The purpose of this prospective study is to identify factors predictive for repeat unintended pregnancy among reproductive-aged women. In the United States (US), almost half of all pregnancies are unintended and 17% of women have more than one unintended pregnancy. Unintended pregnancies, particularly those that are unwanted, are associated with poor maternal and child health outcomes. Repeat unintended pregnancies are more likely to be unwanted and may be associated with the poorest outcomes for women and children. The extant published literature suggests associations between previous abortion, drug and/or alcohol use, and stressful life events (e.g. childhood abuse, intimate partner violence) with the risk of repeat unintended pregnancy. However, these earlier studies were limited in a number of ways including the use of repeat elective termination as a proxy for repeat unintended pregnancy, retrospective study designs, and samples that excluded older, reproductively-capable women. This study aims to 1) estimate the incidence and characterize the distribution of repeat unintended pregnancy among women recruited while presenting for pregnancy termination during a two-year follow-up period 2) validate the relationship between repeat unintended pregnancy and sociodemographic variables (e.g. race/ethnicity, socioeconomic status) and 3) identify the association between repeat unintended pregnancy and reproductive history (e.g. intent of previous pregnancies, parity, elective termination history), stressful life events (e.g. child abuse, intimate partner violence, trauma), and select behavior (drug and/or alcohol use). The data are to be derived from two years of semiannual, follow-up data being collected in an ongoing prospective national study (Turnaway Study) of 956 women at risk for a repeat unintended pregnancy. Ordinal logistic regression will be utilized as the outcome is measured with the London Measure of Unplanned Pregnancy. This study will help to identify and prioritize opportunities to manage prevention in this understudied, but clinically important, subgroup of women at high risk for poor maternal and child health outcomes.
This study has the potential to contribute significantly to what is known about the factors associated with an increased risk for repeat unintended pregnancy. Multiple national health and research organizations in the United States, including the Centers for Disease Control and Prevention and the National Institute of Nursing Research, have identified research focusing on establishing effective prevention strategies in healthcare as a current area of need.21 The current high rate of unintended pregnancy coupled with the estimated risk that 17% of all women will experience a repeat unintended pregnancy makes identification of risk factors for repeat unintended pregnancy vitally important.6 The information obtained from this study will contribute to the identification and prioritization of effective interventions to prevent repeat unintended pregnancy for women at risk.