Neighborhood and individual-level violence and unintended pregnancy

As many as half of all pregnancies are unintended, and unintended pregnancy has been linked to a variety of adverse pregnancy and infant health outcomes. Our aim was to determine if urban women who experience high levels of neighborhood and/or individual-level violence are at an increased risk of reporting an unintended pregnancy. One thousand five hundred thirty-six pregnant women seeking care in an emergency department in Philadelphia, Pennsylvania were recruited in their first or second trimester and completed in-person interviews. Information on demographic characteristics, social support, substance abuse, current experience and history of interpersonal violence, perceptions of current neighborhood-level violence, and the intendedness of their current pregnancy were gathered. Multiple logistic regression analyses were conducted to assess the relationship between violence indicators and pregnancy intendedness. Six hundred twenty-seven women (41%) reported an unintended pregnancy. Not feeling safe in one's neighborhood was significantly associated with reporting an unintended pregnancy (odds ratio (OR), 1.28; 95% confidence interval (CI), 1.02-1.61) when demographic, other neighborhood, and individual-level violence indicators were accounted for. Furthermore, history of sexual abuse (OR, 1.5; 95% CI, 1.11-2.04), violence in previous pregnancy (OR = 1.7, 95% CI, 1.15-2.51), and a high index of spousal abuse score (OR = 1.6; 95% CI, 1.32-2.04) were also associated with unintended pregnancy in multiple logistic regression models. These findings indicate that neighborhood-level violence and other individual-level violence indicators may be important when examining factors related to unintended pregnancy among young, urban women.