Prevalence Of Unwanted Pregnancy Research Articles

Early Child Marriages, Unintended Pregnancies, and its impact on the Health of Young Girls in South Punjab

Background: Unwanted pregnancies are a significant public health issue in South Punjab, Pakistan, largely due to low contraception use and a substantial unmet need for family planning. The high fertility rate and maternal mortality in the region are further compounded by the prevalence of unwanted pregnancies, which also contribute to educational dropouts among girls and affect maternal health adversely. Objective: This study aimed to analyze the impact of education level, household size, wealth index, and type of residency on pregnancy intentions among women in Southern Punjab. Methods: Utilizing a survey design, data from 1,100 women aged 13 to 49, both from slum and non-slum areas across several districts in Southern Punjab, were analysed. Logistic regression and simple percentages were employed to assess the associations between socio-demographic factors and pregnancy intentions. Results: The results indicated that women with higher education levels had a higher proportion of intended pregnancies (220 out of 320, 68.75%) compared to those with no education (20 out of 70, 28.57%). In terms of household size, smaller households (1-2 persons) had a higher incidence of intended pregnancies (60 out of 130, 46.15%) compared to larger households (6 or more persons, 230 out of 490, 46.94%). Regarding the wealth index, the 'rich' category showed a higher likelihood of intended pregnancies (200 out of 255, 78.43%) compared to the 'poor' category (200 out of 530, 37.74%). Additionally, women residing in non-slum areas reported a higher rate of intended pregnancies (340 out of 550, 61.82%) than those in slum areas (350 out of 550, 63.64%). Conclusion: The study underscores the influence of socio-demographic factors on pregnancy intentions. Education level, household size, wealth index, and type of residency are pivotal in determining the likelihood of intended pregnancies. Tailoring family planning initiatives to these factors can significantly improve reproductive health outcomes in Southern Punjab.

Women with unwanted pregnancies, their psychosocial problems, and contraceptive use in primary care in Northern Netherlands: insights from a primary care registry database.

Globally an estimated 1 in 16 women per year experience an unwanted pregnancy (UWP). In the Netherlands, general practitioners (GPs) play an important role in providing care for women with UWP; however, it is unknown how many of these women consult their GP about the pregnancy. UWPs are a major life experience with a possible influence on mental health. Data that GPs register about UWPs, psychosocial problems, and contraceptive use could give more insight into care needs. To create an overview of (i) the prevalence of UWPs in general practice, (ii) the prevalence of psychosocial problems in women with UWP, and (iii) contraceptive use of women with UWP. GP registration data were analysed from 58 general practices located in Northern Netherlands between 2015 and 2019. Patient files were checked for registration of ICPC and ATC codes concerning pregnancy, psychosocial health, and contraceptive use. Chi-square and Fisher's exact test were used to calculate differences between women with a UWP and women with a wanted pregnancy (WP). An analysis of registration dates was conducted to determine when the psychosocial problems were registered in relation to the pregnancy. Of female patients of reproductive age, 1.6% had a UWP and 11.8% had a WP. Women with a UWP reported statistically significantly more psychosocial problems. Furthermore, statistically significantly more contraceptive methods were prescribed to women with UWP compared with both women with WP and women without pregnancy. The finding that women with UWP experience more psychosocial problems can be used to improve aftercare and can be incorporated into current guidelines for GPs.

Reasons for Unwanted Pregnancy among Women of Childbearing Age (15-19 Years) in Jambi Province

The occurrence of unwanted pregnancy (UP) among women of childbearing age (WCA) has been reported to be increasing in various regions, however, this incidence has not been assessed among the adolescents of 15-19 years age group, in Jambi City. The factors influencing this occurrence includes individual, family, and environmental determinants. This study aimed to determine the prevalence of UP among WCA (15-19 years) in Jambi Province. A cross-sectional design was used, while the participants (307 women aged 15-19 years) were selected in Jambi City and West Tanjung Jabung District, using the Multistage Random Sampling. The analytical method used was the Multiple Logistic Regression of alpha 5%. The results showed that the prevalence of UP among WCA (age 15-19 years) was 1.6%, compared to 50% of those that were married. The dominant factor of UP includes the use of contraceptives with an adjusted-odds ratio of 74.5 (95% CI = 3.58-1,549.02), while the control used were the job of WCA, knowledge, dating behaviour, accesses to information media and health facilities, as well as family education. Therefore, it is suggested that creative, innovative, informative promotions, and education were needed via the social media. Besides, the optimization and strengthening of the Gen-Re go to school program should be carried out, as well as synergizing the cross-sectoral activities, government, private sector, and the community (especially parents).

