Contraception, unintended pregnancy and induced abortion

Unwanted fertility is an important concept for understanding fertility behaviour. In Australia, about 10% of live births between 2005-2008 are estimated to have been unwanted, and a further 10% were mistimed in that they occurred earlier than desired. One criticism of measures of unintended childbearing is that they are usually only based on the views of one parent, typically the mother. In recent years, there has been increasing awareness of the need to consider men’s roles and to study childbearing decision in the context of the couple. To this end, many surveys ask respondents to provide proxy answers on behalf of their partner. While proxy reports can be a cost-effective and simple way to gain information about the partner, without actually interviewing them, there has been little systematic research assessing their accuracy. Using data from a 2008 Australian survey we assess the accuracy of proxy reports of pregnancy wantedness by directly comparing them with the partner’s responses. We find that proxy reports are accurate in 87% of cases. In the remaining 13%, they either over or underestimated the degree to which the partner wanted the pregnancy. Proxy reports are often inaccurate when the partner did not want the child.

Due to a large unmet need for modern contraception in Uganda, many women resort to abortion to meet their fertility goals. However, abortion in Uganda is legally restricted, making a majority of the abortions in the country clandestine and unsafe. Apart from the dangerous health consequences, unsafe abortions also take an economic toll on the women who resort to it. Not only do these women have to pay for the abortion, they also have to pay for the treatment of its complications, and remain out of productive employment for the duration of their ill-health. Using data from a primary survey in Uganda, we examine the nature of these consequences to women and their households. Preliminary results show that that 61% of the women in our sample obtained an induced abortion. About 72% of them were under age 30, with a quarter being under age 20. Over half the women came from rural areas and were socially and economically disadvantaged. As indicated by our initial results, we expect to find that the negative economic consequences will be the strongest for the poorest women, who are more likely to slip deeper into poverty because of it.

Adolescent pregnancy has been an important issue in Mexico, particularly in the past years. Recent data in Mexico have shown decline in fertility lower than expected, particularly among adolescents. Moreover, policies have largely ignored an important subgroup of adolescents: 10-14 year-old girls. Recently, Mexico has developed a new type of birth certificate that has allowed us to examine pregnancy characteristics among this particular age group, and to analyze the association between young maternal age and the risk of negative birth outcomes.
Our results show a steady proportion of pregnancies among women aged 14 or younger in the last 4 years, accounting for a little less than 0.7% of 8 million births registered. This group of adolescents exhibits a more disadvantaged position than the rest of the adolescents (15-19), in terms of education and socioeconomic level. Interestingly, our results show significant differences in birth outcomes, such as birth weight and gestational age. Additional and more accurate policies are required to attend this traditionally ignored age group.

Family planning is generally acknowledged as an important component of the reproductive health agenda and a necessity in all programs and policies geared towards the realization of safe motherhood. Several studies have established that most maternal deaths occur in the postpartum period. This paper therefore aims to contribute to existing knowledge on the factors affecting the adoption of PPFP, with special emphasis on examining how influential the women’s contact with maternal health services (antenatal care, delivery in a health facility and postnatal care) had been on adoption of contraception in the postpartum period. The analysis was based on the data from the Women’s Questionnaire and the calendar data from the 2008 Nigeria Demographic and Health Survey (NDHS). The use of maternal health services (ANC visits and timing of postnatal check-up) is significantly associated with the use of a modern method of contraception during the postpartum period. Other significant predictors of the use of a modern method in the postpartum period include region, education, the household wealth index, and exposure to family planning messages. The findings suggest that contraceptive use among postpartum women will increase substantially if more women use maternal health care services, especially for antenatal care and postnatal care.

In Burkina Faso, abortion is legally restricted. It is permitted only in some few cases (incest, rape, fetal defect or when the woman's life is endangered). Socially, the practice is censured and women are often stigmatized when they have an abortion. To estimate the prevalence of abortion, two surveys are conducted since 2001. Two methodologies are used to estimate abortion incidence: the Health Facility Complications Method (HFCM) and the Anonymous Third Party Reporting (ATPR) method (Rossier C., 2006). It is found that the rate of abortion was high in Ouagadougou in 2002 and 60% of women who had an abortion had adverse health consequences, and 14% were treated in hospitals (Guiella. G, 2006).

The first data cover Ouagadougou (2001) and the second one all the country (2009). These two data sources permit the analysis of the trend and the change in Ouagadougou. With a method of analysis of change (decomposition method), we want to understand where the change comes and how it appends. An analysis of women’s attitude and opinions related to abortion will give us a good understanding of the change.

