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Background: Unintended pregnancy is a global public health issue with significant adverse effects which include health and economic consequences. Globally, there were 121 million unintended pregnancies annually between 2015 and 2019 among women of reproductive age between 15 and 49 mainly due to the non-uptake of modern contraceptives, harmful norms, stigma and lack of sexual and reproductive health care and information. Methods: We extracted information from the Nigeria Demographic Health Survey conducted in 2008, 2013, and 2018 to assess the trends and factors associated with unintended pregnancies among women of reproductive-aged 15–49. The descriptive summaries were presented using percentages and binomial logistic regressions for the inferential analysis. All analyses were computed using Stata 15.0 at a 5% level of significance and accounted for the complex survey nature as well as the population size. Results: The study included a total of 63,040 women of reproductive age. The prevalence of unintended pregnancy was highest among adolescents aged 15–19 years (15.1%, 95% CI: 13.9–16.5) and decreased with increasing age. The pooled adjusted model revealed that women had 11% lower odds of reporting unintended pregnancies in 2013 compared to 2008. Adolescent girls (aOR 2.48; 95%CI: 2.14–2.89) and young adults (aOR 1.86; 95%CI: 1.69–2.04) have higher odds of reporting unintended pregnancies compared to older women. Also, unmarried women had 9.8 times higher odds of reporting unintended pregnancies compared to ever-married women. Conclusions: The findings from this study highlight the need for further family planning educational programs and initiatives that support the uptake of effective contraceptive methods to reduce the likelihood of unintended pregnancy and improve women's sexual and reproductive health while considering regional variations within the country to ensure tailored interventions that address specific needs within each region. [ABSTRACT FROM AUTHOR]

AbstractUnsafe abortions contribute significantly to maternal mortality and morbidity in Ghana. To reduce this, in 1982 abortion laws in Ghana underwent reform to broaden the conditions under which abortion is accessed. Although, evidence in other contexts highlights the contribution of violence to women’s experience of unwanted pregnancy and abortion, such evidence is limited within the Ghanaian abortion literature. This study aims to fill that gap. Informed by phenomenology, interviews were conducted with 10 women who had experienced various forms of violence leading to unwanted pregnancy and unsafe abortions. Participants were recruited between June 2017 and March 2018 in the Ashanti region of Ghana where they sought hospital care for unsafe abortion related complications. Participants mentioned intimate partners as the main perpetrators of violence. Financial challenges were also identified as important in increasing women’s vulnerability to violence. Verbal abuse from health workers contributed to denying women access to safe abortion. This paper advances dialogue about the ways in which women’s experience of violence from intimate/non-intimate partners and healthcare workers impacts their overall abortion experience. It advocates the empowerment of women to enable them to leave violent relationships, and the retraining of health workers to enable them to adopt respectful and empathetic care practices. [ABSTRACT FROM AUTHOR]

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Aim: This pilot study aimed to assess the utility of an oral progesterone treatment protocol for women who commenced medical abortion and then changed their mind and wished instead to maintain their pregnancy. Methods: The Progesterone‐After‐Mifepristone—pilot for efficacy and reproducibility (PAMper) trial was designed as a prospective single‐arm pilot clinical trial, conducted via telehealth. Women aged 18 to 45 years in Australia who reported ingesting mifepristone within the last 72 h to initiate medical abortion and had not taken misoprostol were included. Initial contact was by a web‐based form. Following informed consent, participants were prescribed oral progesterone to be taken 400 mg twice per day for 3 days then 400 mg at night until completion of a 19 day course. Pregnancy viability was assessed by ultrasound scan after 14 days of progesterone treatment. Results: Between October 2020 and June 2021, nine women contacted the PAMper trial, of whom six enrolled and commenced progesterone treatment. These women reported ingesting mifepristone at 40–70 days of gestation, with progesterone being commenced within 5.7–72 h of mifepristone ingestion. Five participants had ongoing, live pregnancies at the primary endpoint (ultrasound at >2 weeks). One participant had a miscarriage after 9 days of progesterone treatment. There were no clinically significant adverse events. Conclusion: This small study demonstrated a clinically sound protocol for researching the use of progesterone‐after‐mifepristone for women in this circumstance. Results of this pilot study support the need for further larger scale trials in this field. [ABSTRACT FROM AUTHOR]

This article delves into the intricate world of gift-giving within the context of blesser-blessee relationships in South Africa, where affluent individuals provide financial support to their younger counterparts in return for favours, most often of a sexual kind. Examining the multifaceted nature of these transactions, the article explores the implications of such relationships on the emotional well-being, ethical considerations, and power dynamics of those involved. From imaginary and symbolic gifts to the controversial "envelope practices" we scrutinise the various dimensions of giftgiving in these relationships. Additionally, the article addresses the darker aspects of these dynamics, including issues of exploitation, vulnerability, and societal stigma. While recognizing the desire for intimacy among individuals, especially younger and less mature participants, the article emphasizes the importance of understanding the nuanced complexities of gift-giving within these relationships. The fraud diamond theory is explored as a foundation for the integration of practices like blesser-blessee behaviours within organisational activities, highlighting the role of social norms in shaping acceptable behavior. Ethical leadership is underscored as crucial for maintaining integrity within organisations, emphasising the importance of leaders in mediating uncertainty and promoting virtues such as humanity. Additionally, Lacan's theory is introduced, suggesting that communication is inherently flawed and that the unique context of the blesser-blessee phenomenon in South Africa may pose challenges for understanding. Ultimately, the article calls for a critical examination of the ethical implications and advocates for comprehensive education and support systems to navigate the challenges associated with intimacy, power imbalances, and financial transactions in such relationships. [ABSTRACT FROM AUTHOR]

