Young women's education and behavioural risk trajectories: clarifying their association with unintended-pregnancy resolution

In the USA, most pregnancies occurring to teenage women are unplanned, making both the decisions regarding their resolution and the consequences of those decisions important topics of inquiry. Substantial debate surrounds the potential consequences for young women of either carrying an unintended pregnancy to term or voluntarily terminating it. The present study utilises data from The US National Longitudinal Study of Adolescent Health prospectively to examine the predictors of pregnancy resolution decisions in terms of young women's educational goals and their engagement in risk behaviours. Additionally, the long-term consequences of these decisions for education and risk-taking behaviours are identified. Results indicate that young women with strong educational goals have a greater likelihood of terminating an unintended pregnancy than those with low aspirations, and that pregnancy termination predicts higher educational attainment compared to motherhood. Risk behaviours did not predict pregnancy-resolution decisions, but young women who became mothers reported lower rates of subsequent substance use and fewer sexual partners post-pregnancy than those who terminated the pregnancy or who had never been pregnant. Motherhood appears to be a catalyst for lifestyle change among young women, limiting substance use and sexual partnering, in contrast to abortion, which appears to allow adolescents to continue risk-taking trajectories.     

Reasons for Ineffective Contraceptive Use Antedating Adolescent Pregnancies: Part 2: A Proxy for Childbearing Intentions

Purpose Compare the relationship between childbearing intentions, maternal behaviors, and pregnancy outcomes in a group of early/middle adolescents versus a group of late adolescents (specifically high school seniors, high school graduates, and GED certificate recipients). Methods The reasons given by a racially/ethnically diverse group of 1,568 pregnant 13–18 year olds for not using contraception were used to classify their pregnancies as intended or unintended. Proportion comparison tests and stepwise logistic regression analyses were used to study the relationship between childbearing intentions, maternal behaviors, and pregnancy outcomes. Results Regardless of age, adolescents who intended to become pregnant conceived in an objectively more hospitable and supportive childbearing milieu than those who conceived unintentionally. This is evidenced by their greater likelihood of having goals compatible with adolescent childbearing, cohabitation with the father of the child, and living in a non-chaotic environment. However, pregnancy planning was not associated with improved compliance with preventive health care recommendations during gestation nor with infant outcomes. As such, the consequences among adolescents with intended pregnancies were negative, as evidenced by a higher rate of smoking, STDs late in gestation, school dropout, and repeat conception. Conclusions Like adults, adolescents with intended pregnancies conceived in an objectively more supportive environment than their counterparts with unintended pregnancies. However, this advantage did not translate into better support, healthier maternal behavior during gestation, or improved pregnancy outcomes.     

Pregnancy intention in an urban Australian antenatal population

Objective : To determine the prevalence of unintended pregnancy in women presenting for antenatal care to a large metropolitan hospital in Sydney, Australia, and to investigate health behaviours and demographic factors associated with unintended pregnancy. Methods : From October 2010 to April 2011, a self‐administered questionnaire covering pregnancy intention, contraceptive use and demographic information was given to 1,554 women. A total of 1,218 women (78.4%) completed all questions in the validated pregnancy intention instrument. Results : Two‐thirds of pregnancies (67.6%) were clearly intended, 30.0% were ambivalent and more than 2% experienced an unplanned pregnancy. Those more likely to experience an unintended pregnancy were women under 25 years old (OR 1.86, 95% CI 1.10–3.14), unmarried women (OR 6.08, 95% CI 3.40–10.87) and women of Asian background (OR: 2.45, 95% CI 1.76–3.42). More than one‐third of women (34.6%) did not take any health actions such as stopping smoking before pregnancy. Conclusions : Unintended pregnancies in this population were associated with young age, being unmarried and being of Asian background. This study confirms the idea that many women do not take health actions before pregnancy. Implications : Experts believe that an effective strategy to address unintended pregnancy is to improve access to long‐acting reversible contraceptives, which do not require daily compliance.     

Pregnancy Intendedness and Physical Abuse Around the Time of Pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System, 1996–1997

Objective: This study examines whether unintended pregnancy is associated with physical abuse of women occurring around the time of pregnancy, independent of other factors. Methods: In 1996–1997, state-specific population-based data were obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 39,348 women in 14 states who had delivered a live-born infant within the previous 2–6 months. The study questionnaire asked about maternal behaviors and characteristics around the time of pregnancy. Results: Women who had mistimed or unwanted pregnancies reported significantly higher levels of abuse at any time during the 12 months before conception or during pregnancy (12.6% and 15.3%, respectively) compared with those with intended pregnancies (5.3%). Higher rates of abuse were reported by women who were younger, Black, unmarried, less educated, on Medicaid, living in crowded conditions, entering prenatal care late, or smoking during the third trimester. Overall, women with unintended pregnancies had 2.5 times the risk of experiencing physical abuse compared with those whose pregnancies were intended. This association was modified by maternal characteristics; the association was strongest among women who were older, more educated, White, married, not on Medicaid, not living in crowded conditions, receiving first trimester prenatal care, or nonsmoking during the third trimester. Conclusions: Women with unintended pregnancies are at increased risk of physical abuse around the time of pregnancy compared with women whose pregnancies are intended. Prenatal care can provide an important point of contact where women can be screened for violence and referred to services that can assist them.The Pregnancy Risk Assessment Monitoring System (PRAMS) Working Group comprises the following state collaborators:L. Albert Woolbright, Alabama; Kathy Perham-Hester, Alaska; Gina Redford, Arkansas; Darci Cherry, Colorado; Richard Hopkins, Florida; Leslie Lipscomb, Georgia; Martha Henson, Maine; Yasmina Bouraoui, Michigan; Michael Medvesky, New York; Michelle Beck-Warden, North Carolina; Richard Lorenz, Oklahoma; Kriisten Helms, South Carolina; Linda Lohdefink, Washington; and Melissa Baker, West Virginia     

Pregnancy Intentions,Pregnancy Attitudes,and the Use of Prenatal Care in Missouri

Objectives: This study uses data from 2378 mothers of live-born infants from the NICHD/Missouri Maternal and Infant Health Survey to examine the relationship between pregnancy intention and adequacy of prenatal care. Methods: Pregnancy intention was measured using traditional classifications of mistimed and unwanted pregnancies as well as additional measures of women's attitudes about their pregnancies. Odds ratios for inadequate prenatal care and its component parts (initiation of care and receipt of services) were calculated using multiple logistic regression in separate models and in a combined model for the measures of intention and attitude. Results: Women's attitudes about their pregnancies were associated with inadequate prenatal care, including both inadequate initiation of care and inadequate receipt of services. Traditional measures of intendedness were significantly related only to inadequate initiation of care. Women who were unhappy about the pregnancy (OR = 1.44), unsure that they wanted to be pregnant (OR = 2.81), or denied their pregnancies (OR = 4.82) were more likely to have inadequate prenatal care than women who did not have these attitudes. Women who were unhappy about being pregnant (OR = 1.86), unsure that they wanted to be pregnant (OR = 3.44), or who denied the pregnancy (OR = 6.69) were more likely to have inadequate initiation of care. Women who were unsure that they wanted to be pregnant (OR = 1.95) or who denied their pregnancies (OR = 2.47) were more likely to have received inadequate care once they had entered care. Conclusions: This study suggests that attitudes about pregnancy may be a psychosocial barrier to women obtaining early and continuous prenatal care. Pregnancy attitudes should be assessed and appropriate services provided to improve women's utilization of prenatal care. New measures of pregnancy attitude, beyond the traditional intention measures, can be useful in assessing pregnancy wantedness and identifying women to target for these services.     

Unintended pregnancy among the urban poor

This article seeks to determine the proportion of pregnancies that are unintended among poor women in New York City, compare the New York City rate to national data, and examine factors associated with unintended pregnancy in this population. Pregnancy testing data collected between June 1, 1998, and June 1, 2001, from field sites operated by the Office of Family Health, New York City Department of Health and Mental Hygiene were analyzed. Pregnancy planning (intended vs. unintended) was examined by age group, race/ethnicity, marital status, frequency of contraceptive use, number of previous pregnancies, drug and alcohol use, and smoking. Odds ratios were calculated to determine if pregnancies were more likely to be unintended among women with certain characteristics. Logistic regression was used to examine independent risk factors for unintended pregnancy. Of the 20,518 women who had a pregnancy test during the study period, 9,406 (45.8%) were pregnant. Of the pregnancies, 82% were unintended. Marital status was the strongest predictor of unintended pregnancy, increasing the risk 2.5-fold for unmarried women. Adolescents and those who drank alcohol were also at increased risk of unintended pregnancy. The extremely high percentage of pregnancies that were unintended among the study population suggests that national unintended pregnancy rates are not representative of what occurs among low-income women in an urban setting. Unintended pregnancy interventions should be tailored for the urban poor and target unmarried, young women.     

