The relationship between contraceptive use and unintended pregnancies among married women in Thatta district, Pakistan.

Background & aim: The rate of unintended pregnancy has decreased from 24% to 16% in the last four to five years in Pakistan. However, this rate stills varies among the women living in the rural and urban areas of Pakistan. The females residing in the rural areas are less likely to have many contraceptive choices and receive no/low-quality family planning services; as a result, they end up with birth control failure and unintended pregnancy. Regarding this, more studies are needed to investigate the association between the unintended pregnancy and contraceptive use, particularly in the rural areas of Pakistan.Therefore, the aim of the present study was to determine the relationship between contraceptive use and unintended pregnancy among the women at reproductive age living in Thatta district, Sindh, Pakistan. Methods: This nested case-control study was conducted on the women living in Thatta district during June 2011-July 2012. The pregnant women who did not want more children were considered as cases, and those who intended to have more children were considered as controls. The categorical and continuous variables were analyzed using the Chi-square test and independent t-tests, respectively. Results: According o the results of the present study, the use of contraceptive methods was significantly associated with increased risk of unintended pregnancy among the women living in Thatta district [OR: 2.77 (1.46-5.25)]. Moreover, there was 14% increased risk of unintended pregnancy with one year increase in the age of the women [OR: 1.14 (1.10-1.19)]. The age at marriage showed negative association with unintended pregnancy [OR: 0.92 (0.87-0.97)]. The women having at least one son (alive) were almost three times more likely to report their recent pregnancies as unintended, compared to those with no living son [OR: 2.97 (1.82-4.84)]. In addition, the husband’s education and their opposition with the use of family planning methods [OR 2.16 (1.06-4.39)] were found to be associated with unintended pregnancy. Conclusion: As the findings of the present study indicted, the unintended pregnancy is likely to occur when the women have achieved their desired family size as evidenced by the higher mean age and presence of at least one living son. We recommend to improve the quality of care and family planning services to deal with issues of birth control failure by taking such measures as the provision of emergency contraception and support