Aim: This study was planned to analyse the unwanted pregnancies and to determine the frequency and causes according to risk groups. Materials and Method: This is a cross-sectional study conducted on 409 married volunteer pregnant women who applied to the hospital for prenatal care. A questionnaire prepared by the researchers was used for data collection. Percentage, mean, and chi-square test were used to evaluate the data. Results: The rate of unwanted pregnancies was found to be 23.2%. The rate of unwanted pregnancy decreases with age. The unwanted pregnancy rate decreases as the education level of the woman increases and this ratio decreases to 18.5% among university graduates. Conclusion: In this study, the high rate of unwanted pregnancies was since most of them were not using a family planning method or using traditional family planning methods. It was found that the risk group with the highest unwanted pregnancy rate was among young women. Since the rate of withdrawal method was high especially in young women and this can lead to unwanted pregnancies, it is necessary to give couples premarital education. [ABSTRACT FROM AUTHOR]

The study examines the association of unwanted pregnancy and the utilization of maternal-child health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2-2.4), prolonged labor (AOR=1.6; 95% CI=1.2-2.1), the absence of child's birth documentation (AOR=1.3; 95% CI=1.0-1.6), and smaller baby size (AOR=1.2; 95% CI=1.0-1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2-2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban. [ABSTRACT FROM AUTHOR]

The study examines the association of unwanted pregnancy and the utilization of maternalchild health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2-2.4), prolonged labor (AOR=1.6; 95% CI=1.2-2.1), the absence of child's birth documentation (AOR=1.3; 95% CI=1.0-1.6), and smaller baby size (AOR=1.2; 95% CI=1.0-1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2-2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban. [ABSTRACT FROM AUTHOR]

Objectives: Psychiatric disorders are a significant health concern during the perinatal period. Therefore, this study determined the prevalence of psychiatric symptoms and their associated factors during pregnancy. Methods: All pregnant women who presented to Kafkas University gynecology and obstetrics outpatient clinic for examination between February 4 and May 4, 2019, and consented to participate in this study were included. This study employed the General Health Questionnaire, sociodemographic characteristics of the pregnant women, and perceived health status. Results: Notably, 190 (45.6%) of pregnant women had psychiatric symptoms. Regarding the risk factors, they were 1.920 times more in pregnant women living in the villages or towns than those living in cities or city centers (95% CI: 1.224-3.014); 1.986 times more in unemployed pregnant women than those with a steady income (95% CI: 1.139-3.461); 0.469 times more in those who desired the pregnancy than those with undesired pregnancy (95% CI: 0.261-0.844); 1.650 times more in first pregnancies than those with more than two pregnancies (95% CI: 1.069-2.548). Conclusion: Pregnant women living in rural areas like villages or towns, those unemployed and pregnant for the first time, were determined to be at high risk for psychiatric symptoms. Therefore, physicians at primary healthcare institutions should be periodically trained regarding perinatal psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background Women facing problematic pregnancies, defined as "unplanned, mistimed, unwanted, or otherwise difficult," either have abortions or make adjustments to welcome these pregnancies. These adjustments are understudied. Pregnancy resource centers that provide counseling and services to assist in the process of welcoming pregnancies have been the focus of controversy due to their refusal to counsel or refer for abortions. This survey of a national population of women seeks to quantify changes in attitudes toward problematic pregnancies that are not aborted and to gauge levels of contact with pregnancy help centers and perceptions of harm or benefits attributed to those contacts. Methodology A national research firm was enlisted to obtain 1,000 surveys completed by female residents of the United States aged 41-45, inclusive. Women reporting a history of abortion were surveyed along one path. For those who did not have abortions but reported a problematic pregnancy, questions were presented to assess changes in attitude toward their pregnancy from the date they first learned they were pregnant to 90 days later, their considerations of abortion, whether they had contact with a pregnancy help center, and their assessment of that contact on either harming or improving their lives. Results Among 275 respondents who had no history of abortion but had ultimately welcomed a problematic pregnancy, 112 (40.7%) had been at higher risk of abortion. Positive attitudes toward their pregnancies increased most rapidly for women who had been at higher risk of abortion but were lower on the day they first learned they were pregnant. Overall, 34 (12.4%) reported they had contacted a pregnancy help center that did not refer for abortions. Another 37 (13.5%) were uncertain if they had contacted an organization fitting that description. Both groups reported the contact improved their lives, on average. Negative assessments were uncommon and all were of a small degree. Conclusions Women facing problematic pregnancies who did not choose abortion experienced rapid improvements in feelings of wantedness, timeliness, acceptance, welcoming, and desirability toward the pregnancy. The rate of improvement was most rapid among those who had investigated and considered abortion. Women reporting contact with pregnancy help centers almost always assess it as having improved their lives., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Sterling Institutional Review Board issued approval 10225. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: Charlotte Lozier Institute. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: The author is an advocate for post-abortion counseling programs for women seeking help after unwanted or coerced abortions., (Copyright © 2024, Reardon et al.)

