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Complete Health Indicator Report of Births from Unintended Pregnancies

Definition

Percentage of Utah women with live births who reported their most recent pregnancy was unintended.

Numerator

Number of unintended births among Utah women.

Denominator

Number of Utah women with a live birth.

Data Interpretation Issues

A stratified random sampling approach is used in selecting women 2-4 months postpartum to participate in PRAMS. The data are weighted by the CDC to represent the birth population for that year, adjusted for sampling probabilities, nonresponse, and noncoverage. Each strata must achieve a weighted response rate of 60% or it is not considered representative of that population. See the PRAMS website at [http://www.cdc.gov/prams/methodology.htm] for more detailed information on PRAMS and its methodology.

Why Is This Important?

In the United States, unintended pregnancy is a major public health problem. Unintended pregnancy is a general term that includes pregnancies that a woman reports were either mistimed or unwanted at the time of conception. Women with unintended pregnancies are less likely to seek early prenatal care or receive adequate prenatal care, they are more likely to smoke or drink during pregnancy, and are less likely to initiate or maintain breastfeeding.

Other Objectives

Utah's 42 Community Health Indicators Similar to HP2020 Objective FP-1: Increase the proportion of PREGNANCIES that ARE intended. Similar to HP2020 Developmental Objective MICH-16.6 (Developmental) Increase the proportion of women delivering a live birth who used contraception to plan pregnancy.

How Are We Doing?

During the years 2014 and 2015, 21.9% of women reported that their birth resulted from an unintended pregnancy. Of the women who reported their pregnancies as unintended, 63.5% said they were using some method to avoid pregnancy at the time of conception. Contraceptive failure rates vary between methods used but are very low when used correctly. This high rate of contraceptive failure signals the need to increase education, services, and coverage of methods of long-acting reversible contraception that may be less prone to human error.

How Do We Compare With the U.S.?

Current national PRAMS data are not available.

What Is Being Done?

In order to reduce unplanned pregnancies, public health efforts may include: __Health Education__ - increase knowledge of human reproduction, conception, and proper use of available contraceptive methods; and promote optimal spacing of pregnancies for healthy outcomes. __Reproductive Health Services__ - increase dialogue between health care providers and women regarding reproductive health and family planning options. __Access to Health Care__ - improve insurance coverage for family planning services. As of August 1, 2012, non-grandfathered plans and issuers are required to provide coverage for preventive women's health care including contraception and counseling without cost sharing.

Evidence-based Practices

Various studies have indicated that the use of long-acting reversible contraceptive (LARC) devices such as Implants and Intrauterine Devices (IUD) effectively lower the incidence of unplanned pregnancy in population and clinic settings. Additionally a 2012 study conducted by Piepert et al. looked at the impact of providing free LARC and found that increased access to contraception effectively reduced unintended pregnancy.

Available Services

[http://www.poweryourlife.org]


Related Indicators

Relevant Population Characteristics

Women less than 20 years of age, those with less than a high school education, race other than White, Hispanic ethnicity, being unmarried, annual income less than $15,000, no health insurance or Medicaid before pregnancy, smoked or drank in three months before pregnancy, and those who had a baby within 20 months of the current pregnancy are more likely to report an unintended pregnancy.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Having health insurance improves the accessibility to family planning services.

Related Health Care System Factors Indicators:


Risk Factors

Having an unintended pregnancy can contribute to short inter-pregnancy spacing (span between the birth of one child and the conception of another), which increases the risk of infant morbidity and mortality. In addition, unintended pregnancy can contribute to an increase in the rate of abortions as well as late entry into prenatal care. Women with inadequate care due to late entry are more likely to deliver a low birth weight baby.

Related Risk Factors Indicators:




Graphical Data Views

Births From Unintended Pregnancies by Local Health District, Utah, 2013-2015

::chart - missing::
confidence limits

Local Health DistrictPercentage of Women With Live BirthsLower LimitUpper LimitNote
Record Count: 14
Bear River23.9%18.0%29.9%
Central21.8%12.6%31.0%
Davis County20.6%16.1%25.1%
Salt Lake County22.8%20.3%25.4%
San Juan43.8%14.9%72.8%*
Southeast13.9%2.3%25.5%*
Southwest24.0%17.6%20.4%
Summit25.4%8.6%42.2%*
Tooele31.2%19.9%42.4%
TriCounty26.4%15.5%37.3%
Utah County17.3%14.3%20.3%
Wasatch**
Weber-Morgan31.5%25.3%37.7%
State of Utah22.2%20.7%23.7%

Data Notes

Question: "Thinking back to just before you got pregnant, how did you feel about becoming pregnant?" (check one answer). Answer Options: I wanted to be pregnant sooner, I wanted to be pregnant later, I wanted to be pregnant then, I didn't want to be pregnant then or at any time in the future, or I wasn't sure what I wanted. Women who wanted to be pregnant later or didn't want to be pregnant were categorized as having an unintended pregnancy.   [[br]] [[br]]*Use caution when interpreting San Juan, Southeast, and Summit as the estimates have a relative standard error greater than 30% and do not meet UDOH standards for reliability. ** Wasatch has been suppressed as the estimate has a relative standard error greater than 50% and do not meet UDOH standards for reliability. Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries.

