MINNEAPOLIS — Data from a surveillance system in Maryland show the burden of unintended pregnancy remains large, with multiple potential risks for mothers and infants, according to Dr. Diana Cheng of the Maryland Department of Health and Mental Hygiene, Baltimore.
The Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) was established by the Centers for Disease Control and Prevention to obtain information about maternal behaviors and experiences that may be associated with adverse pregnancy outcomes.
Between 2001 and 2005, a random sample of 7,381 mothers did the PRAMS survey 2–6 months after delivery. The survey included the following question: Thinking back to just before you got pregnant, how did you feel about becoming pregnant? Available answers were “I wanted to be pregnant sooner,” “I wanted to be pregnant later,” “I wanted to be pregnant then,” or “I didn't want to be pregnant then or at any time in the future.”
Pregnancies were classified as intended if the mothers had wanted them then or sooner and as unintended if they said they wanted them later or not at all.
Analysis of the responses showed that 58% of the pregnancies were intended and 42% were unintended, Dr. Cheng said at the annual meeting of the Association of Reproductive Health Professionals.
In women with intended pregnancies, 16% said they wanted their pregnancy sooner and 42% said they wanted their pregnancy then. In those with unintended pregnancies, 31% said they wanted their pregnancies later and 11% said they didn't want to be pregnant then or ever.
Of those whose pregnancies were unwanted, 86% did not take folic acid daily, 44% initiated prenatal care after the first trimester, and 24% smoked during pregnancy. Post partum, 37% did not breast-feed, 30% smoked, 27% reported depression, and 50% did not place their babies on their backs to sleep. Moreover, 11% of women in this group reported a history of physical abuse.
In women with intended pregnancies, by contrast, significantly lower percentages engaged in unhealthy behaviors. For example, in this group, 87% initiated prenatal care during the first trimester, 81% breast-fed, and 69% placed their babies on their backs for sleep.
A total of 10% of babies born to mothers whose pregnancies were unwanted were of low birth weight, as were 7% of babies born to mothers whose pregnancies were intended.
The survey also found that 43% of the women were using birth control at the time they became pregnant. Among the women who did not use birth control, most said they did not think they could get pregnant at that time. Improving women's access to education about contraception will help couples better plan pregnancies and increase the rates of intended pregnancies, she said.