Side effects or fear of side effects have been shown to be an important factor in the lack of adoption of contraceptive methods, particularly modern hormonal methods, however little is known about the actual experience of side effects and their influence on contraceptive use dynamics. This study aims to explore the association between the experience of side effects, the type of method, and the duration of episodes of use. This paper uses calendar data from a longitudinal survey conducted in Southern Ghana containing monthly reporting
of contraceptive use along with concurrent reporting of side effects. Descriptive statistics and single decrement life tables are used for the analysis. The result show that injectable use is most commonly associated with side effects, with 33.8% of episodes of contraceptive use being associated with the experience of side effects compared to 28.3% of pill episodes. However due to the longer length of episodes when taking into account all months of use only 9% of women-months of injection use have side effects compared to 11% of women-months of pill use. The length of pill episodes is not affected by side effects whereas for injectables the length of episodes is shorter when side effects are experienced than when they are not.

More than half (52%) of unintended pregnancies in the United States occur among the 10.7% of women using no contraceptive method. Using a qualitative sample of women obtaining abortions in the U.S. in 2008 (n=49), we explored women’s attitudes towards and beliefs about contraception and found that even though two-thirds of the sample had been pregnant before, 32 respondents perceived themselves to have a low likelihood of becoming pregnant. Respondents’ reasons for this perceived low likelihood feel into three categories: invulnerability to pregnancy, perceptions of sub-fecundity, and lack of attention to the possibility of conception. About half of the women discussed more than one theme when explaining why they perceived themselves to have a low likelihood of becoming pregnant at that time. For some women who were using contraception, their perception was based on their contraceptive use although the majority who fell into this subgroup were using contraception inconsistently or incorrectly. We propose a modified Health Belief Model (Hall 2012) to account for women’s ambivalence about the need for contraception based on our results. Further research is needed to quantify who believe they are not at risk of pregnancy and their reasons why to better address women’s misconceptions about fecundity and conception.

Although progress has been observed in Brazilian social mobility in recent years, significant social deficits are still recognizable. In light of this finding we propose to identify how patterns in reproductive and contraceptive practices are formed in accordance with belonging to different social classes using the 1996 and 2006 National Demographic and Health Survey (PNDS) data. Although the PNDS lacks data typically employed for classifying individuals in social class, this survey has important information about reproductive histories, reproductive intentions, contraceptive practice, among other information. To work with the concept of class we will adjust the Wealth Index, an indicator of socioeconomic status that takes into account features and services to which the household has or has access to it. We aim at highlighting the differences in reproductive patterns and contraceptive practices on the basis of social class. The aim of this paper is therefore to link reproductive patterns and contraceptive practice to membership to a certain social class. More specifically, we propose to use an empirical concept of social class that takes into account more than income and assets. Thus we will use more than economic factors to account for the multiple facets of the concept of social class applied to the Brazilian reality.

While many researches have shown that contraceptive use tends to increase where there is spousal communication and concordance on reproductive intentions, many other studies, using couple data, have equally shown that most spouses do not accurately report the views/intentions of their partners. This study is based on the baseline data from a longitudinal couple study in a peri-urban community, Ipetumodu, in Osun State, Nigeria collected between April and May, 2010. The study shows that there is a noticeable level of discordance when the response of each wife is matched with her husband’s on several issues. For instance, only 14% of couples concurred that they use contraception. The study shows that even in a patriarchal society like Nigeria, a woman’s reproductive intention is a more important determinant of her contraceptive use than her husband’s reproductive desire, and also that couples’ agreement on reproductive intentions is an important predictor of women’s use of contraception.

The reproductive choices made by young women and men have an enormous impact on their health, schooling and employment prospects, as well as their overall transition to adulthood. The knowledge of temporary methods of contraception is fundamental to the ability of married and unmarried women (including youths) to make informed choices about reproductive health decisions. Knowledge of contraception and HIV/AIDS is examined for unmarried women with family life education and married women with health sector interaction. Knowledge of different methods of contraception is better among married adolescent in comparison to unmarried women except for emergency contraceptive pills. Unmarried women discussed contraception with friends followed by brother and sister and one-fifth of them also discussed with parents. However, only seven percent and fourteen percent unmarried women ever discussed with health provider/sex education expert and teacher respectively. Neither family life education, nor formal education was related to reproductive knowledge (conception), which was poor among the unmarried adolescents. Awareness about HIV/AIDS is better among unmarried women in comparison to married women in the age group 15-24. Understanding of sexual issues among young people is inadequate and current format of family life education may be ineffe