The prevalence and variations in unintended pregnancy by socio-demographic and health-related factors in a population-based cohort of young Australian women.

ABSTRACT

OBJECTIVE: The aim of this study is to estimate the prevalence of unintended pregnancy and associated socio-demographic and health-related factors among a national cohort of young Australian women. METHODS: Secondary analysis of three waves (2013-2015) of the Australian Longitudinal Study on Women's Health new young cohort. Women born between 1989 and 1995 were recruited through internet and traditional media, and peer referral. Respondents completed a baseline web-based survey in 2013 (n=17,010) on their health and healthcare use and were followed up annually. This analysis uses data from women reporting ever having vaginal sex in waves 2 (n=9,726/11,344) and 3 (n=6,848/8,961). We assessed correlates of lifetime and recent unintended pregnancy using multivariable regression models. RESULTS: At wave 2, among women aged 19-24, lifetime prevalence of unintended pregnancy was 12.6%, rising to 81.0% among ever pregnant women. Pregnancy outcomes among women with a history of unintended pregnancy differed by geographical residence. Disparities in odds of unintended pregnancy were seen by relationship and educational status, contraceptive use, sexual coercion and risky alcohol use. CONCLUSIONS: Unintended pregnancy among young Australians is disproportionally experienced by women with structural disadvantages and exposure to sexual coercion. PUBLIC HEALTH IMPLICATIONS Service improvements to achieve equitable distribution of contraception and abortion services must be integrated with initiatives responding to sexual coercion.