Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach

The relationship between mental health and teenage pregnancy is complex. Mental health can be both an antecedent and contributing factor to teenage pregnancy and a concurrent factor wherein pregnancy itself can contribute to depression. Expectant and parenting teens (EPT) are faced with the simultaneous challenges of pregnancy and parenting while navigating the developmental tasks of adolescence which increases their risk for mental health problems. In addition, adolescents growing up in stressful community or home situations where their parents experienced depression, further places them and their children at greater risk of repeated patterns over time. However, adverse mental health outcomes are not inevitable. The socio-ecological model combined with a life course perspective provides a framework for understanding the complexity of risk and protective factors at multiple levels that influence knowledge, attitudes, behaviors, and other health outcomes later in life and across generations. This approach has important implications for reducing adolescents' risk of an unintended/mistimed pregnancy and improving mental health and other outcomes for EPT. This paper describes the prevalence of mental health problems in EPT and using a socio-ecological framework and life course perspective explains variations in mental health outcome among EPT. Implications for interventions and innovative approaches are also discussed.

Unwanted or mistimed pregnancy and developmental issues in Ecuadorian children aged 3 to 5: a doubly robust estimate using data from the National Health and Nutrition Survey 2018

Aim: To estimate the effect of unwanted or mistimed pregnancy on early childhood development in Ecuadorian children aged 3 to 5, participating in the National Health and Nutrition Survey 2018.Methods: We used a design-based doubly robust estimate. First, we used propensity score matching to identify a subsample of children aged 3 to 5 equally likely to come from a desired vs. unwanted/mistimed pregnancy. Then, we used a regression model to explore the relation of maternal pregnancy intentions with early childhood development. Results: Among 1,694 observations representing 162,285 Ecuadorian children, mistimed/unwanted pregnancy associated with lagging in development (odds ratio: 1.56; 95% confidence interval: 1.06; 2.29), after adjusting for the household’s geographic area and income, the father’s perception of the pregnancy, the mother’s marital status, age, ethnicity, educational level, and depressive symptoms, and the child’s age, gender, and daycare/class attendance. Unwanted/mistimed was also negatively associated with all four early childhood development index domains, socio-emotional development being the most affected. Discussion: Our doubly robust design found evidence of the relation between the maternal perception of her pregnancy and early child development. Addressing this relation to achieve reproductive justice entails considering a wide spectrum of population health and legal interventions to allow adequate access to education, contraception, and safe abortion. Moreover, pre- and postnatal check-ups could screen for unwanted/mistimed pregnancy and provide support accordingly.

FAKTOR-FAKTOR YANG MEMENGARUHI KEHAMILAN TIDAK DIINGINKAN DI INDONESIA TAHUN 2017

Kehamilan tidak diinginkan (KTD) terdiri dari kehamilan tidak tepat waktu dan kehamilan tidak diinginkan sama sekali. KTD dapat menyebabkan kelahiran yang tidak direncanakan dan dapat mengganggu kesehatan fisik dan mental ibu dan anak. KTD juga merupakan indikator peningkatan risiko kelahiran yang buruk seperti kelahiran prematur, ketuban pecah dini, dan bayi berat lahir rendah, serta dapat menyebabkan keguguran. Selain itu, KTD juga dapat menyebabkan kematian ibu. Dengan banyaknya permasalahan yang disebabkan oleh KTD, peneliti ingin mengetahui faktor-faktor yang memengaruhi KTD pada wanita usia subur di Indonesia dengan menggunakan data SDKI 2017. Dengan menggunakan analisis regresi logistik multinomial, didapatkan hasil bahwa umur ibu, jumlah anak masih hidup, penggunaan kontrasepsi, status pernikahan, wilayah tempat tinggal, dan pendidikan ibu memengaruhi KTD. Kecenderungan wanita mengalami mistimed pregnancy lebih tinggi terjadi pada wanita yang berusia <20 tahun, memiliki lebih dari 3 orang anak, menggunakan kontrasepsi, belum menikah, tinggal di perkotaan, dan pendidikan tertinggi >SMA. Sedangkan, kecenderungan wanita mengalami kehamilan tidak diinginkan sama sekali lebih tinggi terjadi pada wanita yang berusia >35 tahun, memiliki minimal 3 anak, menggunakan kontrasepsi, belum menikah, tinggal di daerah perkotaan, dan pendidikan tertinggi SMP atau SMA.

Correlates of mistime pregnancy and unmet need for family planning among women of reproductive age in Sandema, Ghana.

Background: Universally, an estimated 80 million unintended pregnancies comprising both mistimed and unwanted pregnancies are recorded yearly, but only half of women at risk of a mistimed pregnancy use contraceptives. In developing countries, over 100 million females have unmet need and national surveys in Ghana indicate a 29% unmet need rate. Methods: A cross-sectional community based study was used, involving the use of multi-step cluster sampling methods in selecting 300 women of reproductive age. The study was quantitative in nature, using structured interviewer administered questionnaires. Results: More than half (66%) of the women in reproductive age still had unmet need, 71% were currently pregnant and 36% confirmed ever having a mistimed pregnancy. Overall, 53% of the women confirmed never communicating on family planning issues with their partners, a little below half (45%) of the respondents took their own health care decisions and 79% ever received family planning services from a health professional. Factors related to unmet need included mistimed pregnancy, level of education, preferred birth/pregnancy interval, communication between partners and the autonomy to spend self-earnings. Conclusion: Considering that high rates of unmet need results in mistimed pregnancy, improved policies around the influence of unmet need on mistimed pregnancies are needed.