Pregnancy Outcomes by Pregnancy Intention in a Managed Care Setting

Objectives Published studies show poor pregnancy outcomes associated with unintended pregnancies are disproportionately higher than in planned pregnancies and place a burden on the health care system. This study was designed to compare pregnancy intention rates, compare sociodemographic characteristics of women by pregnancy intention and compare pregnancy outcomes in a managed care setting. Methods A large managed health care organization in California conducted a retrospective medical record review of 1,784 women seeking prenatal care in 2002 to learn how women self-reported their pregnancy intention, compare pregnancy intention rates between this health plan to the national data, and to compare antecedents and pregnancy outcomes based on pregnancy intention. Results Overall, 62.1% of pregnancies were self-reported as intended with 26.4% mistimed and 11.4% unwanted. Being young, single, having lower educational attainment, having other living children, consuming alcohol and being a woman of color were the greatest predictors of having an unintended pregnancy. Despite these predictors, birth outcomes for unintended pregnancies in this setting showed no statistical difference from planned pregnancies. Conclusion Awareness of pregnancy intention of the women who are at greatest risk may be an important contributor to improving birth outcomes and health plan decisions about reproductive care services. Early entry to prenatal care and integrated services that decrease substance abuse and support high-risk pregnancy management are important contributors to reducing poor pregnancy outcomes.     

Pregnancy Intention and Contraceptive Use Among Adult Women

Objectives: We examined pregnancy intention measures and contraceptive use behaviors among reproductive-age women using data from two CDC-based surveillance systems. Methods: We analyzed data for women aged 18–44 from 4 states that collected information on pregnancy and contraceptive use from both the Behavioral Risk Factor Surveillance System (BRFSS, n = 4201) and the Pregnancy Risk Assessment Monitoring System (PRAMS, n = 7761) in 2000. Standard definitions of intended and unintended pregnancy were used. Results: BRFSS data show that 4% (95% CI: 2.8–5.2) of the women were pregnant at the time of interview and that 57% (95% CI: 41.9–71.9) of these pregnancies were intended. Women who had been pregnant within the last 5 years but were not currently pregnant reported that 61% (95% CI: 55.9–65.3) of their most recent pregnancies had been intended. According to PRAMS, 58% (95% CI: 56.5–60.5) of women with live births had intended pregnancies. Contraceptive use varied across the surveys; 68% (95% CI: 65.7–70.7) of all non-pregnant women from BRFSS and 87% (95% CI: 85.1–87.9) of women with a recent live birth from PRAMS reported using contraceptives. Conclusions: Although contraceptive use differed between the BRFSS and PRAMS, the patterns of pregnancy intention were similar for women who had a pregnancy within the past 5 years, those who recently delivered a live-born infant, and those who were currently pregnant. It appears that reporting of pregnancy intention is not affected by timing of assessment across the two surveys.     

Increasing Awareness of Danger Signs in Pregnancy Through Community- and Clinic-Based Education in Guatemala

Objective: This study evaluates the effectiveness of a set of information, education, and communication (IEC) strategies designed to increase the awareness of danger signs in pregnancy, delivery, or the postpartum period among pregnant or recently pregnant women. Methods: Three IEC programs were implemented in 4 regions of southwestern Guatemala between April 1997 and May 1998: (1) a clinic-based program involving the training of health providers in prenatal counseling and the provision of educational media to clients; (2) a community-based strategy consisting of radio messages regarding obstetric complications; and (3) educational sessions conducted through women's groups. Three surveys were conducted. In 1997, 637 pregnant women were interviewed at clinics where the interventions had been implemented. In 1998, 163 pregnant women using a subset of the same health clinics were interviewed. In 1999, a population-based survey of 638 pregnant and postpartum women was conducted. Using logistic regression, we model awareness of danger signs as a function of sociodemographic characteristics, prenatal care utilization, and IEC interventions. Results: Among women using health clinics, the likelihood of having heard of danger signs nearly tripled between 1997 and 1998, when the clinic interventions were fully implemented. In 1999, those who had heard radio messages or participated in women's groups were, respectively, 3 times and 5 times more likely to have heard of danger signs in pregnancy. Conclusions: Safe motherhood programs can effectively increase knowledge of danger signs through clinic- and community-based educational strategies.     

