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Monday, 20 August 2012


Planning and Intention - A bit more about health and reproduction.


So concluding our journal club today where we had an interesting discussion about the ACES study (adverse childhood experiences study) and unwanted pregnancy (Dietz, P, Spitz, A. et al. Unintended Pregnancy Among Adult Women Exposed to Abuse or Household Dysfunction During Their Childhood. JAMA.1999: 282:1359-1364.),  I wanted to add a bit more on the unintended pregnancy issue.

One of the things we discussed was the nuances of unexpected and unwanted in terms of pregnancy. So here's some data from the National Health Statistics Reports July 24, 2012, Intended and Unintended Births in the United States:P 1982-2010. This study looked at data regarding the attitudes of women who had live births.

*Percentage unintended at time of conception 37% in the group evaluated.
*Group that demonstrated significant decline since 1982 = married, non-Hispanic white women.
*Disparity seen between them and unmarried women, black women or women who have educational or economic disadvantage.
*Intended births and teen mothers - only 23% were intended (2006-2010), therefore 4/5 unintended.
Of interest, the authors talk about unintended births as being measured as intended (meant to get pregnant); mis-timed (wanted to, but not now) and unwanted (not wanted to get pregnant or not wanted the infant in the birth order it came into.) They also talk about an 'alternative' definition breaking down the term unintended birth into two elements - action (pregnant/not) and affect or emotional interpretation (wanted or not) They felt that the data was concordant with either evaluation.
It does make you wonder though if the composite effect blurs out subgroup differences here.

Particularly interesting was the authors mention that
*Women in poverty (below 150% ) make up 56% on unintended births and only 35% intended
           (supporting the previous blog mention of poverty as a marker for unplanned births)
*More than one in five intended pregnancies and births (22.8%) are in teenage (ag 15-19) mothers. (birth rate 40.2 births/1000 in 2008. ) If we could disrupt factors such as poverty and influence the situation where unintended births to teens was postponed until age 20, we could have teen birth rates drop for 11% of all births to 4%!

Here's an interesting video about the benefits of contraception from the Guttmacher Institute


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