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APHA Scientific Session and Event Listing

Recorded presentation

Carol J. Rowland Hogue, PhD, MPH¹, Laura MD Gaydos, PhD², Michael R. Kramer, MPH³, Anne Lucy Lifflander, MD, MPH⁴, Dinorah L. Calles³, and Larissa R. Brunner Huber, MPH, PhD². (1) Women's and Children's Center, Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, 404-727-8095, chogue@sph.emory.edu, (2) Women's and Children's Center, Department of Epidemiology, Rollins School of Public Health of Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, (3) Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, (4) Vera Institute of Justice, 233 Broadway, 12th Floor, New York, NY 10279

Twenty years ago, contraceptive failures and failure to use contraception contributed about equal parts to unintended pregnancy. Today, while The U.S. obesity epidemic may be increasing the risk of unintended pregnancy among oral contraceptive users (the largest proportion of fecund contraceptors), of greater concern is the 50 percent rise in noncontracepting behavior. One in seven sexually active, fecund women risk unintended pregnancy by not using any contraception. The risk rises to one in four among women aged 40-44 or formerly married women. Noncontracepting risk is greater for poor women and African American women. Notably, with the exception of teens, religious affiliation is not associated with contraceptive use. However, religious-related policies affect access to contraception. Historically, the public health community has been concerned about health risks of unintended pregnancy to mother and child. Nevertheless, not all pregnancies defined demographically as unintended may carry a public health burden. Motivations are complex, and many women consciously choose to bear children by chance. In the U.S., health risks attributable solely to the pregnancy intention and not to the characteristics of the pregnant woman are limited to those associated with 1) a very short inter-pregnancy interval, or 2) an unwanted pregnancy. For example, in Georgia four percent of low birth weight deliveries, 13 percent of cases of cerebral palsy and 14 percent of cases of mental retardation are attributable to unwanted pregnancy. Because contraceptive behavior is greatly affected by access, availability, and cost, public policy attention to improving access to contraceptive services is vitally important.

Learning Objectives:

• 1. Recognize that contraceptive use in the U.S. has declined in recent years.
• 2. Articulate the association between reduced contraceptive use, unintended pregnancy, and poor pregnancy outcomes.
• 3. Recognized that motivations to plan pregnancies are complex and poorly captured in national surveys.

Keywords: Pregnancy, Women's Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation