Meeting the unmet need for family planning among rural Balinese women

BACKGROUND: Approximately 470 million women of reproductive age in developing countries intend to stop childbearing, yet many of these women go on to have additional children. Unintended pregnancies result in about 60 million unwanted or mistimed births each year. The purpose of this longitudinal study was to identify the predictors of birth avoidance among women in a remote community in Bali, Indonesia who expressed a desire for no more children.

METHODS: We analyzed data from 665 married women of reproductive age who reported intentions to stop childbearing at baseline. Multivariate logistic regression was used to determine the likelihood of avoiding a birth during the four study period.

RESULTS: Almost thirty percent of women who wanted no more children had a birth during the study period. We found that women at highest risk for an unwanted birth were younger, had fewer children and did not use a long-term contraceptive method. Age at marriage, education and distance from the nearest health center were not found to be associated with birth avoidance. In addition, no significant difference was found among women who did not use any contraceptive method compared to those who used a short-term method.

CONCLUSIONS: Young women with small family sizes may have an unmet need for family planning and should not be automatically excluded from family planning services and information. Rural family planning programs should also put more emphasis on promoting long-term methods to women who express clear intentions to stop childbearing.