Academic journal article Iranian Journal of Public Health

Unintended Pregnancies, Their Outcome and Prior Usage of Contraception in Georgia

Academic journal article Iranian Journal of Public Health

Unintended Pregnancies, Their Outcome and Prior Usage of Contraception in Georgia

Article excerpt

Introduction

UPr with high rates of the abortions remains an important problem around the world. In 2008 out of 210.9 million pregnancies, worldwide 42% were unintended (1). Between 1995 and 2008 the rate of UPrs fell by 20%, to 55 from 69(2). This rate was higher in developed countries with reduction by 29%, to 42 from 59(2), compared to developing countries with reduction by less than 20% - to 57 from 71 per 1000 women(2). High rates of UPrs were in Africa and low rates in Western Europe and Asia. North America was the only region in which overall and UPr rates have not declined (2). The rate of UPrs is determined by specific cultural, traditional, socioeconomic, and health system factors of each country (3, 4). Due to insufficient care for pregnancy UPr may affect sexual, reproductive and general health status of woman, result in serious mental and physical problems for her as well as her family (5).

The problem of UPr is important in Georgia as well. According to the Reproductive Health Survey 2010 in Georgia (6), the rate of UPrs fell by 36% that compared to data from surveys from 1999 and 2005 is by 59% and 51% lower, respectively (7, 8). In dynamics total induced abortions rate (TIAR) have fallen as well. In 1997-1999 it was 3.7 abortion per woman (125 abortions per 1000 women), being one of the highest rates worldwide. The rate of IAbs gradually fell to 3.1 abortions per woman (104 abortions per 1000 women) in 2002-2005, and between 2005 and 2010, the abortion rate dropped significantly to 1.6 abortions per woman (56 abortions per 1000 woman). Given trends can be explained with healthcare system reorganization and with programs conducted by international organizations (United Nations Population Fund (UNFPA), United States Agency for International Development (USAID), United Nations Children's Fund (UNICEF)) since 2000, leading to improvement of sexual/reproductive health indicators in Georgia (9, 10), although, these indicators are still unfavorable. As a part of the Soviet Union for a long period, Georgia was limited in opportunities to have contacts with Western medicine. In Georgia, in the early 90s, like in other post-Soviet countries, IAb was the main method of birth control (11). IAb was not stigmatized. According to Georgian legislation IAb was, and is at present, legal and is performed based on woman's will and request until 12 wk of pregnancy (12).

Since 90s of 20th century, the contraception use rate in Georgia was very low and like in other Asian countries, women mainly used traditional methods (withdrawal and rhythm/calendar methods).The contraception prevalence rate for married women increased from 41% in 1999 to 45% in 2005 and 53% in 2010, mainly due to use of modern contraception (6-8). These rates are still insufficient, as the rates of UPrs are still high. Subsequent analysis of 1999 and 2005 Reproductive Health Surveys results showed that non-use of contraception was the major determinant of threat of Abs, and use of modern contraception significantly reduced the number of Uprs (13). The increasing use of modern contraception, especially among young women, significantly reduced the number of UPrs and IAbs.

In order to identify high-risk women and provide implementation of appropriate preventive measures, it is essential for providers of health care system and physicians to know the risk factors associated with UPrs and IAbs.

Objective of our study was to determine the prevalence of UPrs in Georgia, their outcomes, use of modern and traditional methods of contraception in women who terminated their UPr by IAb and identify such predictor variables as area of residence, age, level of education, economic status of woman, ethnicity and religion.

Materials and Methods

Secondary analysis of database of 2010 Reproductive Health Survey was performed. This cross-sectional study, using stratified multistage sampling method was conducted from Oct 2010 through Feb 2011, with approval of Ethics Committee of National Center for Disease Control of Georgia. …

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