Introduction: Sexual violence plays a key role in women's pregnancy intention. We investigated the influence of sexual violence on planned, mistimed, and unwanted pregnancies in sub-Saharan Africa (SSA). Materials and methods: Data from the Demographic and Health Survey (DHS) of 22 countries in SSA were used in this study. Both descriptive and inferential analyses were conducted. We carried out a multinomial logistic regression analysis to examine the effect of sexual violence on planned, mistimed, and unwanted pregnancies. STATA version 14.2 was used to carry out all analyses. Statistical significance was declared at p

Abstract Objective Previous research indicates that attitudes to pregnancy and motherhood are influenced by social values, culture and religion. This study explores the relationship between social support and unwanted pregnancy among Pakistani women. This cross-sectional study was conducted at four teaching hospitals in Lahore in 2014. Results A total of 500 pregnant women who visited the hospitals’ obstetrics and gynecology departments were asked to respond to a questionnaire consisting of respondents’ characteristics and the Social Provisions Scale (SPS). Logistic regression analyzed the predictors of unplanned pregnancy. Unwanted pregnancies were more likely to occur among pregnant women from rural areas, with low scores on the SPS ‘reassurance of worth’ sub-scale, no history of contraceptive use, and who already had at least one son than those with no sons.

Opportunities for young girls in sexual health education is being discriminated against because there are beliefs that girls that know too much can become wayward. Adolescent girls are faced with so many challenges ranging from cultural and parental pressures. This study sought to evaluate the access to health information and family influence on reproductive health literacy amongst adolescent girls. The sample size comprised two hundred and fifty females (n-250) students selected through purposive sampling method. The research instrument is a self-developed structured and validated questionnaire while descriptive statistics of frequency counts and percentages was used to analyze the responses. Two hypotheses were postulated. Findings showed that access to health information regarding reproductive health is limited and also family influence reproductive health literacy. The study therefore recommends that parents should educate their young daughters about family planning method and teachers should take out time from their allotted schedule to discuss sexual related issues with the adolescents in the school.

Background & aim: Despite the success of family planning programs in Iran in the recent decades, considerable proportions of pregnancies are still unintended and can be a cause of poor mental and physical health of the mother and child. The aim of this study was to investigate some important factors affecting uplanned pregnancies among married women in Semnan province, one of the developed provinces of Iran with below replacement fertility level. Methods: The data for this study were drawn from a cross-sectional survey conducted in Semnan province in 2014. A total of 363 married women within the age range of 15-49 years who were pregnant or had the history of at least one delivery were considered. The study sample was selected using multi-stage stratified sampling method. The data were collected using a self-structured questionnaire with 90 items and Cronbach's alpha coefficient of 0.88. Data analysis was performed in SPSS (version 20) using Crammer’s V coefficients and Chi-square tests. Logistic regression analysis was also applied to model the risk of unintended pregnancies based on selected covariates. Results: According to the results, around 18.2% of the pregnancies were unplanned, 7.7% and 10.5% of which were mistimed and unwanted, respectively. Based on the logistic regression analysis, birth cohort, number of children ever born, and contraceptive methods had significant effects on the risk of unintended pregnancies. Furthermore, about 48% of the women experiencing unintended pregnancy were using a traditional contraceptive method before or at the time of the conception. Conclusion: As the findings indicated, the women who used contraceptive method, as well as those with higher number of children and younger birth cohorts had higher risk of unplanned pregnancies. It should be noted that the majority of unplanned pregnancies among the women in younger birth cohort were mistimed pregnancies. So it is recommended to continue offering family planning and health services to these women in order to prevent unplanned pregnancy, unsafe abortion, and many chronic diseases.

