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Chapter 52 - Prevention of Unintended Pregnancy

from Section 11 - Public Health Issues in Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Michelle Cooper  and
Sharon T. Cameron
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

There is evidence that a significant proportion of pregnancies are unintended at conception. Pregnancy planning allows for optimization of a woman’s health prior to conception and is associated with improved outcomes for both mother and baby. Certain periods during the female life course are associated with an increased risk of unintended pregnancy, such as adolescence, or where the risk of pregnancy is under-recognized, such as post-pregnancy and the perimenopause. Interactions with obstetricians and gynaecologists may provide opportunities for prevention through education and enhanced contraceptive provision.

Keywords

pregnancyfamily planningcontraceptionadolescencepostpartum
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 449 - 456
Publisher: Cambridge University Press
Print publication year: 2021

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References

Bearak, J, Popinchalk, A, Alkema, L, Sedgh, G. Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model. Lancet Glob Health 2018;6:e380–e389.Google Scholar
Barrett, G, Smith, SC, Wellings, K. Conceptualisation, development, and evaluation of a measure of unplanned pregnancy. J Epidemiol Community Health 2004;58:426–433.Google Scholar
Lakha, F, Glasier, A. Unintended pregnancy and use of emergency contraception among a large cohort of women attending for antenatal care or abortion in Scotland. Lancet 2006;368:1782–1787.Google Scholar
Poston, L, Barker, M, Hutchinson, J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet 2018;391:1830–1841.Google Scholar
Colbourn, T, Dombrowski, SU, Fall, CHD, et al. Intervention strategies to improve nutrition and health behaviours before conception. Lancet 2018;391:1853–1864.Google Scholar
Dibaba, Y, Fantahun, M, Hindin, MJ. The effects of pregnancy intention on the use of antenatal care services: systematic review and meta-analysis. Reprod Health 2013;10:50.CrossRefGoogle ScholarPubMed
Mohllajee, AP, Curtis, KM, Morrow, B, Marchbanks, PA. Pregnancy intention and its relationship to birth and maternal outcomes. Obstet Gynecol 2007;109:678–686.Google Scholar
Abajobir, A, Maravilla, J, Alati, R, Najman, J. A systematic review and meta-analysis of the association between unintended pregnancy and perinatal depression. J Affect Disord 2016;192:56–63.CrossRefGoogle ScholarPubMed
Smith, GC, Pell, JP, Dobbie, R. Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ 2003;327:313.Google Scholar
World Health organization. Abortions Per 1000 Live Births in 2015. Washington, DC: WHO European Health Information Gateway, 2018.Google Scholar
Say, L, Chou, D, Gemmill, A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014;2:e323–e333.Google Scholar
Mccall, SJ, Flett, G, Okpo, E, Bhattacharya, S. Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data. J Fam Plann Reprod Health Care 2016;42:133–142.Google Scholar
Kilander, H, Alehagen, S, Svedlund, L, et al. Likelihood of repeat abortion in a Swedish cohort according to the choice of post abortion contraception: a longitudinal study. Acta Obstet Gynecol Scand 2016;95:565–571.CrossRefGoogle Scholar
Van Den Branden, Y, Verhaeghe, S, Goossens, J, et al. The prevalence of unplanned pregnancy ending in birth, associated factors, and health outcomes. Hum Reprod 2016;31:2821–2833.Google Scholar
Trussell, J. Contraceptive failure in the United States. Contraception 2011;83:397–404.CrossRefGoogle ScholarPubMed
Diedrich, JT, Klein, DA, Peipert, JF. Long-acting reversible contraception in adolescents: a systematic review and meta-analysis. Am J Obstet Gynecol 2017;216:364.e1–364.e12.CrossRefGoogle ScholarPubMed
Faculty of Sexual & Reproductive Healthcare. UK Medical Eligibility for Contraceptive Use (UKMEC). 2016.Google Scholar
Blanchard, K, Harper, C, Schaffer, K, et al. Advance provision of emergency contraception for pregnancy prevention. Cochrane Database Syst Rev 2007;2:CD005497.Google Scholar
Wellings, K, Jones, KG, Mercer, CH, et al. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 2013;382:1807–1816.Google Scholar
World Health Organization. Standards for Sexuality Education in Europe. Cologne: WHO, 2010.Google Scholar
Kirby, D. The impact of schools and school programs upon adolescent sexual behavior. J Sex Res 2002;39:27–33.CrossRefGoogle ScholarPubMed
Jackson, E, Glasier, A. Return of ovulation and menses in postpartum nonlactating women: a systematic review. Obstet Gynecol 2011;117:657–662.Google Scholar
McDonald, EA, Brown, SJ. Does method of birth make a difference to when women resume sex after childbirth? BJOG 2013;120:823–830.Google Scholar
Heller, R, Cameron, S, Briggs, R, Forson, N, Glasier, A. Postpartum contraception: a missed opportunity to prevent unintended pregnancy and short inter-pregnancy intervals. J Fam Plann Reprod Health Care 2016;42:93–98.Google Scholar
Faculty of Sexual & Reproductive Healthcare. Contraception after pregnancy guideline. 2017.Google Scholar
Cameron, ST, Craig, A, Sim, J, et al. Feasibility and acceptability of introducing routine antenatal contraceptive counselling and provision of contraception after delivery: the APPLES pilot evaluation. BJOG 2017;124:2009–2015.CrossRefGoogle ScholarPubMed
Blumenthal, PD, Voedisch, A, Gemzell-Danielsson, K. Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception. Hum Reprod Update 2011;17:121–137.Google Scholar
Phillips, SJ, Tepper, NK, Kapp, N, et al. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception 2016;94:226–252.Google Scholar
Tepper, N, Phillips, S, Kapp, N, Gaffield, M, Curtis, K. Combined hormonal contraceptive use among breastfeeding women: an updated systematic review. Contraception 2016;94:262–274.Google Scholar
Sonalkar, S, Kapp, N. Intrauterine device insertion in the postpartum period: a systematic review. Eur J Contracept Reprod Health Care 2015;20:4–18.Google Scholar
Lopez, LM, Van Vliet, HA, Grimes, DA, Schulz, KF, Stanwood, NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev 2010;5:CD003036.Google Scholar
Makins, A, Taghinejadi, N, Sethi, M, et al. FIGO postpartum intrauterine device initiative: complication rates across six countries. Int J Gynecol Obstet 2018;143:20–27.Google Scholar
Washington, CI, Jamshidi, R, Thung, SF, et al. Timing of postpartum intrauterine device placement: a cost-effectiveness analysis. Fertil Steril 2015;103:131–137.CrossRefGoogle ScholarPubMed
Klein, J, Sauer, MV. Assessing fertility in women of advanced reproductive age. Am J Obstet Gynecol 2001;185:758–770.Google Scholar
Office of National Statistics. Conceptions in England and Wales: 2016. 2017.Google Scholar

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