Factors analysis of unwanted pregnancies among women childbearing age in Indonesia: analysis of demographic and health survey data in 2017

Background: Unwanted pregnancies were one of the serious threats to human development around the world. This analysis identifies factors associated with unwanted pregnancies, including intrapersonal, interpersonal, and institutional health services.Objective: We analyzed the extent of unwanted pregnancies and how they predict factors related to Indonesia's unwanted pregnancies.Methods: We analyzed data from the Indonesian Demographic and Health Survey (IDHS) in 2017. Descriptive statistics on the prevalence of unwanted pregnancies and correlated factors. Multiple logistic regression was used to examine the association between intrapersonal factors, interpersonal factors, and community factors with unwanted pregnancies.Results: Participants reported that their most recent was 83.8% indicated a desired pregnancy and 16.2% were unwanted. Multivariate analysis shows the age of the woman (OR=1.37), economic status (OR=1.05), number of children (OR=1.47), contraception failure (OR=0.78), and health worker intervention (OR=1.27) was found to significantly increase the risk of unwanted pregnancy (p<0.05). The number of children is the most substantial factor in unwanted pregnancy among women childbearing in Indonesia.Conclusions: Nearly a fifth of pregnancies among vulnerable women in Indonesia are unwanted pregnancies. WomenEnglish translation. should plan pregnancy according to the target number of children desired with a partner.

Meta- analysis and Systematic review of prevalence of unwanted pregnancy among Iranian women

Meta- analysis and Systematic review of prevalence of unwanted pregnancy among Iranian women

Prevalence of Unwanted Pregnancy among Iranian Women: Systematic Review and Meta - analysis

Prevalence of Unwanted Pregnancy among Iranian Women: Systematic Review and Meta - analysis

Prevalence of unwanted pregnancy among Iranian women: an updated meta-analysis

BackgroundUnwanted pregnancy is a global issue with adverse outcomes for the mother, child, family, and society. Previous studies in Iran have reported different prevalence rates for unwanted pregnancy. This meta-analysis was aimed at estimating the overall prevalence of unwanted pregnancy among Iranian women.MethodsA total of 20 articles in English or Persian, published between 2012 and December 2018, were collected. The search was conducted in national and international databases, including Scientific Information Database (SID), MagIran, PubMed, Scopus, and Web of Science, using the following keywords: ‘Unplanned pregnancy’, ‘Unintended pregnancy’, ‘Unwanted pregnancy’, and ‘Mistimed pregnancy’. The data were analyzed using the meta-analysis method and the random effects model. Heterogeneity among studies was assessed using the I2 statistic. All analyses were performed using Stata, version 12.ResultsAnalysis of 20 studies with a total sample size of 16,298 showed that the prevalence of unwanted pregnancy among Iranian women was 26% (95% Confidence Interval [CI]: 23–28). This prevalence was higher in the regions 5 and 2 of Iran (27%) than the other regions, and had no significant decrease between 2012 and 2018 (p = 0. 937).ConclusionMore than one-fourth of pregnancies among Iranian women are unwanted. Providing training programs for couples who do not plan to have children along with the support policies aimed at stimulating population growth, can be an important step in overcoming the issue of unwanted pregnancy and reducing the illegal abortions related to it.

Modern contraceptive methods knowledge and practice among blind and deaf women in Ethiopia. A cross-sectional survey

