What Is Unintended Pregnancy?
Unintended pregnancy is essentially unwanted or unplanned pregnancy - it occurs at a time when the pregnant woman (or the couple) does not desire children or desire them at a much later date.
Are Unintended Pregnancies Common?
Between 2015 and 2019, nearly 121 million unintended pregnancies were recorded per year.
What Are the Causes and Factors That Contribute to Unintended Pregnancy?
Unintended pregnancy may occur as a result of:
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Not using contraception (birth control methods or devices that help prevent pregnancy).
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Incorrect or inconsistent use of contraception.
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Contraceptive failure.
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Rape (less common).
Some of the factors that lead to unintended pregnancy include:
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The desire to stay in a relationship.
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Fear of losing one's partner if sexual intimacy is rejected or contraception is used.
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Lack of awareness on contraception.
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Misinformation about contraception.
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Lack of knowledgeable, trusted mentors.
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Increasing age or young age (adolescents).
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Living in rural locations with less access to resources, information, and support.
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Being educated at only the primary level or lower.
Some of the factors that protect against unintended pregnancy are:
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Having a trusted mentor.
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Having a secondary education or higher. Attending school.
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Living in urban areas with better access to resources, information, and support.
Who Is at Risk of Unintended Pregnancy?
75 % of unintended pregnancies occur in teenagers between 15 to 19 years of age.
Besides adolescents, the rates of unintended pregnancy are highest among women in categories like:
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Ages between 18 to 24 years.
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Low income.
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Uneducated or educated only at a primary level.
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People of color.
Adolescent girls often become pregnant due to peer pressure to form relationships and subsequent relationship pressure to enter into sexual intimacy. Often, they are encouraged not to use contraception or are entirely unaware of contraception.
Sexually active females in rural areas may also be at a higher risk of facing sexual violence and gender discrimination, leading to unintended pregnancy.
Older women may experience unintended pregnancy for reasons like domestic and sexual violence or the belief that they are too old to get pregnant, leading to surprise pregnancies.
Why Do Unintended Pregnancies Occur Even Though Contraception Is Available?
The World Health Organization (WHO) conducted a study in 36 countries and found that at least 66 % of sexually active women who did not intend to have children discontinued contraception due to misguided beliefs regarding the associated side effects. Many also believed their likelihood of getting pregnant was low. The result: 1 in 4 pregnancies was unintended. Several women have genuine concerns about the possibility of infertility if they use contraception, a fact they are made to believe right from a young age.
Why Is Unintended Pregnancy a Matter of Concern and What Are Its Consequences?
Evidence from around the world indicates that unintended pregnancy is a risk factor for maternal and infant mortality and morbidity - the health of both mother and child is affected to the extent that death is a possibility, as are mental and physical diseases.
A typical problem with unintended pregnancies in underdeveloped or developing countries is the lack of access to antenatal care (care and treatment received from doctors during pregnancy) and postnatal care (care and treatment provided to the mother post-delivery). Mothers who unintentionally get pregnant are less likely to seek maternal and child care services. They may also engage in pregnancy-disruptive behavior such as consumption of alcohol and drugs, leading to dire consequences for their unborn child (congenital disabilities or chronic diseases). Mothers who were unaware they were pregnant until much later in the pregnancy would also naturally delay seeking out maternal services.
Some studies have found that unintended pregnancy is associated with specific potentially dangerous issues that may cause the mother's death:
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Preeclampsia: High blood pressure during pregnancy, leading to severe consequences for both mother and child.
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Postpartum Hemorrhage: Excessive bleeding experienced by the mother within one day to twelve weeks of giving birth.
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Postpartum Preeclampsia: High blood pressure and high urinary protein levels after giving birth.
Older women and Unplanned Pregnancies: With unplanned pregnancies in older women, the financial burden coupled with the parents' age might make it inordinately hard to take care of children - parental health and growth and development of the child would suffer as a result. Additionally, maternal mortality rates are high in women over 40 years of age, and childbearing can pose a risk to the infant and mother. Diseases such as hypertension and diabetes mellitus tend to occur more frequently in pregnant older women.
Teenage Pregnancy: The health risks of unintended pregnancies are much more significant in teenagers than adult women. Some commonly noted problems have been:
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Poor weight gain.
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Anemia (lack of healthy red blood cells in the body).
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High blood pressure.
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Sexually transmitted diseases (STDs).
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Long labor periods.
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Greater risk of hypertension and obesity as they grow older.
Teenage mothers often suffer in terms of personal growth. They are less likely to complete school or get a higher education. They are also usually financially unstable or unemployed.