Objective: Despite the annual increase in the rates of family planning use among women of reproductive age in Turkey since 1988, still the most commonly preferred contraceptive method is coitus interruptus. The aim of this study was to evaluate the knowledge levels, attitudes, and behaviors of women concerning contraceptive methods. Methods: Our study included 18-49 years old women; who had experienced sexuel intercource and presented to Health Science University Şişli Hamidiye Etfal Education and Research Hospital Family Medicine outpatient clinic for any reason in the period from 01.06.2017 to 01.08.2017. The design of our study was prospective, cross-sectional, and descriptive. After obtaining the verbal and written informed consent of the eligible participants, a 22-item questionnaire was applied in face-to-face interviews. The SPSS 15.0 program was used for performing the statistical analyses. A p-value of <0.05 was considered statistically significant. Results: A total of 217 people participated in this study. The mean age of the participants was 32.6 ± 8.5 years (min: 18, max: 49). 171 participants (78.8%) were married, 143 (65.9%) were unemployed, and 95 (43.8%) had completed secondary education or higher. Of the participants, 58.1% (n = 126) were currently using a contraceptive method. 177 participants (81.6%) had tried at least one contraceptive method at some point in their lives. The most preferred contraceptive method was coitus interruptus (n=50, 39.7%). All participants knew about at least one method of contraception, but when assessed in terms of knowledge, they were found to have inadequate knowledge about most methods. Only 4.6% of all participants (n=10) had adequate knowledge about the most preferred method, coitus interruptus. 98 people (45.2%) had experienced at least one unplanned pregnancy and the voluntary abortion rate was 10.6% (n=23). The most common reason behind unplanned pregnancies was the failure of the coitus interruptus method (34.7%, n=34). Conclusion: Women of reproductive age still prefer the traditional coitus interruptus method most commonly as contraception. All participants knew about at least one method of contraception, but when assessed in terms of knowledge, they were found to have inadequate knowledge about most methods. Almost half of the participants experienced an unplanned pregnancy at least once in their lives and unplanned pregnancies were most common with the coitus interruptus method. We think that increasing the trainings about contraceptive methods will decrease unplanned pregnancies. [ABSTRACT FROM AUTHOR]

Introduction: The literature on the social aspects of on-demand abortion is scarce. For many years, our country was among the first in Europe concerning the number of abortions. The World Health Organization has published alarming statistics on the number of abortions performed on demand. The existing research must be interpreted according to administrative, cultural, religious, financial particularities, in the larger context of the societal traits, at a given time. We must also take into account the existence of alternatives to abortion, and also the socially transmitted models that shape the choices of women with "unwanted" pregnancies. To reduce the number of pregnancies that end in abortion on demand, it is important to know the factors that contribute to or maintain this behavior. Social factors have been considerably neglected, the existing research generally focusing on investigating the psychological effects of abortion. Objectives: The aim of the research was to identify the sociocultural factors that contribute to the occurrence of unwanted pregnancies and the decision to have an abortion in Romania. Methods: The data were collected through anamnesis, interview, micro-inquiry, marital satisfaction standardized tests, administered to 280 women with unwanted pregnancies, aged between 15-49 years, who participated in the study. This exploratory study used an in-depth interview to highlight the factors associated with taking the decision to undergo an abortion on demand. Results: The determinants that potentiate unwanted pregnancies and abortion on-demand in Romania are: age, level of formal education, background (rural/urban), quality of marital relationship, existing children, financial difficulties, unemployment, beliefs perpetuated in the family or group of women - abortion seen as an acceptable behavior, no use of/mistrust in contraceptive methods. Conclusions: The research identified the social determinants to understand the factors that increase the incidence of women experiencing unwanted pregnancies who undergo abortions ondemand, in an attempt to develop programs to prevent such situations and psychological counseling guides for women falling in these categories, in order to decrease the abortion rate in Romania (given the psycho-affective impact on women and their families, produced by unwanted uterine surgery, which often is seen as the only solution to such outcome), and in order to raise awareness and understand repetitive patterns and adequately address women's needs. [ABSTRACT FROM AUTHOR]

To investigate the reasons for discontinuation of the last contraceptive method used among adolescent women with a current unintended pregnancy. Demographic and health, cross-sectional, surveys. Thirty-five low- and middle-income countries. We selected 2173 girls aged 15-19 years with a current unintended pregnancy, using a multistage cluster random sampling method. A questionnaire administered by trained interviewers, which included sociodemographic as well as individual maternal and contraceptive history, was used to collect data. The prevalence of contraception utilization and the contribution of each reason for contraceptive discontinuation before the current unintended pregnancies. Almost three-quarters of adolescent women were not using any contraception before the current unintended pregnancy, and less than 1 in 100 was using a long-acting modern method. Among girls who last used a traditional method, 111/150 (74.0%) discontinued because of failure. Among girls who last used a long-acting modern method, 7/11 (63.6%) discontinued because of health concerns and side effects. This study highlights that approximately 80.0% of adolescent women with an unintended pregnancy in 35 low- and middle-income countries were either nonusers or using traditional methods. An additional 20.4% were using a short-acting modern method. Long-acting methods would have prevented the overwhelming majority of unintended pregnancies, including the vast numbers from contraceptive failure. [ABSTRACT FROM AUTHOR]

Objectives: To explore the reasons for discontinuation of the last contraceptive method used in women with a current unintended pregnancy.Study Design: We conducted a retrospective analysis using contraceptive calendar data from Demographic and Health Surveys from 36 low- and middle-income countries from 2005 through 2014. The prevalence of contraception utilization and the contribution of each reason for contraceptive discontinuation was calculated, at country level as well as for the pooled dataset, for 10,901 women aged 15-49 before the current unintended pregnancies.Results: Unintended pregnancies ranged from 5.5% of all pregnancies in the Kyrgyz Republic to 60.0% in Colombia and Peru. In Central Asian and in six African countries, over 80% of women with a current unintended pregnancy had not used any contraceptives in the previous five years. Use of long-acting modern methods remained consistently low across all countries. Among women who last used a traditional method, 83.8% discontinued due to failure. Among women who last used a long-acting modern method, 40.2% discontinued because of side effects.Conclusions: Our findings confirm that more than 65.0% of women with an unintended pregnancy in 36 low and middle-income countries were either non-users or using traditional methods. An additional 31.2% were using short-acting modern methods. Long-acting methods would have prevented the overwhelming majority of unintended pregnancies.Implications: This paper shows the need for the health system to support use of suitable methods, reduce switching failure and identify early when women are having concerns about the method they are using. [ABSTRACT FROM AUTHOR]

