Lecturer, Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh, and doctoral candidate, Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia,
DECRA Postdoctoral Research Fellow, School of Medicine and Public Health, University of Newcastle.
Int Perspect Sex Reprod Health. 2020 May 12;46:77-87. doi: 10.1363/46e8820.
Ineffective use or nonuse of contraceptives following an unplanned birth can contribute to the risk of a subsequent unintended pregnancy; however, the literature on the relationship between unintended pregnancy and postpartum contraceptive use is sparse, especially in low- and middle-income countries.
Data on 4,493 women from the 2014 Bangladesh Demographic and Health Survey were analyzed; the subjects of the analysis had had a live birth in the three years prior to the survey and were currently at risk of pregnancy. Multilevel logistic regression analysis was used to examine associations between the intendedness of a woman's last pregnancy resulting in a live birth and her current modern contraceptive use adjusting for individual, household and community-level variables.
Twenty-six percent of women reported that their last pregnancy resulting in a live birth had been unintended (15% mistimed and 11% unwanted); 61% reported current use of a modern contraceptive method. Compared with women who reported the pregnancy as having been wanted, those who reported the pregnancy as mistimed had greater odds of current modern contraceptive use (odds ratio, 1.6); no association was found between having had an unwanted pregnancy and subsequent modern contraceptive use. Other important correlates of modern contraceptive use included women's autonomy and desire for children, time since last birth and community-level poverty.
Bangladeshi women who experience an unwanted pregnancy may have an elevated risk of subsequent unintended pregnancy. Broader coverage of family planning services, and integration of family planning with maternal health care, may increase modern contraceptive use following an unplanned birth.
在非意愿妊娠后未能有效使用或未使用避孕药具可能会增加随后非意愿妊娠的风险；然而，关于非意愿妊娠与产后避孕药具使用之间关系的文献很少，尤其是在中低收入国家。
对 2014 年孟加拉国人口与健康调查中的 4493 名妇女进行了数据分析；分析对象为在调查前三年内有活产且目前有妊娠风险的妇女。采用多水平逻辑回归分析，根据个人、家庭和社区层面的变量，考察了最后一次导致活产的妊娠的意愿性与当前现代避孕药具使用之间的关联。
26%的妇女报告说，她们最后一次导致活产的妊娠是非意愿的（15%是时机不当的，11%是不想要的）；61%报告目前使用现代避孕方法。与报告怀孕是想要的妇女相比，报告怀孕时机不当的妇女更有可能当前使用现代避孕药具（比值比，1.6）；没有发现怀孕不想要与随后使用现代避孕药具之间存在关联。现代避孕药具使用的其他重要相关因素包括妇女的自主权和对孩子的渴望、上次分娩后的时间以及社区层面的贫困。
经历意外怀孕的孟加拉国妇女可能有更高的随后非意愿妊娠风险。更广泛地提供计划生育服务，并将计划生育与孕产妇保健相结合，可能会增加非意愿分娩后现代避孕药具的使用。