Female Perceptions of Male Versus Female Intendedness at the Time of Teenage Pregnancy

Teen pregnancy is a major public health concern and the majority of these pregnancies are unintended. The study population included women whose first pregnancy occurred at age 19 or younger (n?=?2,142). Data from the 2002 National Survey of Family Growth was used to determine whether women??s reports of her own pregnancy intentions differed from her perception of her male partner??s pregnancy intentions at the time of conception. Chi-square tests and multinomial logistic regression were used to examine perceived discrepant pregnancy intent. Most (55.4%) reported that the pregnancy was unintended by both, 22.1% indicated only he intended the pregnancy, 5.6% indicated only she intended the pregnancy, and 16.9% reported both intended the pregnancy. Compared to adolescent pregnancies respondents recalled being unintended by both her and her partner, Black and Hispanic respondents were more likely than whites to indicate the pregnancy was intended and were more likely to indicate that she did not intend the pregnancy but believed her partner did. Respondents who were older at the time of conception were more likely to indicate that the pregnancy was intended by both her and her partner. There are differences in recall of pregnancy intentions as perceived by respondents. Female adolescents perceived that the male who fathered the pregnancy intended to get pregnant at that time more often than she did. Teen pregnancy prevention efforts should consider both females and males intentions to become pregnant.     

Differences between mistimed and unwanted pregnancies among women who have live births

CONTEXT: Mistimed and unwanted pregnancies that result in live births are commonly considered together as unintended pregnancies, but they may have different precursors and outcomes. METHODS: Data from 15 states participating in the 1998 Pregnancy Risk Assessment Monitoring System were used to calculate the prevalence of intended, mistimed and unwanted conceptions, by selected variables. Associations between unintendedness and women's behaviors and experiences before, during and after the pregnancy were assessed through unadjusted relative risks. RESULTS: The distribution of intended, mistimed and unwanted pregnancies differed on nearly every variable examined; risky behaviors and adverse experiences were more common among women with mistimed than intended pregnancies and were most common among those whose pregnancies were unwanted. The likelihood of having an unwanted rather than mistimed pregnancy was elevated for women 35 or older (relative risk, 2.3) and was reduced for those younger than 25 (0.8); the pattern was reversed for the likelihood of mistimed rather than intended pregnancy (0.5 vs. 1.7-2.7). Parous women had an increased risk of an unwanted pregnancy (2.1-4.0) but a decreased risk of a mistimed one (0.9). Women who smoked in the third trimester, received delayed or no prenatal care, did not breast-feed, were physically abused during pregnancy, said their partner had not wanted a pregnancy or had a low-birth-weight infant had an increased risk of unintended pregnancy; the size of the increase depended on whether the pregnancy was unwanted or mistimed. CONCLUSION: Clarifying the difference in risk between mistimed and unwanted pregnancies may help guide decisions regarding services to women and infants.     

Pregnancy Intention and Pregnancy Happiness: Are They Different?

Objectives: This study examines the relationship among pregnancy intention and attitudes, inconsistent contraceptive use, and plans for potential pregnancy among 311 women who presented at local health departments to seek a pregnancy test and for whom a pregnancy would be unintended. Methods: Women were surveyed prior to receiving pregnancy tests. Pregnancy intention was measured using traditional classifications of mistimed and unwanted pregnancies. Frequency distributions and chi-square tests were computed to examine and compare rates of happiness about the pregnancy among women with mistimed or unwanted pregnancy and to compare rates of inconsistent contraceptive use and plans for the pregnancy by intention and level of happiness. Results: Although all of the women selected for our sample stated that their pregnancies would be unintended, almost half (46%) were inconsistent contraceptive users. Further, 48% reported that they would be somewhat or very happy about a pregnancy. The proportion of women who were uncertain about the future of a pregnancy and who considered adoption or abortion was highest among those for whom a potential pregnancy was mistimed and who were unhappy about the pregnancy. Conclusions: Differentiating between pregnancy intention and happiness has practice implications for family planning and prenatal providers. Additional research should further elaborate these distinctions.     