Purpose: One-third of all pregnancies in the United States are conceived within 18 months of a prior live birth. Preventing unintended pregnancies may help to decrease the prevalence of pregnancies with these short interpregnancy intervals. However, data on factors associated with pregnancy intention among women who have had short birth intervals are sparse. Pregnancy Risk Assessment Monitoring System data were used to further evaluate these associations.Methods: Because only Mississippi and Tennessee Pregnancy Risk Assessment Monitoring System include a survey question about birth interval length, this analysis was limited to women from those states who recently had a short birth interval (n = 384). Pregnancy intention and demographic, lifestyle, and reproductive data were obtained from surveys and birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs).Results: Nearly 76% of women with short birth intervals reported their pregnancy as unintended. Women who were non-Hispanic black or consumed alcohol during pregnancy had statistically significant increased odds of reporting the pregnancy with a short birth interval as being unintended (OR = 3.98; 95% CI: 1.73-9.16 and OR = 10.56; 95% CI: 1.80-61.83, respectively).Conclusions: Although all women should be counseled on postpartum contraceptive use, findings suggest that important subpopulations of women may benefit from more targeted counseling during prenatal care visits and the immediate postpartum hospital stay regarding the importance of using contraception to not only better space pregnancies but also prevent unintended pregnancies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sexually transmitted infections and unplanned pregnancies are two major public health problems. The male condom reduces the risks while as people acquire more experience and knowledge of their correct and consistent use. MATERIAL AND METHOD: An observational, analytical, transversal and prospective study was done. The type of sample was by conglomerates, selecting 9 groups of high school students. A questionnaire called "knowledge of the correct use of masculine condoms" was applied to these students. RESULTS: There were included 201 students, from which 105 were men. The mean age was 16 years old; 191 were single, 4 were married and 6 lived in free union. Results showed that less than a half of the people has a correct knowledge of the use of the masculine condom whether of their sex or marital status. CONCLUSION: Despite of the information given constantly by diverse media, professionals in health and academic institutions, a very low percentage of subjects have knowledge about the correct use of the male condom. [ABSTRACT FROM AUTHOR]

In Benin, the prevalence of so-called 'modern' contraception is very low, yet the fertility rate is also relatively low and when compared to the situation in neighbouring countries, this relationship is very surprising. This, therefore, raises the question of voluntary abortion, the legal access to which is extremely restricted. Apart from the numerous methods, some of which are more aggressive than others and with varying levels of support from various healthcare professionals, there is a drug described in the literature as being used as a form of self-medication since the 1990s in some regions of the world (Latin America, Caribbean). According to experts, it has enabled maternal death to be lowered considerably, of which a good part is due to the practice of performing unsafe abortions. Is this what misoprostol in Cotonou is used for? Is this drug easily accessible? Is it used, whether as self-medication or not, by women who are met with an unwanted pregnancy? And if not, what other methods are available to them? This is a qualitative ongoing study and investigated 25 women who have recently had an abortion. After presenting the profile of the women who met with an unwanted pregnancy, the factors used when making the decision to have an abortion will be discussed, as well as the other methods considered by the women, including misoprostol, which is still rarely used. Nevertheless, it would seem we are in a pivotal period, which could see a rise in the use, including through self-medication, of this drug. [ABSTRACT FROM AUTHOR]

Background & Aim: Unwanted pregnancy is one of the most important causes of mother and child mortality. It may end up to illegal abortion and result in inevitable physical and psychological consequences. This study aimed to determine the correlates of unwanted pregnancy among pregnant women attending medical and health centers in Semnan. Methods & Materials: In this cross-sectional study, we recruited 229 pregnant women using random sampling. Women with at least one alive child were recruited. Data were gathered using a questionnaire and analyzed using descriptive; analytical statistical tests. Results: The mean age was 30.7. The mean age at marriage was 19.7. Of all women, 32.3% had unwanted pregnancy. The results showed that there were significant relationships between age of marriage (P

