Unintended pregnancies in Hamedan, Iran: Levels and determinants

The recent limitation in the provision of publicly funded family planning services in Iran has concerned stakeholders in reproductive health about the incidence of unintended pregnancies. This study used data from Hamedan Survey of Fertility (HSF), conducted in April-June 2015 among a representative sample of 3,000 married women aged 15-49 years living in the city of Hamedan (Iran), to estimate levels of unintended pregnancies and examine factors related to pregnancy intentions for the most recent birth, using multinomial logistic regression analyses. Results showed that 23 percent of pregnant women reported their pregnancy as unintended (17 percent mistimed and 6 percent unwanted). Moreover, unintended pregnancies in the five years preceding the survey were the result of failures of withdrawal (35 percent) and of modern contraceptive use (33 percent), along with contraceptive discontinuation (23 percent) and non-use (9 percent). Multivariate results indicated that the risk of unintended pregnancy was lower among women reporting modern contraceptive failures and lower among those reporting contraceptive discontinuation and non-use, compared with women experiencing withdrawal failures. The high incidence of unintended pregnancies among women experiencing contraceptive failures and discontinuation imply their high unmet need for contraceptive knowledge and counseling rather than for access to contraceptive methods.