Pregnancy intention in an urban Australian antenatal population

To determine the prevalence of unintended pregnancy in women presenting for antenatal care to a large metropolitan hospital in Sydney, Australia, and to investigate health behaviours and demographic factors associated with unintended pregnancy.

From October 2010 to April 2011, a self-administered questionnaire covering pregnancy intention, contraceptive use and demographic information was given to 1,554 women. A total of 1,218 women (78.4%) completed all questions in the validated pregnancy intention instrument.

Two-thirds of pregnancies (67.6%) were clearly intended, 30.0% were ambivalent and more than 2% experienced an unplanned pregnancy. Those more likely to experience an unintended pregnancy were women under 25 years old (OR 1.86, 95% CI 1.10-3.14), unmarried women (OR 6.08, 95% CI 3.40-10.87) and women of Asian background (OR: 2.45, 95% CI 1.76-3.42). More than one-third of women (34.6%) did not take any health actions such as stopping smoking before pregnancy.

Unintended pregnancies in this population were associated with young age, being unmarried and being of Asian background. This study confirms the idea that many women do not take health actions before pregnancy.

Experts believe that an effective strategy to address unintended pregnancy is to improve access to long-acting reversible contraceptives, which do not require daily compliance.