This study examines the prevalence, reasons, and predictors of unwanted pregnancies and induced abortions among ever married HIV-infected women attending a care facility in Maharashtra, Western India, and discusses its programmatic and policy implications. Retrospectively collected data of pregnancies conceived after the diagnosis of HIV were analyzed using descriptive and logistic regression techniques. Among the 622 women interviewed, 113 women had 158 pregnancies with known outcomes after HIV diagnosis. Among these pregnancies, 80 (51%) were unwanted and 79 (50%) were voluntarily terminated. Fear of transmitting HIV to the child was a frequently mentioned reason for an unwanted pregnancy (71.8%) and induced abortion (59.5%). Women from urban areas [OR 2.43 (95% CI 1.23–4.79)] and with two or more live births before HIV diagnosis [OR 3.33 (95% CI 1.36–8.20)] were significantly more likely to report an unwanted pregnancy. Women with two or more live births before HIV diagnosis [OR 3.16 (95% CI 1.20–8.35)], who did not know that HIV transmission to the baby can be prevented [OR 3.29 (95% CI 1.48–7.34)] and with an unwanted pregnancy [OR 4.82 (95% CI 2.33–10.00)], were significantly more likely to terminate the pregnancy. Despite increased coverage of antiretroviral treatment, effective provision of reproductive healthcare services to HIV-infected women remains challenging. A high prevalence of unwanted pregnancies and induced abortions and a low level of knowledge about prevention of mother to child transmission (PMTCT) underscore the need for preconception counseling and provision of comprehensive family planning services to HIV-infected women. Enrolling all HIV-infected pregnant women, irrespective of their decision to continue with their pregnancy, in the PMTCT program and discussing with HIV-infected women and their partners at HIV diagnosis a full array of contraceptive methods and not just consistent use of condoms might be helpful in reducing unwanted pregnancies. [ABSTRACT FROM PUBLISHER]

Aim The objective was to examine lifetime exposure to violence, physical and sexual, among women seeking termination of pregnancy (TOP) and its association with socio-demographic factors, PTSD, symptoms of anxiety and depression. Design The design of the study was a Swedish multi-centre study targeting women requesting TOP. Methods All women requesting TOP with a gestational length less than 12 pregnancy weeks were approached for participation in the study. The questionnaire comprised the following research instruments: Screen Questionnaire-Post traumatic Stress Disorder (SQ-PTSD) and Hospital Anxiety and Depression Scale (HADS). The response rate was 57% and the final sample was 1514 women. Descriptive and analytic statistics were applied. Results Lifetime exposure to violence was common among women seeking abortion. Exposure to violence was associated with low education, single marital status, smoking and high alcohol consumption. Exposure to violence was associated with the occurrence of signs of PTSD and symptoms of anxiety and depression. Among those having PTSD, all had been exposed to sexual violence and almost all had been exposed to physical violence, while for those with symptoms of anxiety and depression almost half had been exposed to either physical or sexual violence. Conclusion Exposure to physical and sexual abuse was common among women requesting TOP, and was strongly associated with the occurrence of PTSD, symptoms of anxiety and depression. This underscores the importance for health professionals to recognize and offer support to those women exposed to violence. [ABSTRACT FROM AUTHOR]

STUDY QUESTION: What is the contribution of the underuse of modern methods (MM) of contraception to the annual undesired pregnancies in 35 low- and middle-income countries? SUMMARY ANSWER: Fifteen million out of 16.7 million undesired pregnancies occurring annually in 35 countries could have been prevented with the optimal use of MM of contraception. WHAT IS KNOWN ALREADY: Every year, 87 million women worldwide become pregnant unintentionally because of the underuse of MM of contraception. STUDY DESIGN, SIZE, DURATION: Demographic and health surveys (DHS) of 35 countries, conducted between 2005 and 2012, were analysed. PARTICIPANTS/MATERIALS, SETTING, METHODS: Contraceptive use of 12 874 unintentionally pregnant women was compared with 111 301 sexually active women who were neither pregnant nor desiring pregnancy. MAIN RESULTS AND THE ROLE OF CHANCE: An average of 96% of 15-to 49-year-old eligible women took part in the survey. When adjusted for covariates and compared with the use of MM of contraception, the use of traditional methods was associated with a 2.7 [95% confidence interval (CI): 2.3 -3.4] times increase in odds of an undesired pregnancy, while non-use of any method was associated with a 14.3 (95% CI, 12.3- 16.7) times increase. This corresponded to an estimated 16.7 million undesired pregnancies occurring annually in the 35 countries, of which 15.0 million could have been prevented with the optimal use of MM of contraception (13.5 million women did not use MM whilst 1.5 million women utilized MM incorrectly). Women with the lowest educational attainment and wealth quintile were 8.6 (95% CI: 8.2-9.1) and 2.6 (95% CI: 2.4-2.9) times less likely to use contraceptives compared with those with the highest level of each, respectively. Of the 14 893 women who neither desired pregnancy nor used contraception, 5559 (37.3%) cited fear of side effects and health concerns as the reason for non-use, 3331 (22.4%) cited they or their partner's opposition to contraception or religious prohibition and 2620 (17.6%) underestimated the risk of pregnancy. LIMITATIONS, REASONS FOR CAUTION: Despite the fact that DHS are considered high-quality studies, we should not underestimate the role played by recall bias for past pregnancies. Few women report a current pregnancy in the first trimester and undesired pregnancies at that time are probably prone to under-reporting. Some terminated pregnancies may not be included in the current pregnancy group. Furthermore, covariates measured at the time of the survey may not have reflected the same covariates at the time the currently pregnant women became pregnant. WIDER IMPLICATIONS OF THE FINDINGS: Underuse of MM of contraception burdens especially the poor and the less educated. National strategies should address unfounded health concerns, fear of side effects, opposition and underestimated risk of pregnancy, which are major contributors to undesired pregnancies. FUNDING/CONFLICT(S) OF INTEREST: NO external funding was utilized for this report. There are no conflicts of interest to declare. Keywords: unwanted pregnancies / family planning / demographic health surveys / side effects / low- and middle-income countries [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to describe the extent of sexual activity in adolescent school girls. Methods: This was a cross-sectional study with prolective collection of data carried out at Lycée General Leclerc, Yaounde (Cameroon), from October 1 to November 30, 2011. Heterosexual coitus was considered as sexual activity. A pretested selfadministered questionnaire was proposed to all consenting girl students aged 10 to 19 years. The data were analyzed using Epi Info 3.2.1 and Microsoft Excel 2007 software. Results: Of the 2660 students who responded to the questionnaire, 21.3% (566) admitted being sexually active. Out of these, 64.3% (364) were aged between 10 and 16 years at their first heterosexual contact. The mean age at the first sexual intercourse was 15.3 years. Although 56.4% (319) of the sexually active respondents had only one sexual partner, 43.6% (247) of them had at least two partners. Sexual activity was occasional in 71.4% of those being sexually active. Meanwhile, 52.1% (295) of the sexually active adolescent girls used condoms during sexual intercourse, 41.5% (235) did so occasionally, and 6.4% (36) had regular unprotected sex. Conclusion: More than one-fifth of adolescent girls were sexually active in this study. Sexual intercourse started mostly at the age of 16 or less, and it was mostly occasional. Half of the cases had multiple sexual partners, and half were not using condoms during sexual intercourse. We, thus, recommend the implementation of interventions aimed at delaying the age of the first sexual intercourse and accessibility of condoms to students in this setting. [ABSTRACT FROM AUTHOR]

