Pregnancy Intention, Ambivalence, and Contraceptive use in Community Health Center (CHC) Populations

Abstract Introduction: Understanding the complexity of pregnancy intentions and resulting behaviors is essential to ensuring high quality, patient-centered reproductive health services that meet the needs of women and their partners. Community Health Centers (CHCs) play an important role in providing family planning care for traditionally underserved women, who may be at increased risk of experiencing unintended pregnancy. This study presents emerging findings on pregnancy intentions, ambivalence, and contraceptive behaviors among patients in CHC settings. Methods: This study employed a national survey (n=1,557) of women of reproductive age (18-44 years), sampled from 19 different CHC sites. The survey gathered information on patient characteristics, experiences with care, decision-making criteria and utilization of contraceptive services. Pregnancy intention was measured using the One Key Question®. Results: Approximately 12% of women reported that they wanted to become pregnant in the next year, while 88% were not actively seeking to become pregnant. Nearly 30% of those who did not desire a pregnancy reported not using contraception at the time of the survey. 1-in-4 women were pregnancy ambivalent and used contraception at approximately the same rates as women seeking to become pregnant. Conclusions: Women who express pregnancy ambivalence use contraception at similar rates to those who intend to become pregnant in the next year, potentially increasing their risk for unintended pregnancy. Understanding the characteristics and behaviors of underserved patients across different pregnancy intentions may help ensure that women receive the information, services, and support they need to achieve their reproductive health goals. Keywords: pregnancy intentions, family planning, community health centers, CHC, One Key Question®

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“At Least I Didn’t Get Raped”: A Qualitative Exploration of IPV and Reproductive Coercion among Adolescent Girls Seeking Family Planning in Mexico

Journal of Interpersonal Violence ◽

10.1177/0886260520959571 ◽

2020 ◽

pp. 088626052095957

Author(s):

Jasmine Uysal ◽

Jamila K. Stockman ◽

Elizabeth Miller ◽

Teresita Rocha-Jimenez ◽

Gudelia M. Rangel ◽

...

Keyword(s):

Family Planning ◽

Community Health ◽

Unintended Pregnancy ◽

Adolescent Girls ◽

Partner Violence ◽

Community Health Centers ◽

Health Centers ◽

Gender Based Violence ◽

Reproductive Coercion ◽

Increased Risk

Adolescent girls who report intimate partner violence (IPV) are at an increased risk of experiencing reproductive coercion (RC); both these forms of gender-based violence (GBV) are associated with unintended pregnancy. Yet little is known about these experiences among adolescent girls in Mexico. Qualitative data were collected as part of formative research for the adaptation of an evidence-based intervention to address RC and IPV in community health centers in Tijuana, Mexico. From September, 2017 to January, 2018, adolescent girls aged 16 to 20 years old ( n = 20) seeking voluntary family planning (FP) services were identified and recruited from two publicly funded community health centers. We conducted semi-structured, in-depth interviews and analyzed the transcripts using inductive and deductive techniques. Participants in this sample commonly described experiencing IPV and RC (including pregnancy coercion and contraceptive sabotage), which many girls reported resulted in unintended pregnancy. Further, participants’ narratives and general lack of knowledge on how to cope with IPV or RC illuminated the acceptability of offering GBV prevention intervention within FP clinics serving this population. Findings highlight an urgent need to prevent IPV and RC, and reduce risk for unintended pregnancy among adolescent girls in this region and the potential of FP clinics to serve as a safe space for intervention delivery. Findings contribute to the limited qualitative evidence from Mexico, describing adolescent girl’s experiences of IPV and RC, strategies for preventing pregnancy in the context of RC, and opportunities for support from FP providers.

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The Organization and Delivery of Family Planning Services in Community Health Centers

Women s Health Issues ◽

10.1016/j.whi.2015.02.007 ◽

2015 ◽

Vol 25 (3) ◽

pp. 202-208 ◽

Cited By ~ 8

Author(s):

Debora Goetz Goldberg ◽

Susan F. Wood ◽

Kay Johnson ◽

Katherine (Holly) Mead ◽

Tishra Beeson ◽

...

Keyword(s):

Family Planning ◽

Community Health ◽

Community Health Centers ◽

Health Centers ◽

Family Planning Services

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Pregnancy Intentions and Its Associated Factors Among Married Women in Resunga, Gulmi, Nepal

10.21203/rs.3.rs-93497/v1 ◽

2020 ◽

Author(s):

Rita Karki ◽

Surendra Maharjan ◽

Ganesh Khatiwada ◽

Junu Shrestha

Keyword(s):

Socioeconomic Status ◽

Family Planning ◽

Unintended Pregnancy ◽

Statistical Tests ◽

Research Work ◽

Married Women ◽

Reproductive Age ◽

Health Concern ◽

Pregnancy Intentions ◽

Chi Square Analysis

Abstract BackgroundPregnancy intention refers to a women’s thinking at the time she became aware that she was pregnant. Pregnancy intentions can be categorized as intended and unintended. It is an important public health concern in every corner of the world, especially in developing countries. The study was carried out with an objective of determining the pregnancy intentions among married women in Resunga municipality, Gulmi, Nepal and test the association of pregnancy intentions with various socio-demographic, and reproductive health-related variables.MethodsThe community based cross-sectional study design was used to achieve the objective of the study. Married women of reproductive age of the Resunga municipality, Gulmi were selected and a multistage random sampling technique was adopted. Total 406 participants were involved in this study. Pretested semi-structured interview schedule adapted from Demographic and Health Survey of Nepal was used for data collection. All the statistical tests were performed in SPSS, version 25.0. The p -value was set at 5% level of significance. Descriptive and data exploratory analysis were performed. Bivariate and multivariate logistic regression analysis technique were conducted to explore the association between pregnancy intentions and predictor variables.ResultsThe study showed that out of total 410 pregnancies, 248 (60.5%) pregnancies were unintended, of which 78(19.05%) were unplanned and 170 (41.5%) were ambivalent. The remaining 162 (39.5%) pregnancies were considered intended. The chi-square analysis and bivariate analysis showed that women age, socioeconomic status, husband opposition, methods used before pregnancy, and intention of using contraception in the future were significantly associated with pregnancy intentions. When these variables were subjected for multivariate analysis, only socioeconomic status, and method of family planning used before pregnancy were found to be significantly associated with pregnancy intentions.ConclusionsThe study showed that unintended pregnancy is very high. The factors that were found to be associated with an unintended pregnancy were socioeconomic status and method of family planning used before pregnancy. The findings of this research work could be useful while providing different reproductive and family planning related services to women by considering predictors of unintended pregnancy that might increase planned pregnancy ultimately.

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