Unintended and unwanted pregnancy in Halifax: the rate and associated factors

Abstract

We present the results of a study designed to assess the incidence of unintended and unwanted pregnancies in Halifax, Nova Scotia, and to characterize the socioeconomic and demographic factors associated with women at high risk. Of 200 pregnancies, 32.5% were unintended and 16.5% unwanted. This, together with the rate of therapeutic abortions among Halifax area women, suggests that approximately 45% and 32% of conceptions leading to viable pregnancies are unintended and unwanted, respectively. Contrary to data collected in 1971, the majority of these women were single. Marital status and parity were significant determinants of both pregnancy intention and wantedness. According to these results, unintended and unwanted pregnancies continue to occur at high rates among certain groups of women living in the Halifax region, despite improvements in the efficacy and availability of contraceptives.

PIP: In Canada during June-July 1992, 200 postpartum mothers at the Grace Maternity Hospital in Nova Scotia completed a questionnaire so researchers could examine unplanned and unwanted pregnancies in metropolitan Halifax. Most of the pregnancies (67.5%) were planned. Women with unintended pregnancies were younger than those with intended pregnancies (p 0.005). Married women were significantly more likely to have an intended pregnancy than single women (odds ratio [OR] = 15.53; p 0.001). The more children a woman had, the more likely that a pregnancy was unintended (p 0.05). Women with unplanned pregnancies tended to have never used contraception (25% vs. 14%; p 0.05) or have used withdrawal as their principal method of family planning (25% vs. 5%; p 0.001). Women with planned pregnancies were much more likely to have used oral contraceptives as their principal method of family planning (64% vs. 24%; p 0.001). Most women with unintended pregnancies (86.5%) did not use effective birth control around the time of conception. The leading reasons for unintended pregnancy were carelessness (37%) and unintended intercourse (25%). Contraceptive failure was responsible for 13.5% of unintended pregnancies. Most unintended pregnancies (51%) were also unwanted, resulting in 16.5% of all 200 pregnancies being unwanted. Single women were much more likely to have an unwanted pregnancy than married women (OR = 17) or women living with a partner (OR = 5.8) (p 0.01). The more children a woman had, the more likely that a pregnancy was unwanted (p 0.01). Renters were more likely to have an unwanted pregnancy than did owners (OR = 6.5; p 0.05). Program planners and administrators planned to use these results to determine resource allocations to high risk populations. The results suggest the need for improved birth control counseling and to learn more about the decision women not planning or wanting to conceive to discontinue contraception. Widespread acceptance of emergency contraception would reduce unwanted pregnancies.