The impact of unintended and unplanned pregnancy on maternal health care use: A panel study of Morocco.

详细信息   

• 作者：Chapman ; Steven Edward.
• 学历：Doctor
• 年：2003
• 导师：Mosley, W. Henry
• 毕业院校：The Johns Hopkins University
• 专业：Health Sciences, Public Health.;Sociology, Demography.
• ISBN：9780493876559
• CBH：3068130
• Country：USA
• 语种：English
• FileSize：7610761
• Pages：209

文摘

The incidence and absolute numbers of unintended pregnancies and births are at an historic high. Annually, forty-six million unintended pregnancies are aborted and 25 percent of the world's 133 million births are unintended. Evidence is conflicting whether and when unintended pregnancies that are not aborted are subject to maternal neglect, produce financial strains on households or are rationalized over time as wanted. This is so in part because the definition and measurement of unintended fertility ranks among the most contentious and elusive topics in demographic research.;This study examines whether unintended pregnancies that are not aborted deter women from using maternal health services and, if so, why. In doing so, it aims to overcome issues of bias, spuriousness and conceptual ambiguity that surround research on unintended fertility. The study situates intentions and planning within the behavioral model of health services use and the construct of unmet need for contraception. The study analyzes panel data from Morocco from the early 1990s. The setting is one in which rapid declines in demand for children and increases in contraceptive and maternal health service use were underway, as is broadly the case in many developing countries today.;The study compares prospective and retrospective intention definitions and measures. It finds that, over a three year period, approximately 60% of births are prospectively either unintended or both unintended and unplanned. Unintended pregnancy, prospectively defined, negatively impacts the health seeking behavior of approximately one of three mothers, particularly those seeking to space childbirth more than two years and, for prenatal care only, women resident in urban settings and those of relatively high economic status. The overall negative impact on use prevalence is approximately one percent for prenatal care and three percent for delivery care. The prenatal care impact primarily results from household financial strain. Past behavior controls result in no evidence of maternal neglect. Retrospective intention measures do not correlate with maternal health care use. The public health impact of unintended pregnancy beyond abortion is modest in this setting. Studies with specific measures of wantedness, health service beliefs and need perceptions could result in improved program targeting.