计划与非计划怀孕围孕期环境危险因素暴露差异的分析

目的 分析计划与非计划怀孕围孕期环境危险因素暴露的差异,估计计划怀孕在降低环境危险因素暴露风险中的作用.方法 利用无锡市2002-2004年孕产妇回顾性调查资料,共调查1628名孕产妇;运用logistic回归模型控制孕妇生育年龄、教育水平等因素后估计了计划怀孕在降低围孕期孕妇用药、工作和生活环境接触有毒有害物质及一些不良行为因素暴露风险中的作用.结果 在调查对象中,计划怀孕比例为73.2%,城市孕妇计划怀孕比例略低于农村孕妇,生育年龄在30岁及以上的孕妇计划怀孕比例显著高于生育年龄低于30岁的孕产妇.计划和非计划怀孕孕妇在服用药物及熬夜等不良行为暴露比例上差异有统计学意义,计划怀孕组可疑致畸药物和有熬夜习惯的暴露比例分别为2.5%和2.9%,显著低于意外妊娠组的6.0%和5.5%.在控制生育年龄等因素后,与非计划怀孕孕妇相比,计划怀孕孕妇围孕期服用可疑致畸药物和熬夜的比例分别降低了60%和50%左右,饮食无规律、长时间上网及看电视的比例约降低了1/3左右.结论 计划怀孕可显著降低孕妇围孕期服用可疑致畸药物及一些不良行为因素的暴露风险.降低非计划或意外妊娠发生比例,提高计划怀孕比例是一项经济有效的出生缺陷干预措施.     

Circumstances of Pregnancy: Low Income Women in Georgia Describe the Difference between Planned and Unplanned Pregnancies

Introduction and Background: The United States has a higher rate of unintended pregnancies than many other developed countries despite the availability of effective contraception. Using Azjen's Theory of Planned Behavior and Luker's Theory of Contraceptive Risk Taking this qualitative study explores the reasons for the high rate of unintended pregnancy among low income women in Georgia. Methods: Six focus groups (N=39) were conducted at county health department clinics. Women were recruited at the clinics to participate in a discussion of Pregnancy and Motherhood. All English or Spanish speaking women between the ages of 18 and 49 were eligible for participation. Results: Three dimensions of pregnancy planning emerged-the decision to have a child, taking specific behaviors to increase the likelihood of conception, and making plans to care for a child. Planned pregnancies may occur when a couple or a woman decides that they are ready to have a child, but also occur in less stable situations that pose risks for the family and the child. Unplanned pregnancies may be welcomed or be unwanted depending on the circumstances. Women perceive advantages and disadvantages to planned and unplanned pregnancies. Discussion: There are major differences between the definition and values of planned and unplanned pregnancies promoted by public health practitioners and those of the women in our study. This suggests the need for research on the circumstances in which pregnancies occur, as well as targeted interventions and policies that help women and men define and achieve the circumstances in which they would like to bear and rear children.     

Unintended Pregnancy in a Commercially Insured Population

Objectives: While much attention has been focused on unintended pregnancy in disadvantaged populations, few studies have focused on women in lower risk groups. This study, conducted in a national managed care organization, reports the prevalence of unintended pregnancy resulting in live births and examines associated factors. Methods: Women ages 18–49 who delivered a live infant during a 6-month interval were eligible for the study. Telephone surveys were conducted after delivery. We report the rate of unintended pregnancy resulting in a live birth, and describe its association with sociodemographic and pregnancy-related factors, partner's intention status, and contraceptive use. Results: Of 1173 births, 29% were unintended. Women who reported that the partner did not want the pregnancy were 7.4 times more likely than women whose partner wanted the pregnancy to regard the pregnancy as unintended. Only 40% of the women with an unintended birth used birth control and 64% of those used less effective methods such as condoms and diaphragms. Conclusions: In a population where the majority of women were married, educated, and with incomes over $40,000, almost 1/3 of the births resulted from unintended pregnancies. Future research is needed to help us better understand contradictions in pregnancy intention and contraceptive behavior. Comprehensive efforts are needed to promote consistent and correct use of contraception by women at risk for unintended pregnancy, and to involve male partners in family planning.     

