Lessons from an audit of unplanned pregnancies

Area of Science:

• Reproductive Health
• Contraception Effectiveness
• Public Health

Background:

• Unplanned pregnancies represent a significant public health concern.
• Understanding contraceptive failure rates is crucial for reproductive health strategies.
• Adolescent and young adult populations often face higher rates of unplanned pregnancies.

Purpose of the Study:

• To audit contraceptive use and effectiveness over two years.
• To identify contraceptive methods associated with unplanned pregnancies.
• To assess reasons for contraceptive non-use or failure.

Main Methods:

• A two-year audit of pregnant women within a single group practice.
• Analysis of contraceptive methods used by women experiencing unplanned pregnancies.
• Assessment of contraceptive failure rates across different age groups.

Main Results:

• 36% of 518 pregnancies were unplanned, with higher rates in women aged 15-19.
• Women under 25 used contraceptives less reliably than those 25 and over.
• The combined pill was most effective; sheath and incorrect oral contraceptive use were common failure methods.

Conclusions:

• Contraceptive reliability varies significantly by age, with younger women showing lower reliability.
• Fear of side effects and inadequate medical advice hinder combined pill use.
• Enhanced doctor-patient communication and accessible oral contraceptive information are vital to reduce unplanned pregnancies.