Adolescent Women with Unintended Pregnancy in Low- and Middle-Income Countries: Reasons for Discontinuation of Contraception

Abstract

Study objective: To investigate the reasons for discontinuation of the last contraceptive method used among adolescent women with a current unintended pregnancy.

Design: Demographic and health, cross-sectional, surveys.

Setting: Thirty-five low- and middle-income countries.

Participants: We selected 2173 girls aged 15-19 years with a current unintended pregnancy, using a multistage cluster random sampling method.

Interventions: A questionnaire administered by trained interviewers, which included sociodemographic as well as individual maternal and contraceptive history, was used to collect data.

Main outcome measures: The prevalence of contraception utilization and the contribution of each reason for contraceptive discontinuation before the current unintended pregnancies.

Results: Almost three-quarters of adolescent women were not using any contraception before the current unintended pregnancy, and less than 1 in 100 was using a long-acting modern method. Among girls who last used a traditional method, 111/150 (74.0%) discontinued because of failure. Among girls who last used a long-acting modern method, 7/11 (63.6%) discontinued because of health concerns and side effects.

Conclusion: This study highlights that approximately 80.0% of adolescent women with an unintended pregnancy in 35 low- and middle-income countries were either nonusers or using traditional methods. An additional 20.4% were using a short-acting modern method. Long-acting methods would have prevented the overwhelming majority of unintended pregnancies, including the vast numbers from contraceptive failure.

Keywords: Adolescent health; Demographic health survey; Developing countries; Family planning; Unwanted pregnancies.