BackgroundEvidences from various parts of the world reveal that women with disabilities are facing widespread barriers in accessing public services. Service providers and program managers do not grasp the relevance of their work and interventions in addressing the sexual and reproductive health needs of women with disabilities. The present study therefore aimed to assess family planning knowledge and practice among women with sensory disabilities.MethodsA mixed method approach using quantitative and qualitative methods was employed to collect the data. The study included 326 blind and deaf women using respondent driven sampling technique and 29 purposely selected key informants. We carried out the study from August 2016–April 2017. The quantitative data were analyzed using SPSS and the qualitative analysis was done using Open code software version 4.02 and triangulated with the quantitative findings.ResultsThe findings showed that nearly two third of the respondents of were sexually active. The majority (97.2%) of study respondents had heard about FP methods, however the level of comprehensive knowledge on modern contraceptive methods was 32.5%. The prevalence of unwanted pregnancy was 67.0% and abortion was 44%.Almost half of sexually active respondents ever used modern contraceptive methods, yet the contraceptive prevalence at the time of survey was 31.1%. Implants were the most commonly used (51%) contraceptive method among current users.ConclusionsThe use of modern contraceptive methods among women with sensory disabilities was low. Thus, the government and concerned organizations need to address the attitudinal, social, and physical barriers women with sensory disabilities are facing while seeking, accessing to and using family planning services.

Unwanted pregnancy and induced abortion among female undergraduates in University of Ibadan, Nigeria

Objectives: To assess the prevalence of unwanted pregnancies and induced abortion among female undergraduates. Methodology: A cross-sectional survey was conducted among female undergraduates in University of Ibadan, Nigeria. The survey used a structured, self-administered questionnaire. Data analysis was conducted using Statistical Package for the Social Sciences version 20 with Chi-square and t-tests. Statistical significance was set at P Findings: The mean age of the participants was 20.3 (±2.7) years and 80% were single at the time of the study. The prevalence of induced abortion was 51%. The overall prevalence of unwanted pregnancy was 17%, and 92.7% of students who had ever been pregnant had considered the pregnancy unwanted. Only 7.3% reported willingness to be pregnant while engaged and 58.3% were unwilling to keep pregnancy if engagement ends. Unwanted pregnancy was less among those ever married (χ2 = 49.96, P Conclusion: The prevalence of unwanted pregnancy and induced abortion is high especially among university undergraduates. As it appears to happen more often while they are engaged, unprotected sex during the engagement period needs to be targeted.

Factors related to unwanted pregnancies and abortion in the northern district of the city of Tehran, Iran

ABSTRACTThe aim of this study was to investigate the levels and determinants of unwanted pregnancies and therapeutic and elective induced abortions in an Iranian sample of women. This study was conducted from the beginning of 2013 to the end of July 2013, using data from 950 women aged 15–45 years. To evaluate the relationship of independent variables to the number of unwanted pregnancies, a negative binomial regression model was used. A multinomial logistic model was used to investigate the relationship of the history of at least one unwanted pregnancy to therapeutic and elective induced abortion. The prevalence of unwanted pregnancy among participants was 19.2 percent (n = 182). Among those with a history of unwanted pregnancy, eighteen had had at least one induced abortion (14.5 percent of the total abortions reported). Having enough knowledge about the intrauterine device during unprotected intercourse on average was associated with a 57 percent reduction in unwanted pregnancies (mean odds ratio = 0.43, 95 percent Confidence Interval (CI): 0.11–0.93). Given the high rates of complications following unwanted pregnancies and associated maternal health threats, timely identification and training of women at risk, as well as the development of appropriate attitudes regarding reproductive health, may help avoid such pregnancies and their complications.

Contraceptive Use, Unwanted Pregnancies and Abortions among Hairdressers in Ibadan, Southwest Nigeria.

The study was conducted in Ibadan, Southwest Nigeria to determine prevalence and predictors of contraceptive use, unwanted pregnancies and induced abortions among hairdressers. 1687 female hairdressers were surveyed using a cross sectional design and cluster sampling technique. Mean age was 27.0±8.1 years, 851 (50.4%) were single and 1005 (59.6%) qualified hairdressers. 817 (56.8%) of sexually active were currently using contraception. Attainment of secondary school education was a predictor of contraceptive use; OR=1.4, 95% CI (1.1-1.8). 429 (29.8%) ever had an unwanted pregnancy; 26.5 % among singles, 32.3 % among married. Predictors of unwanted pregnancies were age >30years; OR=1.9, 95% CI (1.4-2.5) and being a qualified hairdresser; OR=1.6, 95% CI (1.2-2.2). 347 (24.1%) ever had an induced abortion; 21.5.0 % of singles, 26% of married. Being married; OR=5.2, 95% CI (2.2-11.9) was the only predictor of induced abortion. Prevalence of unwanted pregnancies and abortions were high especially among married hairdressers.

