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Multicenter Study
. 2017 Aug;32(8):900-908.
doi: 10.1007/s11606-017-4049-3. Epub 2017 Apr 21.

Unintended Pregnancy and Contraceptive Use Among Women Veterans: The ECUUN Study

Sonya Borrero  1   2 , Lisa S Callegari  3   4 , Xinhua Zhao  5 , Maria K Mor  5   6 , Florentina E Sileanu  5 , Galen Switzer  5   7 , Susan Zickmund  8   9 , Donna L Washington  10   11 , Laurie C Zephyrin  12   13 , E Bimla Schwarz  14
Affiliations
Multicenter Study

Unintended Pregnancy and Contraceptive Use Among Women Veterans: The ECUUN Study

Sonya Borrero et al. J Gen Intern Med. 2017 Aug.

Abstract

Background: Little is known about contraceptive care for the growing population of women veterans who receive care in the Veterans Administration (VA) healthcare system.

Objective: To determine rates of contraceptive use, unmet need for prescription contraception, and unintended pregnancy among reproductive-aged women veterans.

Design and participants: We conducted a cross-sectional, telephone-based survey with a national sample of 2302 women veterans aged 18-44 years who had received primary care in the VA within the prior 12 months.

Main measures: Descriptive statistics were used to estimate rates of contraceptive use and unintended pregnancy in the total sample. We also estimated the unmet need for prescription contraception in the subset of women at risk for unintended pregnancy. For comparison, we calculated age-adjusted US population estimates using data from the 2011-2013 National Survey of Family Growth (NSFG).

Key results: Overall, 62% of women veterans reported current use of contraception, compared to 68% of women in the age-adjusted US population. Among the subset of women at risk for unintended pregnancy, 27% of women veterans were not using prescription contraception, compared to 30% in the US population. Among women veterans, the annual unintended pregnancy rate was 26 per 1000 women; 37% of pregnancies were unintended. In the age-adjusted US population, the annual rate of unintended pregnancy was 34 per 1000 women; 35% of pregnancies were unintended.

Conclusions: While rates of contraceptive use, unmet contraceptive need, and unintended pregnancy among women veterans served by the VA are similar to those in the US population, these rates are suboptimal in both populations, with over a quarter of women who are at risk for unintended pregnancy not using prescription contraception, and unintended pregnancies accounting for over a third of all pregnancies. Efforts to improve contraceptive service delivery and to reduce unintended pregnancy are needed for both veteran and civilian populations.

Keywords: VA; contraception; family planning.

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Conflict of interest statement

Funders

This study was supported by the VA Health Services Research and Development Service (HSR&D) Merit Review Award, IIR 12-124 (PI: Sonya Borrero). Lisa Callegari is supported by a VA Career Development Award, CDA 14-412. The findings and conclusions in this report are those of the authors and do not represent the views of the Department of Veterans Affairs or the United States government.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Figures

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Figure 1
Flow diagram showing participant recruitment and response rates.
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