The Association Between Body Weight,Unintended Pregnancy Resulting in a Livebirth,and Contraception at the Time of Conception

Objectives: Annually, 3 million pregnancies in the United States are classified as unintended, with many of these unintended pregnancies occurring to women who use some type of contraceptive. Obesity may be affecting the biological effectiveness of contraceptives. We investigated whether there is an association between body weight and unintended pregnancy and whether this association differs by a woman's contraceptive status at the time of conception. Methods: We conducted a case–control study using multistate data from the 1999 Pregnancy Risk Assessment Monitoring System. A total of 18,445 women provided complete information on pregnancy intention, contraceptive use at the time of conception, weight, height, and other covariates. Multivariable logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among contraceptors, overweight and obese women had nearly twice the odds of having an unintended pregnancy as compared to women with normal body mass indices (OR=1.73 [95% CI: 1.20, 2.36] and OR=1.75 [95% CI: 1.21, 2.52], respectively) after adjustment for age, marital status, education, socioeconomic status, Medicaid, race/ethnicity, and parity. No association was found between heavier weight and unintended pregnancy among noncontraceptors. Conclusions: Though the observed associations could be the result of selection bias or unmeasured confounding, the findings suggest that the effect of obesity on unintended pregnancy is limited to contraceptive failure. Prospective studies designed specifically to examine a body weight–contraceptive failure association are needed to determine if heavier women should be advised to use contraceptive methods other than hormonal contraceptives to prevent unintended pregnancy.     

Fertility control? Middle‐aged Australian women's retrospective reports of their pregnancies

OBJECTIVE: To assess middle-aged Australian women's retrospective reports of how intended and wanted were their pregnancies, and the degree of happiness associated with these pregnancies. METHODS: A self-administered questionnaire was sent to 1000 participants in the Mid-Age cohort of the Australian Longitudinal Study on Women's Health. RESULTS: Responses from 811 women (81%) showed that, although 32% of first pregnancies were unplanned and 29% were unwanted, most women recall being happy with their pregnancies and termination rates were very low. The second pregnancy was the most planned and wanted and associated with the highest levels of happiness. CONCLUSIONS: While the majority of middle-aged women report having been happy to be pregnant, and the majority of pregnancies are described retrospectively as planned and wanted, a significant proportion of pregnancies are unwanted, unplanned or resulting from unintended contraceptive failure. IMPLICATIONS: The data support the continuing need for widely available, affordable and sensitive fertility control services.     

The place of abortion in the pregnancy decision‐making process in young adult women in Catalonia,Spain

Induced abortion is one option to control fertility in Spain. Young adult women (25–34 years old) show a different abortion pattern compared to women in other age groups, being less likely to seek abortions than younger women and having one of the lowest proportions of unintended pregnancies. We aimed to analyse the factors involved in the pregnancy decision‐making process to better understand why young adult women seek abortions in Catalonia, Spain. In‐depth semi‐structured interviews with 25 nulliparous pregnant young adult women and one focus group discussion with healthcare providers were conducted in 2008/2010. We found that inconsistent contraceptive use prior to an unintended pregnancy was due to ambivalence and weighing of priorities during sex. The quality of the relationship was paramount to the abortion decision whereas other reasons (financial/employment status, fulfilling aspirations, support networks) were less important. We conclude that the motivations for the abortion decision are interrelated and based on the current life stage of women and that there is pressure on young adult women in Spain to become mothers. Induced abortion is perceived as the last resort to postpone motherhood. Our findings reinforce the unequal societal burden placed on women to take responsibility for prevention of unintended pregnancy.     

Women’s Autonomy and Unintended Pregnancy Among Currently Pregnant Women in Bangladesh

This paper examines the net effect of women's autonomy on their pregnancy intention status among currently pregnant Bangladeshi women. This study is based on data from the Bangladesh Demographic Health Survey, 2007 (BDHS). A subset of interviews from currently pregnant women (718) were extracted from 10,146 married women of reproductive age. The BDHS 2007 used a pre-tested, structured questionnaire to collect sociodemographic, women's empowerment, and pregnancy information. Associations between unintended pregnancy and explanatory variables were assessed using bivariate analysis. Logistic regression was used to assess the net effect of women's autonomy on current pregnancy intention status after controlling for other variables. Results indicate that women's autonomy is a significant predictor of unintended pregnancy after adjusting for other factors. A unit increase in the autonomy scale decreases the odds of unintended pregnancy by 16%. Besides autonomy, our results also indicate that current age, number of children ever born, age at marriage, religion, media access, and contraceptive use exert strong influences over unintended pregnancy. Women who have ever used contraceptives are 82% more likely to classify their current pregnancies as unintended compared with women who are non-users of contraceptives. Improvement in women's autonomy and effective and efficient use of contraceptives may reduce unintended pregnancies as well as improve reproductive health outcomes.