Introduction: The fight against maternal deaths has gained attention as the target date for Millennium Development Goal 5 approaches. Induced-abortion is one of the leading causes of maternal deaths in developing countries which hamper this effort. In Ghana, alcohol consumption and unwanted pregnancies are on the ascendancy. We examined the association between alcohol consumption and maternal mortality from induced-abortion. We further analyzed the factors that lie behind the alcohol consumption patterns in the study population. Method: The data we used was extracted from the Ghana Maternal Health Survey 2007. This was a national survey conducted across the 10 administrative regions of Ghana. The survey identified 4203 female deaths through verbal autopsy, among which 605 were maternal deaths in the 12 to 49 year-old age group. Analysis was done using Statistical software IBM SPSS Statistics 20. A case control study design was used. Cross-tabulations and logistic regression models were used to investigate associations between the different variables. Results: Alcohol consumption was significantly associated with abortion-related maternal deaths. Women who had ever consumed alcohol (OR adjusted 2.6, 95% CI 1.38-4.87), frequent consumers (OR adjusted 2.6, 95% CI 0.89-7.40) and occasional consumers (OR adjusted 2.7, 95% CI 1.29-5.46) were about three times as likely to die from abortion-related causes compared to those who abstained from alcohol. Maternal age, marital status and educational level were found to have a confounding effect on the observed association. Conclusion: Policy actions directed toward reducing abortion-related deaths should consider alcohol consumption, especially among younger women. Policy makers in Ghana should consider increasing the legal age for alcohol consumption. We suggest that information on the health risks posed by alcohol and abortion be disseminated to communities in the informal sector where vulnerable groups can best be reached. [ABSTRACT FROM AUTHOR]

Despite widespread awareness of and access to modern contraception, high rates of unwanted pregnancies and abortions still persist in many parts of the world, even where abortion is legally restricted. This article explores perspectives on contraception and abortion, contraceptive decision-making within relationships, and the management of unplanned pregnancies. It presents findings from an exploratory qualitative study based on 17 in-depth interviews and 6 focus group discussions conducted in 2 locations in Nigeria in 2006. The results suggest that couples do not practice contraception consistently because of perceived side effects and partner objections. Abortion is usually resorted to because pregnancy was unwanted due to incomplete educational attainment, economic hardship, immaturity, close pregnancy interval, and social stigma. Males usually have greater influence in contraceptive-decision making than females. Though induced abortion is negatively viewed in the community, it is still common, and women usually patronise quacks to obtain such services. An abortion experience can change future views and decisions towards contraception. Family planning interventions should include access to and availability of adequate family planning information. Educational campaigns should target males since they play an important role in contraceptive decision-making. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Information and prevention campaigns regarding human sexuality regularly miss their attempted point because they ignore the complexity of the fantasies they collide with. As much indeed as contraception spreading does not reduce the number of pregnancies (followed by medical abortion or not) among teenagers, promoting the condom does not alter durably attitudes towards the risk of contamination by AIDS virus. Public Health players are unaware of the unconscious guilt bound to post-modern sex because of the difficulty to envision Freudian psychoanalytical theory as a matter of positive knowledge while it asserts that Desire is unique to every person and is ruled by his or her OEdipus complex. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A quantitative, descriptive, explorative, contextual study was conducted to determine pharmacists' and drug vendors' levels of knowledge, and attitudes towards and practices of emergency contraceptives (ECs) services in Addis Ababa, Ethiopia. From all licensed pharmacies and drug shops in Addis Ababa, 40 service providers were randomly selected, during 2008, and interviewed using structured interview schedules. The findings revealed that although these service providers were knowledgeable about the purpose and dosing schedules of EC, they lacked knowledge about side-effects, contra-indications, and types of ECs. Most respondents portrayed subjective attitudes towards easy EC access, especially for adolescent girls, since they believed that it would encourage promiscuity and unprotected sexual intercourse. The knowledge, practices and attitudes of these pharmacists and drug vendors should be improved, as it has a direct effect on potential EC users for preventing unwanted pregnancies among young women, especially adolescent girls. [ABSTRACT FROM AUTHOR]

