Pregnancies Not Just a Problem for the Disadvantaged, Study Shows
currently affiliated with Emory University have gathered more evidence
confirming that unintended pregnancies are a cross-cutting problem in
our society and are not limited to the socially or economically disadvantaged.
In a study population where the majority of women were married, educated
and had incomes over $40,000, the researchers concluded that almost
one-third of the births in the study period were the result of an unintended
pregnancy. The findings will be released in the September 6 issue of
the Maternal and Child Health Journal.
The study, conducted with
data from a managed care organization that operates nationwide, compares
the socio-demographic factors, pregnancy history and elements of contraceptive
use between women with intended and unintended pregnancies.
has been focused on unintended pregnancies in disadvantaged populations,
but few studies have focused on women in more affluent, lower-risk groups,"
says Diane Green, Ph.D., lead study investigator. "These data show that
the same issues are in play even for women with higher education levels
and more financial resources."
Researchers at the Emory
Center on Health Outcomes and Quality, formerly the USQA Center for
Health Research, analyzed data from 1,173 births. Two-thirds of the
women in the study were ages 25-34 years when they gave birth, 58% were
white, 90% were married, almost half had completed four years of college
or more, and three-fourths lived in households where the annual household
income exceeded $40,000.
When examining contraceptive
use among the women, researchers found that only 40 percent of the women
with unintended pregnancies reported using contraception, leaving 60
percent of the women who had no intentions of getting pregnant, but
yet were not using contraception. Of the 40 percent of the women who
were using contraception but still conceived, two-thirds were using
barrier methods like condoms and diaphragms. Barrier methods, Dr. Green
explained, are often less effective than hormonal methods of contraception.
"Pregnancies that occurred
despite the use of contraception may have resulted from inconsistent
or incorrect use of contraception," Dr. Green says.
Researchers also asked the
women about their perception of their partner's desire for the pregnancy.
Women who reported that the partner did not want the pregnancy were
seven times more likely than women whose partner wanted the pregnancy
to regard the pregnancy as unintended.
"The male partner has a high
degree of influence on the use of contraception," Dr. Green says. "By
including them more actively in contraceptive decisions and family planning
matters, we can reduce the rate of unintended pregnancies."
A variety of different organizations
involved in family planning or healthcare can help to reduce rate of
unintended pregnancy, Dr. Green says. Health care systems, including
clinicians and health educators, can provide improved education on proper
contraceptive use, and can promote consistent use of contraception by
those at risk for unintended pregnancy.
Study co-authors Julie A.
Gazmararian, PhD, MPH (Emory University, Rollins School of Public Health,
formerly with the USQA Center for Health Care Research), Lisa D. Mahoney,
MPH (formerly with the USQA Center for Health Care Research) and Nancy
A. Davis, MPH (Aetna Inc., formerly with the USQA Center for Health
Care Research). The study was funded by Aetna Inc. The opinions expressed
and conclusions reached are solely those of the authors and do not necessarily
represent those of Aetna.
In November 2001, the USQA
Center for Health Care Research, a division of U.S. Quality Algorithms,
Inc., the health informatics subsidiary of Aetna Inc., moved to Emory
where it became the cornerstone of the Emory Center of Health Outcomes
The Emory Center on Health
Outcomes and Quality, a multi-school, multi-disciplinary group within
The Robert W. Woodruff Health Sciences Center, was created to conduct
outcomes-based research that includes assessing and improving methods
for measuring quality of care and designing interventions to improve
health outcomes. It works with consumers, physicians and insurers to
evaluate and implement new approaches for improving quality of care.