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September 5, 2002


Unintended Pregnancies Not Just a Problem for the Disadvantaged, Study Shows

Researchers 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.

"Traditionally, attention 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 and Quality.

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.

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