Prevalence of unwanted pregnancy among Iranian women: an updated meta-analysis

Background Unwanted pregnancy is a global issue with adverse outcomes for the mother, child, family, and society. Previous studies in Iran have reported different prevalence rates for unwanted pregnancy. This meta-analysis was aimed at estimating the overall prevalence of unwanted pregnancy among Iranian women. Methods A total of 20 articles in English or Persian, published between 2012 and December 2018, were collected. The search was conducted in national and international databases, including Scientific Information Database (SID), MagIran, PubMed, Scopus, and Web of Science, using the following keywords: ‘Unplanned pregnancy’, ‘Unintended pregnancy’, ‘Unwanted pregnancy’, and ‘Mistimed pregnancy’. The data were analyzed using the meta-analysis method and the random effects model. Heterogeneity among studies was assessed using the I2 statistic. All analyses were performed using Stata, version 12. Results Analysis of 20 studies with a total sample size of 16,298 showed that the prevalence of unwanted pregnancy among Iranian women was 26% (95% Confidence Interval [CI]: 23–28). This prevalence was higher in the regions 5 and 2 of Iran (27%) than the other regions, and had no significant decrease between 2012 and 2018 (p = 0. 937). Conclusion More than one-fourth of pregnancies among Iranian women are unwanted. Providing training programs for couples who do not plan to have children along with the support policies aimed at stimulating population growth, can be an important step in overcoming the issue of unwanted pregnancy and reducing the illegal abortions related to it.

Early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in rural eastern zone, Tigray, Ethiopia: cross-sectional study

Objectives The objectives of this study were to assess early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in the rural eastern zone, Tigray, Ethiopia. Results Totally 803 mother–child pairs were participated in this study with a response rate of 99.25%. Out of this, 787 mothers had ever breastfed their children. Four hundred eighty-seven (61.9%) mothers initiated breastfeeding within 1 h after they gave birth. Mothers having an educational status of primary education were about 2 times more likely to initiate breastfeeding within 1 h of birth [AOR: 1.99, 95% CI 1.36–2.92] and those mothers having secondary education and above were 3.23 times more likely to start breastfeeding [AOR = 3.23, 95% CI 1.99–5.26]. Mothers who had mistimed pregnancy were 58% less likely to initiate breastfeeding within 1 h of birth [AOR: 0.42, 95% CI 0.27–0.65]. On the other hand, mothers who had delivered their child vaginally were 4.6 times more likely to start early initiation of breast feeding [AOR: 4.59, 95% CI 1.99–10.56].

FACTORS INFLUENCING MISTIMED AND UNWANTED PREGNANCIES AMONG NEPALI WOMEN

SummaryThis paper assesses the factors influencing mistimed and unwanted pregnancies in Nepal separately using data from the 2011 Nepal Demographic and Health Survey. Women who had given birth within the five years before the survey were interviewed about the intendedness of their last pregnancy. The data were analysed with a chi-squared test, followed by multiple logistic regression analysis. Among the total 5391 participants, 11.29% and 13.13% reported their last pregnancy as mistimed and unwanted respectively. Logistic regression analysis showed that women from the hill region were more likely to report mistimed pregnancy, while women from the Western and Far-Western development regions were less likely to report mistimed pregnancy. Education status was positively correlated with the reporting of mistimed pregnancy. Women involved in agriculture, with full autonomy on household decision, with some exposure to mass media, belonging to higher age group and having third or higher parity were less likely to report mistimed pregnancy. Similarly, women from the Western development region had relatively higher odds of reporting unwanted pregnancy. Women with husbands involved in a paid job had lower odds of unwanted pregnancy. Women’s autonomy was also positively correlated with unwanted pregnancy. Women with the intention to use contraceptive had lower odds of unwanted pregnancy. Interventions targeting the factors identified by this study could be useful in reduction of mistimed and unwanted pregnancies among Nepali women.

Correlates of unintended pregnancy in Beheira governorate, Egypt

This study looked at the frequency and determinants of unplanned births among women in Beheira governorate, Egypt, and the effects on antenatal and postnatal care sought by the mother for herself and her child. Unintended births comprised 23.6%; 13.8% were unwanted and 9.8% were mistimed. Contraceptive failure accounted for 28.8% of unintended pregnancies; 47.1% of women who reported unintended pregnancy were not using [corrected] contraception. Age, education and parity were predictors of unwanted pregnancy. Contraceptive use and maternal employment status predicted mistimed pregnancy. Unintended pregnancy was a barrier to antenatal care, but not to child care. Our findings suggest that family planning programmes should help women of reproductive age achieve spacing and fertility limits.