Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

Contraception
Zhuzhi MooreTrevor Croft

Abstract

To analyze data from recent Demographic and Health Surveys (DHS) conducted in 21 low- and middle-income countries (LMICs) to examine patterns of interpregnancy intervals, unmet need, pregnancy risk and family planning method use and method mix among women 0-23 months postpartum. Secondary analysis of postpartum women aged 15-49 years in 22 DHS surveys from 21 LMICs conducted between 2005 and 2012. We applied an adapted unmet need definition for postpartum women to look at prospective fertility preferences. We also constructed a new composite pregnancy risk indicator for postpartum women who have been sexually active since their last birth. In 9 of 22 surveys, 50% or more of nonfirst births occur at interpregnancy intervals that are too short. Overall prospective unmet need for family planning by postpartum women has not changed demonstrably since a 2001 analysis and is universally high: 61% of all postpartum women across the 21 countries have an unmet need for family planning. In 10 of 22 surveys, pregnancy risk rises steadily throughout the 2 years after birth. In the remaining 12 surveys, the risk of pregnancy peaks at 6-11 months after birth. Even when postpartum women are using family planning, they rely overwhelmingly on s...Continue Reading

References

Feb 2, 2006·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Adebanjo B AdeyemiMarie M Alabi
Oct 27, 2009·Studies in Family Planning·Ricardo Vernon
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Jul 13, 2012·Lancet·John ClelandAmy Tsui
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May 31, 2013·Studies in Family Planning·Madeleine Short Fabic, Yoonjoung Choi
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Oct 3, 2014·Global Health, Science and Practice·Thomas W Pullum
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Citations

Dec 9, 2015·Studies in Family Planning·Iqbal H ShahJohn Cleland
Nov 5, 2015·Current Opinion in Obstetrics & Gynecology·Lisa M Goldthwaite, Kate A Shaw
Jun 9, 2017·Obstetrics and Gynecology·Lilian Sheila de Melo Pereira CarmoCarolina Sales Vieira
Feb 3, 2018·Studies in Family Planning·Saumya RamaRaoJohn Townsend
Apr 23, 2017·The Cochrane Database of Systematic Reviews·Jen SothornwitMalinee Laopaiboon
May 9, 2019·American Journal of Public Health·Elizabeth K HarringtonJennifer A Unger
Jul 25, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·A Furey, A Fiander
Feb 11, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Klaira LermaPaul D Blumenthal
Jun 18, 2020·Sexual and Reproductive Health Matters·Wan-Ju WuSheela Maru
Jan 24, 2020·International Journal of Reproductive Medicine·Tsegaye MehareYewbmirt Sharew
May 12, 2017·Studies in Family Planning·Charlotte E WarrenJonathan Hopkins
Apr 25, 2018·Contraception and Reproductive Medicine·Carrie Cwiak, Sarah Cordes
Oct 28, 2019·Contraception and Reproductive Medicine·Jonathan Ian Coomson, Abubakar Manu

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