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

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.