title: Determinants of unintended pregnancies in rural Ghana.
abstract: BACKGROUND
  Unintended pregnancies may carry serious consequences for women and their families, including the possibility of unsafe abortion, delayed prenatal care, poor maternal mental health and poor child health outcomes. Although between 1993 and 2008, unintended births decreased from 42% to 37% in Ghana, the rate of decline is low, whilst levels are still very high. This raises the need to understand factors associated with unintended pregnancies, especially among women in rural settings where the rates and risks are highest to help improve maternal health.
  
  
  METHODS
  We collected data from 1,914 pregnant women attending antenatal clinic between January 2012 and April 2012 in four health facilities in the Mfantseman Municipal of the Central Region of Ghana. We used bivariate and multivariate logistic regression analyses to explore how socio-demographic characteristics, past reproductive health experiences, partner characteristics and relations, awareness and past experience with contraceptives, influenced the status of women's current pregnancy (whether intended or unintended).
  
  
  RESULTS
  The mean age of the 1,914 respondents in this study was 25.6 ± 6.5 years. Seventy percent (70%) said the pregnancies they were carrying were unintended. The odds of carrying unintended pregnancy among women with five or more children were higher than those with one to two children [AOR 6.06, 95% CI (3.24-11.38) versus AOR 1.48, 95% CI (1.14-1.93)]. Women with other marital arrangements showed significantly higher odds of carrying unintended pregnancy compared to those married by ordinance (Muslim or Christian wedding). Women not living with their partners exhibited increased odds of having unintended pregnancies compared to women who lived with their partners (AOR 1.72, 95% CI: 1.28 - 2.30). Awareness of traditional methods of family planning (withdrawal and rhythm) was associated with lower odds of having unintended pregnancy compared to non-awareness (AOR 0.66, 95% CI (0.49-0.89).
  
  
  CONCLUSIONS
  In this study, important risk factors associated with unintended pregnancies were: parity, living arrangements with partner, marriage by ordinance and awareness of traditional, non-pharmacological contraceptive methods. Family planning interventions targeting different groups of women, especially during the postpartum period, would be essential to reduce rates of unintended pregnancies and promote positive health outcomes.
authors.affiliation: Department of Community Medicine, University of Cape Coast, Cape Coast, Ghana. sakeliason@yahoo.co.uk.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Eliason
authors.forename: Frank
authors.initials: F
authors.lastname: Baiden
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Yankey
authors.forename: Kofi
authors.initials: K
authors.lastname: Awusabo-Asare
mesh_terms: D000293:Adolescent; D000328:Adult; D003076:Coitus Interruptus; D005191:Family Characteristics; D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017533:Marital Status; D012252:Natural Family Planning Methods; D010298:Parity; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012111:Residence Characteristics; D012307:Risk Factors; D012424:Rural Population; D055815:Young Adult
references.citation: J Fam Pract. 1996 Aug;43(2):161-6
references.pmid: 8708626
references.citation: Perspect Sex Reprod Health. 2003 Mar-Apr;35(2):94-101
references.pmid: 12729139
references.citation: BMC Pregnancy Childbirth. 2013 Mar 19;13:69
references.pmid: 23510090
references.citation: Demography. 1987 Nov;24(4):517-30
references.pmid: 3428452
references.citation: Reprod Health. 2013 Jul 22;10:34
references.pmid: 23870234
references.citation: Sex Reprod Healthc. 2011 Jan;2(1):29-35
references.pmid: 21147456
references.citation: Stud Fam Plann. 2010 Dec;41(4):241-50
references.pmid: 21465725
references.citation: Issues Brief (Alan Guttmacher Inst). 2010 Jul;(2):1-4
references.pmid: 20653094
references.citation: Int J Equity Health. 2010 Jun 03;9:14
references.pmid: 20525237
references.citation: Lancet. 2006 Nov 4;368(9547):1595-607
references.pmid: 17084760
references.citation: J Fam Plann Reprod Health Care. 2013 Oct;39(4):e2
references.pmid: 23902713
references.citation: Int Perspect Sex Reprod Health. 2012 Dec;38(4):178-86
references.pmid: 23318167