Accidental Pregnancy and Contraceptive Practices in Contemporary Australia: Preliminary Results from a National Population-based Survey
ESC Congress Library. Rowe H. 05/28/14; 50622; A-207 Disclosure(s): I have no disclosures to declare
Dr. Heather Rowe
Dr. Heather Rowe
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Abstract
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Objectives
Australia faces the contradictory problems of high rates of unintended pregnancy and of infertility. These population patterns are well documented in demographic surveys, but little is known about how they are experienced in individual lives. The objective of this study, funded in partnership by the Australian Research Council, the Royal Women’s Hospital, The Victorian Government Department of Health, Family Planning Victoria and Melbourne IVF, was to investigate how Australians manage fertility. The aim of this paper is to describe contraceptive practices and correlates of unintended, mistimed, or unwanted pregnancies in an Australian national sample of women and men of reproductive age.

Design and methods
A population-based cross-sectional survey was conducted. The survey and a letter of invitation to participate were mailed to a random sample of people aged 18 to 50 extracted from the Australian Electoral Roll. Information was collected about sociodemographic factors and management of fertility across the life-course, including about contraceptive practices and the circumstances of any accidental pregnancies. Correlates of accidental pregnancy were assessed in a multivariable model.

Results
The survey was sent to 15,590 people (7795 women; 7795 men), yielding a nationally-representative sample (recruitment fraction 15%). Almost all had access to affordable, acceptable contraception, but few expressed willingness to use long-acting reversible contraceptives. Most agreed that men and women should share responsibility for contraception. At least one accidental pregnancy was reported by 25% of the respondents. Accidental pregnancy was independently associated with living in a rural location, being born overseas, social disadvantage and experience of forced sex.

Conclusions
Availability of acceptable contraception is insufficient to ensure that pregnancies are intended and not mistimed or unwanted. Four independent risks for accidental pregnancy were established; experience of forced sex confers the greatest (almost two-fold) risk. Prevention of accidental pregnancy should focus of rural health and social services, unmet needs of migrant groups, promotion of long-acting reversible contraceptives and prevention of violence against women. The results will inform targeted health service, public health, health promotion and sex education policy responses.

Objectives
Australia faces the contradictory problems of high rates of unintended pregnancy and of infertility. These population patterns are well documented in demographic surveys, but little is known about how they are experienced in individual lives. The objective of this study, funded in partnership by the Australian Research Council, the Royal Women’s Hospital, The Victorian Government Department of Health, Family Planning Victoria and Melbourne IVF, was to investigate how Australians manage fertility. The aim of this paper is to describe contraceptive practices and correlates of unintended, mistimed, or unwanted pregnancies in an Australian national sample of women and men of reproductive age.

Design and methods
A population-based cross-sectional survey was conducted. The survey and a letter of invitation to participate were mailed to a random sample of people aged 18 to 50 extracted from the Australian Electoral Roll. Information was collected about sociodemographic factors and management of fertility across the life-course, including about contraceptive practices and the circumstances of any accidental pregnancies. Correlates of accidental pregnancy were assessed in a multivariable model.

Results
The survey was sent to 15,590 people (7795 women; 7795 men), yielding a nationally-representative sample (recruitment fraction 15%). Almost all had access to affordable, acceptable contraception, but few expressed willingness to use long-acting reversible contraceptives. Most agreed that men and women should share responsibility for contraception. At least one accidental pregnancy was reported by 25% of the respondents. Accidental pregnancy was independently associated with living in a rural location, being born overseas, social disadvantage and experience of forced sex.

Conclusions
Availability of acceptable contraception is insufficient to ensure that pregnancies are intended and not mistimed or unwanted. Four independent risks for accidental pregnancy were established; experience of forced sex confers the greatest (almost two-fold) risk. Prevention of accidental pregnancy should focus of rural health and social services, unmet needs of migrant groups, promotion of long-acting reversible contraceptives and prevention of violence against women. The results will inform targeted health service, public health, health promotion and sex education policy responses.

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