Prevalence of Unwanted Pregnancy and Associated Factors among Women in Reproductive Age Groups at Selected Health Facilities in Addis Ababa, Ethiopia

Background: Unsafe abortions resulting from unintended pregnancies denote an important public health challenge throughout the world. Although various strategies have been used to address this problem unsafe abortion from unwanted pregnancy remained the cause for a significant number of maternal morbidity and mortality. Objective: To assess the prevalence of unwanted pregnancies and factors associated with unwanted pregnancies. Methodology: A facility based cross-sectional study was conducted to select randomly 349 women of reproductive age from five hospitals providing antenatal care in Addis Ababa. Data were collected using standardized pretested interviewer administered questionnaire. Logistic regression was used to analyze the association between the dependent and independent variables. Result: A total of 333 reproductive age group females participated in the study making the response rate 95.4%. A total of 126 (37.8%) and 50 (39.6%) respondents had unwanted pregnancy and induced abortion at some point in their lives. Marital status and number of sexual partner were significantly associated with unwanted pregnancy with AOR [1.783 (1.036, 3.068), 11.355 (5.106, 25.253)] respectively. Conclusion: The prevalence of unwanted pregnancy and induced abortion were high, and most of the induced abortion was the result of unwanted pregnancy. This study has implication that comprehensive approaches should be emphasized to increase awareness, access and use of family planning methods.

Premarital sexual relationships: Contraceptive knowledge and practice among iranian youths

Objective: The youths' sexual behaviors are counted as the main priorities of the public health due to the high prevalence of unwanted pregnancies, illegal abortions, and sexually transmitted infections. This research was carried out to explain the youths' contraceptive knowledge and practice in premarital sexual relationships. Methods: This qualitative research was carried out on 30 single boys and girls aged 18–24, living in Isfahan, Iran, who had already started sexual activities. Data collection was done with semi-structured interviews. The data were analyzed by using conventional content analysis. Results: Two main categories were extracted including inadequate awareness regarding contraception (with subcategories “unreliable information sources” and “gender inequality in familiarity with contraceptive methods”) and inappropriate contraceptive practice (with sub-categories “use of unreliable contraceptive methods” and “gender inequality in applying contraceptive methods”). Conclusion: Sexual health education programs should equip the youths with adequate knowledge on contraception and use of reliable contraceptive methods. Furthermore, attempts should be made along with tackling gender inequality is very significant for youths' sexual and reproductive health security.

Comparing Infant Nutrition in Wanted and Unwanted Pregnancies

BackgroundThe current study was conducted to investigate the relationship between unwanted pregnancy based on couples’ opinions and infant nutrition type in women referred to the health centers in Mashhad city and their husbands.Materials and MethodsIn this analytical-descriptive study, unwanted or wanted progenies were studied from the viewpoints of 366 women referred to the health centers in Mashhad city, Iran and their husbands, and also their relationships with infant nutrition type at the age of 4 months. The data were collected through questionnaires. The validity and reliability of the method and instruments were confirmed by content validity and test-retest. Moreover, data analysis was done using SPSS-16.0 software.ResultsThe average age of women in wanted pregnancy was 26.43±4.57 years and 27.57±5.22 years in unwanted women. The results showed a statistically significant relationship between unwanted pregnancy from the viewpoints of couples and infant's nutritional status (P=0.03). The prevalence of unwanted pregnancy in women with lower education (middle and high school) was higher than those with higher education.ConclusionOur results showed a significant association between baby’s nutrition and unwanted pregnancy. Furthermore, an increased use of non-exclusive breastfeeding in unwanted pregnancy is necessary. Hence, proper use of contraceptive methods, preventing the adverse consequences of unwanted pregnancy such as non-exclusive breastfeeding, useful educational strategies, counseling and health services are necessary to be taken into account.

Level, Trend and Correlates of Mistimed and Unwanted Pregnancies among Currently Pregnant Ever Married Women in India.