Data Source

Utah Pregnancy Risk Assessment Monitoring System (PRAMS), Utah Department of Health


Women Who Reported Their Most Recent Pregnancy Was Unintended by Age Group, Utah, 2014-2015

::chart - missing::
confidence limits

Age GroupPercentage of Women With Live BirthsLower LimitUpper LimitNote
Record Count: 7
17 or Under63.5%49.1%77.9%
18-1941.4%31.4%31.4%
20-2428.2%24.0%32.4%
25-2919.6%16.5%22.7%
30-3417.5%14.1%20.8%
35-3919.9%14.5%25.4%
40+14.8%3.6%26.1%*

Data Notes

Question: "Thinking back to just before you got pregnant, how did you feel about becoming pregnant?" (check one answer). Answer Options: I wanted to be pregnant sooner, I wanted to be pregnant later, I wanted to be pregnant then, I didn't want to be pregnant then or at any time in the future, or I wasn't sure what I wanted. Women who wanted to be pregnant later or didn't want to be pregnant were categorized as having an unintended pregnancy.   [[br]] [[br]] * Use caution when interpreting the estimate for the 40+ age category. The estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. [[br]]

Data Source

Utah Pregnancy Risk Assessment Monitoring System (PRAMS), Utah Department of Health


Women Who Reported Their Most Recent Pregnancy Was Unintended by Year, Utah, 1999-2015

::chart - missing::
confidence limits

MethodologyYearPercentage of Women With Live BirthsLower LimitUpper Limit
Record Count: 15
Old Methodology200134.5%31.9%37.1%
Old Methodology200232.5%29.4%35.5%
Old Methodology200333.5%31.9%35.2%
Old Methodology200431.4%29.1%33.7%
Old Methodology200533.9%32.4%35.4%
Old Methodology200634.2%31.8%36.6%
Old Methodology200730.9%28.6%33.2%
Old Methodology200833.0%30.7%35.3%
Old Methodology200933.6%31.1%36.1%
Old Methodology201032.4%29.8%35.0%
Old Methodology201131.8%29.0%34.5%
New Methodology201224.7%22.3%27.4%
New Methodology201322.8%20.3%25.7%
New Methodology201422.5%19.9%25.1%
New Methodology201521.3%18.7%23.9%

Data Notes

Question: "Thinking back to just before you got pregnant, how did you feel about becoming pregnant?" (check one answer). Answer Options: I wanted to be pregnant sooner, I wanted to be pregnant later, I wanted to be pregnant then, I didn't want to be pregnant then or at any time in the future, or I wasn't sure what I wanted. Women who wanted to be pregnant later or didn't want to be pregnant were categorized as having an unintended pregnancy.   [[br]] [[br]]Beginning in 2012, the PRAMS survey added the response "I wasn't sure what I wanted". The addition of this response may have diluted the percentage of responses in the other categories, so 2012-2015 data not comparable to previous years.

Data Source

Utah Pregnancy Risk Assessment Monitoring System (PRAMS), Utah Department of Health


Women Who Reported Their Most Recent Pregnancy Was Unintended by Race and Ethnicity, Utah, 2014-2015

::chart - missing::
confidence limits

EthnicityPercentage of Women With Live BirthsLower LimitUpper Limit
Record Count: 4
Hispanic or Latino34.7%29.9%39.6%
White, Non-Hispanic19.6%17.5%21.7%
Other, Non-Hispanic20.9%13.8%28.0%
All Utahns21.9%20.1%23.7%

Data Notes

Question: "Thinking back to just before you got pregnant, how did you feel about becoming pregnant?" (check one answer). Answer Options: I wanted to be pregnant sooner, I wanted to be pregnant later, I wanted to be pregnant then, I didn't want to be pregnant then or at any time in the future, or I wasn't sure what I wanted. Women who wanted to be pregnant later or didn't want to be pregnant were categorized as having an unintended pregnancy.

Data Source

Utah Pregnancy Risk Assessment Monitoring System (PRAMS), Utah Department of Health

References and Community Resources

[http://www.cdc.gov/reproductivehealth/unintendedpregnancy] Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being: [https://www.hrsa.gov/womens-guidelines/index.html] Preventing Unintended Pregnancies By Providing No-Cost Contraception (Piepert, 2012): [http://journals.lww.com/greenjournal/Fulltext/2012/12000/Preventing_Unintended_Pregnancies_by_Providing.7.aspx] Increasing Use of Contraceptive Implants and Intrauterine Devices To Reduce Unintended Pregnancy (ACOG, 2009)

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 02/01/2018, Published on 02/07/2018
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 18 October 2018 1:46:22 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Wed, 7 Feb 2018 13:20:19 MST