Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis.

ABSTRACT

OBJECTIVES: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries. METHODS: A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics. RESULTS: A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25-39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted). CONCLUSIONS: Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.