Unintended pregnancy accounts for more than 40% of the total pregnancies worldwide. An Unintended pregnancy can have serious implications on women and their families. With more than one-fourth of the children in India born out of unintended pregnancies such pregnancies are considered to be one of the major public health concerns today. The present study is aimed at determining major predictors of unintended pregnancy among currently pregnant ever-married women in India. The present study has used National Family Health Survey (NFHS) data, conducted by the International Institute for Population Sciences (IIPS), Mumbai, to show the trend, pattern and determinants of mistimed and unwanted pregnancies. Bivariate and multinomial logistic regression model have been used with the help of Stata 13 software. The results show that the likelihood of a mistimed pregnancy is more prevalent among young women whereas the prevalence of unwanted pregnancy is observed more among the women aged 35 years or more. The results also show that the risk of experiencing mistimed pregnancy decreases if the woman belongs to ‘other’ castes and has higher education. The likelihood of unwanted pregnancy decreases among married women aged 18 years and above, those women having higher education, some autonomy and access to any mode of mass communication. Knowledge of these predictors of mistimed and unwanted pregnancy will be helpful in identifying the most vulnerable group and prioritize the intervention strategies of the reproductive health programmes for the population in need.

Prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant females in Kampala, Uganda: a facility based cross-sectional study.

BackgroundSexual coercion is associated with sexually transmitted infections and unwanted pregnancies with consequential unsafe abortions and increased maternal morbidity and mortality. Current literature focuses mainly on its risk factors but less on its resultant deleterious health effects. We conducted a study to determine the prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant women.MethodsIn a cross-sectional study, four hundred and sixteen (416) consenting pregnant females aged 15–24 years attending antenatal clinics in Lubaga division Kampala district in Uganda were enrolled using systematic sampling. Quantitative and qualitative data on sexual coercion were collected by female interviewers.Adjusted Prevalence Proportion Ratios (Adj. PPRs) of unwanted pregnancy and associated 95 % confidence intervals were estimated by generalized linear models with log link function and Poisson family distribution using robust variance estimator. Quantitative data were analyzed using Stata version 10.0, while qualitative data were analyzed using manifest content analysis.ResultsPrevalence of sexual coercion was 24 % and was higher among those who had non consensual sexual debut (29.0 %) compared with those who had consensual sexual debut (22.6 %). The prevalence of unwanted pregnancy was 18.3 % and was higher among participants who had been sexually coerced relative to their counterparts (p < 0.001). History of sexual coercion in the past 12 months and non consensual sexual debut were associated with unwanted pregnancy [adj.PPR = 2.23, 95 % CI: (1.49-3.32)] and 1.72, 95 % CI: (1.16- 2.54)] respectively. Qualitative results indicated that different forms/contexts of sexual coercion, such as deception, transactional sex and physical force influenced unwanted pregnancies.DiscussionThis study highlights that a quarter of our participants in our quantitative study had experienced sexual coercion in the past twelve months and nearly a third of these, had history of non consensual sexual debut. Unwanted pregnancy was higher among the sexually coerced and those who had non consensual sexual debut.ConclusionSexual coercion among pregnant women aged 15–24 years in Kampala, Uganda is high and is significantly associated with unwanted pregnancy. Comprehensive sex education targeting young people (<25 years), along with availability and access to youth friendly centers may be useful in addressing sexual coercion and its negative outcomes.

Unwanted Pregnancy and Associated Factors among Female Students of Madawalabu University Bale Zone, Oromia Region South East, Ethiopia

Globally as well as in the developing world unintended pregnancies are among the major social and health problems. In Ethiopia, 54% of pregnancies to girls under age 15 are unwanted. In some countries where accesses to safe and legal abortion services are restricted, unsafe abortion is the cause for more than 30% of maternal deaths. The aim of this study was to assess factors associated with unwanted pregnancy among female students of Madawalabu University from 01- 21, March 2014. A cross sectional study was conducted among 814 female students of Madawalabu university drawn randomly from 6 selected schools in 01- 21, March 2014. Self administered questionnaire, adapted from previous relevant studies was used to assess Factors associated with unwanted pregnancy among female students of Madawalabu University. Data was entered, cleaned and then analyzed using Bivariate and multivariate logistic regression models. A total of 814 female students responded to the questionnaire adequately making the response rate of 96%. The mean age of study participants was 20.74 years with standard deviation of 1.47. The overall prevalence of unwanted pregnancy among those who ever had sexual intercourse was 8.1% and among all study participants it was 32.4%. Ever hearing about family planning, consistent use of family planning in the last twelve months, and drinking alcohol in the last one week were among significantly associated with unwanted pregnancy Thus, Madawalabu University HIV/AIDS prevention and control office and other stakeholders are recommended to promote extensively family planning utilization to avoid unwanted pregnancies.

