Contextual Analysis of Unintended Pregnancy among Married Women: Policy Implications

Family planning is essential to the well-being of families. Health promotion related to family planning means that families will have the knowledge and access to opportunities to plan and space their children in order to achieve personal goals, independence and to prevent costly health and social risks associated with unintended pregnancy. This study utilized an ecological approach to examine the major factors that contribute to the risk of married women having an unintended pregnancy by merging the 1995 National Survey of Family Growth (NSFG) together with the 1995 NSFG contextual data. Multilevel modeling showed that married women of lower socioeconomic status, higher parity, whose husband also did not intend the pregnancy or were living in a community with a high rate of marital dissolution, had a higher probability of an unintended pregnancy. Those finding have implications for clinical work, health promotion and public policy. Government policies promoting "healthy marriage" should include family planning counseling to help couples avoid unintended pregnancy. Also, participation of husbands in reproductive education, decision making, and family planning services should be increased. The findings indicate the need for national surveys that include data on couples. A knowledge base about the effects of men and women in reproduction, parenting, and family functioning will help to design changes in health care that would have a positive effect on the delivery of family planning or childbearing services in the U.S.