Monday, February 02, 2015

Most Unintended Pregnancies Happened Even After Contraceptive Use: Study

This study has a twist. It questions men and unintended pregnancy. As always, formatted for easier reading.

The data presented in this study were drawn from the nationally representative FECOND study, a population-based survey conducted in France in 2010. The sample comprised 8675 individuals (3373 men), aged 15-49 years, who responded to a telephone interview about socio-demographics and topics related to sexual and reproductive health. The total refusal rate was 20%.
This study included 2997 men, of whom 664 reported 893 recent pregnancies (in the 5 years preceding the survey). Multivariate Poisson's regression with population-averaged marginal effects was applied to assess the individual and contextual factors associated with men's intentions for recent pregnancies. The contraceptive circumstances leading to the unintended pregnancies were also assessed.
Of all heterosexually active men, 5% reported they had experienced an unintended pregnancy with a partner in the last 5 years. 
A total of 20% of recent pregnancies reported by men were qualified to be unintended, of which 45% ended in induced abortion.
 Of pregnancies following a previous unintended pregnancy, 68% were themselves unintended. 
Among all heterosexually active men, recent experience of an unintended pregnancy was related to age, mother's education, age at first sex, parity, contraceptive method history, lifetime number of female partners and the relationship situation at the time of survey. 
Recent unintended pregnancies were also related to pregnancy order and to the financial and professional situation at the time of conception. 
The majority of unintended pregnancies occurred when men or their partners were using contraceptives; 58% of contraceptive users considered that the pregnancy was due to inconsistent use and 39% considered that it resulted from method failure. 
Half of the non-users who reported an unintended pregnancy thought that their partner was using a contraceptive method. The relative risk of non-use of a contraceptive method during the month of conception of a recent unintended pregnancy was higher among those without a high school degree (IRR = 2.9, CI 1.6, 5.2) and higher among men for whom the pregnancy interfered with education (IRR = 1.8, CI 1.0, 3.1) or work (IRR = 1.9, CI 1.1, 3.6).
From the perspective of men, the unintended pregnancy rates may be underestimated due to a combination of underreporting of abortion and post-rationalization of birth intentions. Our use of a dichotomous measure of unintended pregnancy is unlikely to fully capture the multidimensional construct of pregnancy intentions.

Hum Reprod. 2015 Jan;30(1):186-96. doi: 10.1093/humrep/deu259. Epub 2014 Oct 14.
Male experiences of unintended pregnancy: characteristics and prevalence.
Kågesten A1, Bajos N2, Bohet A3, Moreau C4.