Helping women achieve healthy timing and spacing of their pregnancies: A systematic review of the literature

The 2012 London Summit on Family Planning has spearheaded a renewed focus on increasing access to family planning. Key to increasing demand for and use of family planning services will be understanding interventions that are effective at meeting the needs of vulnerable populations. While multiple reviews have examined the effects of interventions aimed at reducing unintended and adolescent pregnancies, this paper examines the evidence on interventions aimed at preventing or reducing fertility-related, high-risk pregnancies through use of modern contraceptive methods. This analysis is based on a systematic review of peer reviewed articles from 1990 to present. The articles identified will be analyzed using a qualitative analytical framework. The qualitative analysis consists of identifying the country context, interventions implemented, outcomes reported, and analysis of the intervention and main findings. Articles will be evaluated based on the strength of the evidence, including an evaluation of the study design, adequacy of the sample size, comparability of the intervention and comparison groups, control for confounding factors, and statistical significance of the results. This paper will guide program managers and policy makers on which interventions contribute to reducing fertility-related, high-risk pregnancies.