Abstract: This manuscript covers Plan B, the brand name of emergency contraception that now has dual over the counter and prescriptive status. Although Plan B has been available over the counter since November 2006 to men and women older than 18, very few patients know about this option. In addition, many clinicians and patients believe myths about Plan B. This article describes the uses of Plan B, its potential to decrease unwanted pregnancies and abortions, current laws, indications and effectiveness, mechanism of action, and helpful hints. [Copyright &y& Elsevier]

Purpose: To determine the methods used to prevent pregnancy by women seeking abortion of unwanted pregnancy, their knowledge and use of emergency contraception, and reasons for wanting the abortion. Design: The sample was 144 randomly selected women, who requested abortion for termination of their pregnancies at two hospitals in Izmir, Turkey, during the study period. Methods: A questionnaire was completed by the researcher in face-to-face interviews. Findings: In this sample 43.8% had had previous abortions; 77.1% used some method of family planning; 7.0% used emergency contraceptives. The methods selected after unprotected sexual intercourse by these women included vaginal douche (37.5%), waiting to see whether the menstrual cycle would begin (27.0%), going to a hospital or maternal-child health center (24.3%), and two other alternatives (4.2%). One-fifth of the women said that, if they get pregnant again, they will have another abortion. Conclusions: The number of unwanted pregnancies is high and many women seek abortions as a birth control method. Women in this sample needed information about effective methods for preventing pregnancy. [ABSTRACT FROM AUTHOR]

Sadig Rasheed gives an overview of the challenges facing South Asia in maternal and child health. He suggests that while much has been understood much more needs to be done to reverse the difficult situation facing women and girls in South Asia. [ABSTRACT FROM AUTHOR]

Research on the consequences of unwanted pregnancies can offer useful perspectives on the need to improve and expand the range of family planning options available to women in developing countries. This paper investigates the use of maternal and child health services by women who have unwanted or mistimed pregnancies. The results of our analysis indicate that wantedness of births exerts a significant influence on health care use in Thailand, after controlling for other determinants of utilization. Women with unwanted pregnancies are less likely to seek prenatal care or receive tetanus toxide inoculations. Further, women from disadvantaged socioeconomic groups, women with high parity and those with lower educational levels have the highest proportion of unintended pregnancies. The study concludes by making suitable policy recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Sexual violence plays a key role in women's pregnancy intention. We investigated the influence of sexual violence on planned, mistimed, and unwanted pregnancies in sub-Saharan Africa (SSA)., Materials and Methods: Data from the Demographic and Health Survey (DHS) of 22 countries in SSA were used in this study. Both descriptive and inferential analyses were conducted. We carried out a multinomial logistic regression analysis to examine the effect of sexual violence on planned, mistimed, and unwanted pregnancies. STATA version 14.2 was used to carry out all analyses. Statistical significance was declared at p<0.05., Results: At the descriptive level, we found that 74.1% of women of reproductive age in SSA had planned pregnancies, with the remaining 25.9% having either mistimed (20.4%) or unwanted (5.5%) pregnancies. Women in Nigeria had the lowest proportion of mistimed pregnancies (7.5%) whereas those in Burundi had the greatest percentage of unwanted pregnancies (12.4%). Women who had history of sexual violence had increased risk of mistimed [ARRR = 1.5, CI = 1.3-1.7] and unwanted pregnancies [ARRR = 1.6, CI = 1.3-2.0], compared to those with no history of sexual violence. Women aged 40-44 [ARRR = 3.3, CI = 1.4-7.6] and 45-49 [ARRR = 4.4, CI = 1.7-11.2] had higher risk of unwanted pregnancies, compared to women aged 15-19. Women who were cohabiting had higher risk of mistimed [ARRR = 1.3, CI = 1.1-1.4] and unwanted pregnancies [ARRR = 1.6, CI = 1.3-2.1], compared to married women., Conclusion: Sexual violence plays a key role in mistimed and unwanted pregnancies. It is, therefore, prudent to develop various assessment techniques to detect sexual violence in unions and refer victims to appropriate services to diminish the risk of mistimed and unwanted pregnancies. Our findings provide a basis for developing and implementing policies and interventions aimed at reducing mistimed and unwanted pregnancies., (© 2020 The Authors.)