Journal Article

Family Planning and the Burden of Unintended Pregnancies

Amy O. Tsui, Raegan McDonald-Mosley and Anne E. Burke

in Epidemiologic Reviews

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 32, issue 1, pages 152-174
Published in print April 2010 | ISSN: 0193-936X
Published online June 2010 | e-ISSN: 1478-6729 | DOI: http://dx.doi.org/10.1093/epirev/mxq012
Family Planning and the Burden of Unintended Pregnancies

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Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology.

Keywords: contraception; contraceptive behavior; family planning services; pregnancy outcome; pregnancy, unplanned; reproduction

Journal Article.  12633 words.  Illustrated.

Subjects: Public Health and Epidemiology

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