To evaluate the perception of contraceptive counseling and knowledge regarding the impact of unintended pregnancy and (2) examine the prevalence of, and predictors for contraceptive use among systemic lupus erythematosus (SLE) patients. Study designA cross-sectional survey was conducted at the Rheumatology Clinic of a university hospital. SLE patients who attended the clinic from April 2018 to January 2019 and at risk for unintended pregnancy and were invited to be interviewed. The structured interview guide consisted of three parts: personal and obstetric information, perception of contraceptive counseling and knowledge about the impact of unintended pregnancy, and contraceptive use. ResultsThe mean age of the 137 patients who gave informed consents was 34 ± 8 years, with 47 patients (34%) stating that they had received contraceptive counseling. Seventy-five patients (52%) reported practicing contraception. The intention to not become pregnant (Odds Ratio; 95% CI = 7.28; 1.75–30.27), perception of adequate contraceptive counseling (2.77; 1.06–7.20) and discussion with partners and physicians about contraception (3.95; 1.64–9.50) were predictors for contraceptive use (p < 0.05). ConclusionMost patients reported no contraceptive counseling with approximately half of the patients using contraceptive methods within the past three months. Desire to avoid pregnancy, perception of adequate contraceptive counseling, and the influence of partners and physicians were significant predictors for contraceptive use. ImplicationsContraceptive counseling should be routinely included in discussions about disease processes and treatment plans, including access issues. Best practices for contraceptive counseling and integrated, multi-disciplinary team services should be developed and provided in clinical settings.

Utilization of modern contraceptives and predictors among women in Shimelba refugee camp, Northern Ethiopia.

Women living in refugee camps, in addition to the common hardships, such as drought, and famine, are also prone to another peculiar problem: an unintended pregnancy. The impact of unintended pregnancy is so severe that the rate of women who die or suffer an injury while giving birth in crisis settings is almost double the world average death rate. Thus, this study was aimed to investigate the utilization of modern contraceptive and associated factors among women in the reproductive age group in Shimelba refugee camp, Northern Ethiopia. A community-based cross-sectional study was employed and 329 study subjects were selected using simple random sampling technique with a face-to-face interview. The prevalence of using modern contraceptive was 47.7% and the study showed that being older [AOR = 0.017, 95%CI: 0.001, 0.467], being single [AOR = 0.17, 95%CI:0.031,0.914], being unemployed [AOR = 0.21, 95% CI:0.001,0.392], having no partner support [AOR = 0.006, 95% CI:0.001,0.044], and inconvenient service site AOR = 0.089,95% CI:0.013, 0.595] were factors that contributed to women not using modern contraceptive methods. Receipt of counseling on family planning utilization was more likely to helps women to use it [AOR = 3.37, 95% CI: 1.1095, 10.236]. Our study concluded that the current prevalence rate of contraceptive use is fairly good. However, much effort has to be made to improve this result. The situations in refugee can exacerbate the existing barriers to the use of contraceptives. Given its grave consequence on the livelihood of women, the contraceptive issue should be given due emphasis using several techniques including education to expand the awareness on modern contraceptive so as to augment access to family planning.

Impact of Unintended Pregnancy on Maternal and Neonatal Outcomes.

Pregnancy outcomes might be affected by unintended pregnancy such as preeclampsia, preterm birth, cesarean section and low birth weight. The aim of the present study is to assess the association between unintended pregnancy and pregnancy outcomes. This was a cross-sectional study conducted in 103 hospitals in Tehran, Iran, in July 2015. The data were collected by trained midwives. The interested independent variable was unintended pregnancy and also preeclampsia, weight gain during pregnancy, preterm birth, cesarean section and low birth weight were considered as interested outcomes, and the association of unintended pregnancy and interested outcomes were assessed. Out of 5152 cases, 1021 (19.82%) cases were unintended pregnancy. There was no significant relationship between unintended pregnancy and low birth weight (adjusted OR 0.67, 95% CI 0.403-1.13, P = 0.138), the risk of preterm birth (adjusted OR 1.15, 95% CI 0.850-1.57, P = 0.351) and preeclampsia (adjusted OR 1.21, 95% CI 0.846-1.75, P = 0.289). The results of multiple linear regression model showed that the mean difference between two groups was 0.70kg, and weight gain mean in unintended pregnant women significantly was lower than unintended pregnant women (mean difference = 0.70, 95% CI 0.14-1.26kg, P = 0.014). Multiple logistic regression showed that after adjusting confounders, there was a significant relationship between unintended pregnancy and cesarean section, and the adjusted odds of cesarean section in unintended pregnant women was 1.32 times of intended pregnant women (95% CI 1.07-1.63, P = 0.009). We found higher risk of cesarean section and inappropriate weight gain during pregnancy as adverse outcomes of unintended pregnancy in adjusted model.

Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support

BackgroundResearch into the impact of unintended pregnancy on the wellbeing of women tends to focus on pregnancies ending in either termination or lone motherhood. Unintended pregnancy is common in partnered women, but little is known about the association between unintended pregnancy and postpartum affective disorders, such as depression and anxiety in this group. Poor relationship quality and lack of social support are considered risk factors for psychological distress (PD). We examined the association between unplanned motherhood and subsequent PD in partnered women, for whom evidence is sparse, accounting for the role of relationship quality and social support.MethodsData for 12,462 partnered mothers were drawn from the first survey of Millennium Cohort Study, completed at 9 months postpartum. Women reported whether their baby was planned, and how they felt when they discovered that they were pregnant. Pregnancy intention is categorised as “planned”, “unplanned/happy”, “unplanned/ambivalent” and “unplanned/unhappy”. PD was assessed using the modified 9-item Rutter Malaise Inventory. Social support was measured by a composite score for perceived support, and a measure of actual support from friends and family. Relationship quality was assessed using a modified Golombok-Rust Inventory of Marital State. The effect of pregnancy intention on the odds of PD at 9 months was estimated, adjusting for potential confounding factors. All analyses were weighted for response and design effects.ResultsIn total 32.8%(weighted) (4343/12462) of mothers reported an unplanned pregnancy: 23.3 wt% (3087) of mothers felt happy, 3.5 wt% (475) ambivalent, and 6.0 wt% (781) unhappy upon discovery. Unplanned pregnancy was associated with a significantly increased odds of PD compared to planned (OR 1.73 (95%CI: 1.53, 1.95)). This was more pronounced among women who reported negative or ambivalent feelings in early pregnancy (OR 2.72 (95%CI:2.17, 3.41) and 2.56 (95%CI:1.95, 3.34), respectively), than those who reported positive feelings (OR 1.39 (95%CI:1.21, 1.60)). Adjustment for relationship quality, in particular, reduced odds of PD after unplanned pregnancy (e.g. from 2.19 (95%C: 1.74, 2.74) to 1.63 (95% CI: 1.29, 2.07 in the unplanned, unhappy group compared to the planned).ConclusionsA third of partnered mothers reported that their pregnancy was unintended, yet this group is under-researched. Unplanned motherhood was associated with increased risk of PD at 9 months postpartum, particularly among women who felt unhappy or ambivalent at the start. The roles of relationship quality and social support require further investigation, as possible means to intervene and improve maternal wellbeing.

Community Health Centers' Role in Family Planning

Community Health Centers' Role in Family Planning Ruth Lesnewski, MD (bio), Lisa Maldonado, MA, MPH (bio), and Linda Prine, MD (bio) Whenever I see a woman who has an unintended pregnancy, I make a point of looking through her chart to see if she had a recent office visit. About 75% of the time, I find she did have a visit within the previous three months, but contraception was not addressed. —Family physician and medical director of a federally qualified health center Federally qualified health centers, also known as community health centers (CHCs), care for our nation's neediest populations. By latest count, 1,128 federally qualified health centers operate more than 8,500 sites serving 20.2 million men, women, and children.1 These numbers are expected to grow with expanded funding via the Patient Protection and Affordable Care Act. Community health centers are charged with providing a wide scope of preventive health services to people of all ages—including prenatal care, immunizations, cancer screening, and family planning.2 Community health centers form an integral part of the communities they serve. In some areas, these health centers offer the only medical resources available for miles around. Community health centers have demonstrated excellent outcomes in reproductive health. Community health center patients are less likely to have pre-term births or low-birthweight babies,3 and are more likely to obtain Pap tests and mammograms than other low-income patients.4 However, CHCs' effectiveness at providing family planning services is unclear. A 2001 study5 by the Guttmacher Institute found that only 60% of CHC sites provided contraception. Community health centers provided contraception to about 28% of their female patients of reproductive age. More recent studies by Guttmacher and others found that while most publicly funded clinics offered oral contraceptives, CHCs were less likely to provide the most effective contraceptive methods (namely the IUD and implant) and were not as likely to follow evidence-based contraceptive practices such as quick start (that is, same-day initiation of contraception).6 The role of CHCs in caring for our nation's most underserved populations is unquestioned. Community health centers serve one in five low-income women7 and are also more likely than other publicly funded family planning providers to serve men, special [End Page 429] needs groups, minorities, and patients with limited English proficiency.6 Yet, CHCs can do more to prevent unintended pregnancy in the United States. The Impact of Unintended Pregnancy We know a lot about unintended pregnancy in the United States. We know that most families in the United States want two children. We know that most people want to plan childbearing and avoid unintended pregnancies.8 One way of looking at this is that most women spend about 75% of their reproductive years trying to avoid pregnancy.9 We also know that nearly half of all pregnancies in the United States are unintended.10 Our rate of unintended pregnancy is far higher than that of most other developed nations. We know that poor and low-income women, the very women CHCs serve, are much more likely to experience an unintended pregnancy than other women.11 Unintended pregnancy can have lasting consequences. In 2001, the latest year of available data, 3.1 million unintended pregnancies in the U.S. resulted in 1.3 million abortions, 400,000 miscarriages, and 1.4 million births. Women with unintended pregnancies are less likely than women with intended pregnancies to initiate prenatal care promptly,12 to quit smoking cigarettes,2,13 to consume adequate amounts of folic acid,14 and to breastfeed their infants.15 Teens who have a child are less likely than others to graduate from high school or complete college.16 Children born of unintended pregnancies are more likely to have a premature birth, to die in the first year of life, to suffer abuse, and to fail in school.17 Consistent use of effective contraception can make a difference. Most women who experience unintended pregnancies are not using contraception at all or are using it inconsistently during the month of their conception.18 Teen pregnancy rates have dropped to all-time lows as a result of increased access to...