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Is unintended pregnancy associated with family planning use in the postpartum period? Using three measures to define the relationship of unintended pregnancy and postpartum family planning

Linnea Zimmerman, Johns Hopkins Bloomberg School of Public Health
Celia Karp, Johns Hopkins Bloomberg School of Public Health

The measurement of unintended pregnancy in low-and-middle income countries relies largely on one timing-based measure despite recognition of the complex nature of pregnancy intentions. It is unclear if measures other than the timing-based measure may have a stronger relationship with contraceptive uptake in the postpartum period. We explore the relationship of three different measures aimed at assessing the intendedness of a pregnancy among a cohort of 2,177 postpartum women in Ethiopia using longitudinal data. We use design-based analysis to explore the distribution of unintended pregnancy and three postpartum family planning outcomes; 1) intention to use contraception and uptake of postpartum family planning by 2) 6-weeks and 3) 6-months. Overall, we find limited association between experience of an unintended pregnancy, using any measure, and postpartum family planning uptake. Our results reinforce an emerging body of literature that suggests accounting for women’s future pregnancy preferences are more relevant for estimating demand for contraception in the postpartum period than retrospective events. Next steps will be to 1) include one year data to assess the relationship of PPFP uptake at one year 2) conduct a longitudinal analysis to account for correlation in observations from the same women.

Keywords: Family planning and contraception, Fertility and childbirth

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  Presented in Session 196. Postpartum Contraceptive Needs and Use