Mental Health and Unintended Pregnancy: Unintended pregnancy has been associated with greater odds of maternal depression and parenting stress. Reasons for this include marital troubles and limited involvement of the father in the child's care. Suicidal ideation, stress, anxiety, and reduced relationship satisfaction may also occur.
Infants and Unintended Pregnancy: Unintended pregnancy may affect infant health in various ways. These include:
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Low Birth Weight: Infants born to adolescent mothers and women over 40 will usually weigh less at birth.
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Higher Rates of Illness and Injuries: Due to negligence, poor health habits, or poverty in adolescent mothers.
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Spontaneous Abortion: Common in older mothers.
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Birth Defects: Also frequent with older mothers.
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Genetic and Other Abnormalities: Abnormalities like Down's syndrome are common in unintended pregnancies with older women.
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High Rate of Miscarriage: Over 40 in 100 pregnancies in older women will result in miscarriage.
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The Effect of Maternal Medical Conditions: Medical conditions in older women such as diabetes and high blood pressure will adversely affect their infants.
Growing Children: The effects of unintended pregnancies on growing children are usually related to their personal development and emotional growth. Such children are often raised in single-parent households - which negatively affects their self-esteem and personal development. They are also more likely to discontinue education relatively early in life. Behavioral and emotional problems are rife in children like these. They tend to leave home early and may become unmarried teenage parents themselves. More often than not, their marriages end in divorce, showing a pattern similar to their parental influences. Perhaps due to their educational limitations or as an indirect consequence of their lives in single-parent households, these children also find it hard to hold steady jobs as adults. They are often involved in criminal cases and generally engage in self-destructive behaviors.
Unintended Pregnancies and Abortion: An estimated 61 % of unintended pregnancies between 2015 to 19 ended in abortion - around 73 million abortions per year.
Abortion is a procedure that terminates or ends a pregnancy, usually through medication or undergoing a surgical procedure. While abortions do not generally affect future pregnancies or cause infertility, there is a risk of these outcomes if a womb infection is developed during the abortion or if the procedure is performed by an unlicensed, untrained quack or fake doctor. The consequences of unsafe abortion are grave, particularly in countries where abortion is either banned or restricted. It can result in maternal and infant death or disease.
How Can Unintended Pregnancy Be Prevented?
Preventing unintended pregnancy hinges centrally on the provision and availability of resources. This includes:
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Access to Contraceptive Services: This is especially required in rural locations.
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Access to Education and Information: In schools, colleges, rural and urban areas.
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Access to a Trusted Mentor: Adolescents, in particular, may need a knowledgeable and supportive confidante.
Providing such services could result in a corresponding decline in unintended pregnancy and sexually transmitted infections; and an inclination to protect oneself by:
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Using protection.
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Delaying sexual initiation.
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Limiting sexual partners.
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Making informed decisions about body autonomy and sexual activity.
Another critical component is making changes to the structural, cultural, and legal systems worldwide:
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In most countries, adolescent girls avoid open discussion of early sexual initiation, fearing negative judgment. Unfortunately, this usually results in unplanned pregnancy, sexually transmitted infections, death by suicide, or pregnancy-related death. Therefore, changing cultural and societal outlook is a necessity.
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Legal restrictions on contraception are hugely problematic. Women in certain countries and young teenage girls are often denied access to contraception, either because of their age, gender, or inability to pay for contraception. Contraception should be made readily available and accessible to prevent negative consequences.
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Safe and legal abortion services are also crucial to reducing maternal mortality.
What Is a Reproductive Life Plan?
Preventing or achieving pregnancy depends mainly on understanding the pregnancy goals of women and couples. When aligned with relevant services, these goals form a reproductive life plan.
What Is Preconception Health Promotion?
Preconception health services improve the health of couples falling in the reproductive age category before conception. These services will also contribute to better female health and wellness - helping them make informed choices about their health and safety, whether or not they choose to get pregnant.
What to Do in Case of Unintended Pregnancy?
The best way to help women going through an unintended pregnancy is to avoid judgment and offer quality help and services. Antenatal and postnatal care and visits from trained reproductive health workers will improve outcomes. Those most in need of help include women from poor economic backgrounds with low educational qualifications; women who face sexual violence and domestic abuse; and women with a history of sexually transmitted infections or previous unplanned pregnancies. These women should be given extra attention, time, and focus as they are most likely to suffer from the destructive consequences of unplanned pregnancies.
Conclusion:
Unintended pregnancy is a matter of global concern, despite advancements in education and awareness. However, it is heartening to note that there has been a slow decline in unintended pregnancies in the last decade. With changing perspectives and better access to resources, unplanned pregnancy rates will undoubtedly continue to fall, and better maternal and infant health and wellbeing will be achieved.