Evaluation of the Relationship between Unwanted Pregnancy and Infant Feeding

Introduction: Unwanted pregnancy is one of the most important problems, facing married couples. This type of pregnancy has a negative impact on maternal, fetal, and neonatal outcomes. In this study, we aimed to evaluate the relationship between unwanted pregnancy (based on the couples’ opinions) and infants’ nutrition in patients admitted to medical centers of Mashhad in years 2009-2010. Methods: In this cross-sectional study, 300 women with infants under the age of 1 year, who were referred to medical centers of Mashhad, were asked whether or not their pregnancy was planned. Then, they were questioned about their infants’ nutritional status (at the age of 4 months). Data were collected using questionnaires and interviews. Validity and reliability of the methods were confirmed using content analysis and test-retest. Data were analyzed using SPSS version 11.5 and statistical tests. In statistical tests, P-value of 0.05 was considered statistically significant. Results: The findings of statistical analysis showed a significant association between unwanted pregnancy and infant’s nutritional status (P=0.03). Also, the prevalence of unwanted pregnancy in couples with lower education level (high-school education or less) was noticeably higher than other couples. Conclusion: Since unwanted pregnancy often leads to non-exclusive breastfeeding and adverse health outcomes, we highly recommend avoiding unprotected intercourse. Educational programs and marital consultation are also useful for raising couples’ awareness.

Unintended pregnancy in the life-course perspective.

In this contribution unintended pregnancies are studied as a multidimensional concept from a life-course perspective. Standardized data on the prevalence of unwanted pregnancies in different stages of women's life course are combined with a qualitative analysis of the subjective meaning of "unwanted" and of subjective explanations of getting pregnant unintentionally. The study "frauen leben 3" on family planning in the life course of 20-44 year old women was conducted on behalf of the Federal Centre for Health Education (BZgA) from 2011 until 2014 in four federal states in Germany. A standardized questionnaire was used to collect retrospective information on 4794 pregnancies (including induced abortions), and biographical in-depth interviews provide qualitative information on 103 unwanted pregnancies. The standardized data were analyzed with bivariate methods and multivariate logistic regression models. The qualitative procedure to construct typologies of subjective meanings consisted of contrasting cases according to the generative approach of Grounded Theory. In contrast to unwanted pregnancies, mistimed pregnancies are characterized to a greater extent by negligence in the use of contraceptives, by a positive reaction to the pregnancy and by a more general desire to have a child. Four different subjective meanings of "unwanted" are constructed in qualitative analysis. The logistic regressions show that the selected factors that increase the likelihood of an unwanted pregnancy vary according to age and stage in the life course. The quantitative analysis reveals furthermore that relationship with a partner had a significant effect in all stages of the life course. The qualitative interviews specify the age- and life course-related aspects of these effects.

Prevalence of unwanted pregnancy and its related factors in women Mashhad city in 2013

Background & Objectives: An approximately one third of pregnancies are unwanted, and half of them will lead to abortion. The present study was conducted to assess the prevalence of unwanted pregnancies and its related factors in women at Mashhad city. Materials and Methods: This study was carried out on 100 mothers who referred to health centers of Mashhad, and they were selected with cluster randomization . Data was collected by valid and reliable questionnaire.Results were analyzed in spss11/5. Results: The prevalence of unwanted pregnancy was estimated to be 29/5 percent and 28.3 of this women with unwanted prognancy had a tendency to abortion. The cause of unplanned pregnancy at 48/4% was Sufficient number of children and 29% was inappropriate. There was a significant relationship between unwanted pregnancy whit educational level of the couples, so that the incidence of unwanted pregnancy in women and their husbans who had university education was higher than at other women (P <0.05). There was a significant relationship between unwanted pregnancy whit occupation’s mother, age and number of children,so that prevalence of unwanted pregnancy in working mothers with higher than 35 years and had 3 or more children was higher than the other women(P <0.05). Conclusion: Prevalence of unwanted pregnancies was one-third of all pregnancies. These results showed that extending of the education programs about contraceptive methods and disadvantages of unwanted pregnancy especially for working women with higher education level and older age is necessary