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Reproductive consequences of contraceptive failure in 19 developing countries
1Centre for Population Studies, London School of Hygiene and Tropical Medicine, United Kingdom. John.Cleland@lshtm.ac.uk
Obstetrics and Gynecology
|August 5, 2004
Summary
Contraceptive failure contributes less to unintended births and fetal loss in developing nations than previously thought. Nonuse of contraception remains the primary driver of unintended pregnancies, highlighting the need for continued family planning initiatives.
Area of Science:
- Reproductive Health
- Global Health
- Demography
Background:
- Unintended births and fetal loss are significant public health concerns in developing countries.
- Contraceptive use has increased in many developing regions, but levels remain below those in industrialized nations.
Purpose of the Study:
- To quantify the role of contraceptive failure in unintended births and fetal loss within developing countries.
- To compare these contributions to estimates from developed countries.
Main Methods:
- Analysis of nationally representative survey data from married women in 19 developing countries.
- Utilized retrospective monthly calendars of contraceptive use and pregnancy outcomes over a 5-year period.
- Applied life table analysis to estimate contraceptive failure probabilities and logistic regression to analyze fetal loss determinants.
Main Results:
- Contraceptive failure rates were comparable to those found in studies primarily from the United States.
- Approximately 75% of pregnancies from contraceptive failure resulted in live births, with most classified as unintended.
- About 12% of pregnancies from contraceptive failure ended in fetal loss, with a significant proportion being induced.
Conclusions:
- Contraceptive failure accounts for a smaller proportion (median 15% for births, 12% for fetal loss) of unintended outcomes in developing countries compared to the US (estimated 50%).
- Nonuse of contraception is the leading cause of unintended births.
- Continued emphasis on family planning promotion is crucial for public health in these regions.