Ilene S. Speizer, PhD, Preventive Medicine and Community Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA 23298, 804-339-0354, isspeizer@vcu.edu, Hamish Mohammed, MPH, Department of Epidemiology, Tulane University, 1440 Canal St, New Orleans, LA 70112, Aimee Afable-Munsuz, PhD, Center on Social Disparities in Health, University of California, San Francisco, 500 Parnassus Avenue, Box 0900, San Francisco, CA 94143, and John S Santelli, MD, MPH, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K22, Atlanta, GA 30341.

Using clinic-based data from inner-city New Orleans, we examine the effect of perceptions of method effectiveness and barriers to use on contraceptive behavior (comparing current family planning users vs. non-users or ineffective users who are currently pregnant) and on pregnancy intention (women with intended vs. unintended pregnancies). Multivariate regression analyses were performed separately for first pregnancy risk (never pregnant family planning users versus currently 1st time pregnant women) and for second pregnancy risk (family planning users with one pregnancy compared to currently second time pregnant women). Models also compare intended versus unintended pregnancy among currently first (or second) time pregnant women.

For both first and second pregnancy risk, women who think that birth control is not or somewhat effective versus effective are significantly more likely to be currently pregnant. Also, women who report more barriers to condom use and to service use are significantly more likely to be currently pregnant than those who report fewer barriers. For the second pregnancy risk, women with intended first pregnancies are 2.85 (CI: 1.63-4.99) more likely to be family planning users and not pregnant than women with unintended first pregnancies. Women with unintended first pregnancies are 2.40 (CI: 1.08-5.36) times more likely to be having unintended second pregnancies compared to women with intended first pregnancies.

This population experiences repeated unintended pregnancies and possible contributing factors are negative perceptions of birth control effectiveness and barriers to use. Future programs should address repeat unintended pregnancy risk and barriers to achieving fertility goals among inner-city women.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Articulate the differences between women experiencing intended and unintended pregnancies in inner-city New Orleans.
• Identify key factors associated with risk of an unintended first or second pregnancy.
• Recognize the importance of repeat unintended pregnancy in this inner-city population and discuss program approaches for reducing repeat unintended pregnancies.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.