Prevalence of unwanted pregnancy in Iranian women: a systematic review and meta-analysis

The effect of cognitive-behavioral counseling on maternal-fetal attachment among pregnant women with unwanted pregnancy in Iran: A randomized clinical Trial

Background

Unwanted pregnancy is an important public health concern that can have significant health, social, and economic effects on the mother, the baby and her family. The establishment and enhancement of maternal-fetal attachment (MFA) play a role in the promotion of emotional communication between the mother and the child in the future. This study aimed at investigating the effect of cognitive-behavioral counseling on maternal-fetal attachment among pregnant women with unwanted pregnancy.

Methods

In this randomized clinical trial, 60 eligible pregnant women with unwanted pregnancy and gestational age of 22-28 weeks who had referred to health centers in Mashhad, a city in the northeast of Iran, were selected and they were through random block assignment divided into two groups of counseling with the cognitive-behavioral approach (n = 30) and the control group (n = 30). In addition to the routine pregnancy care, the cognitive-behavioral counseling group received four group counseling sessions on a weekly basis, while the control group only received the routine pregnancy care from healthcare providers. Maternal-fetal attachment before and after intervention in the two groups was assessed through Cranley's Maternal-Fetal Attachment Scale. Comparison of mean scores within and between the two groups was performed using SPSS 21 through independent and paired t-tests.

Results

At the end of the study and after the intervention, the mean scores of maternal-fetal attachment in the intervention and control groups were 94.06 ± 11.73 and 80.16 ± 10.09, respectively, and the difference between the groups was significant. Although the difference between the mean scores of each group at the beginning and the end of the study was significant, this difference between the two groups was also noticeable (21.56 ± 12.16 vs 7.40 ± 12.39) and statistically significant.

Conclusions

Cognitive-behavioral counseling can be effective in enhancing the maternal-fetal attachment in unwanted pregnancies; therefore, it is recommended to be integrated into pregnant women's healthcare programs.

Prevalence and predictor factor of lifetime abortion in female sex workers in Iran: results of the national rapid assessment and response in 2017

Female sex workers are at a high risk of abortion. This cross-sectional study included 855 female sex workers to determine the prevalence of lifetime abortion and its related factors. Logistic regression models were used to identify the factors related to lifetime abortion. The prevalence of lifetime abortion was reported at 40.8%. The chance of having a lifetime abortion was 7.8times higher in women aged >35years and 2.4times higher in financially dependent women. The high prevalence of lifetime abortion indicates that these women's health and fertility needs are not met.

Sexual and reproductive health-related questions and concerns of newly married couples: A qualitative content analysis

Background and Aims

Approximately half of Iranian marring couples have poor sexual knowledge and attitudes. This article delves into the main concerns and queries regarding sexual and reproductive health among Iranian newly married couples.

Methods

We conducted a content analysis of the sexual and reproductive health questions and concerns that were anonymously submitted by newly married couples to the researcher via social media in 2021-2022.

Results

A total of 141 questions and concerns that were related to sexual and reproductive health were considered for content analysis. Findings illustrated two main categories: (1) the need to create a reproductive life plan, and (2) the need for sexual knowledge and counseling. The first category consisted of three subcategories: "Poor contraceptive knowledge," "Need for support in case of a missed period or unplanned pregnancy," and "Need for preconception care." The second category included three subcategories: "Concern regarding virginity," "Sexual problems on the honeymoon," and "Sexual problems in newlyweds."

Conclusion

Iranian newly married couples need long-term specialized services addressing their reproductive life planning and sexual knowledge needs. Integrating reproductive life planning and comprehensive sex education into the primary care services for newly married couples can help to reduce delayed childbearing, unintended pregnancy, unsafe and illegal abortion, and subsequent infertility.

Access to Family Planning Services Following Natural Disasters and Pandemics: A Review of the English Literature

Background: When natural disasters strike, there is a sudden decrease in access to care due to infrastructure loss and displacement. A pandemic has the similar ability to acutely limit access to care. The relationship between decreased access to care and natural disasters has been previously explored.

Objective: The purpose of this article is to present a focused review of the available and emerging literature regarding the overall impact of natural disasters and pandemics on unintended pregnancy and decreased care in this setting.

Methods: A literature search was conducted on PubMed, Cochrane, Google Scholar, and Embase databases. The search was restricted to studies that were population-based, prospective or retrospective. Only peer-reviewed articles were considered. The search was further restricted to manuscripts in English or officially translated manuscripts. All qualifying papers from which data were extracted were subjected to a quality assessment conducted by two independent investigators (SK and AA). Each investigator reviewed all nine papers relevant to data collection using the Effective Public Health Practice Project (EPHP). MeSH terms were utilized across various databases. Studies were selected that were population-based, prospective or retrospective. Case reports and case series were not used. The primary outcomes were the rates of unintended pregnancy. Secondary outcomes included the use of contraception, short interval pregnancy, and access to reproductive services.

Results: An initial search yielded 74 papers, of which nine papers were reviewed for qualitative data, examining the subjects affected by natural disasters or pandemics. An additional two papers regarding theoretical data and COVID-19 were analyzed. Although there seems to be a rise in unintended pregnancy and more difficulty accessing care following natural disasters and pandemics, there are variations in the rates based on region and event.

Conclusions: The full effects of the COVID-19 pandemic on the rates of unplanned pregnancies will become apparent in the months and years to come. As obstetrician-gynecologists, we must communicate openly with our patients regarding the use of available contraception, sexual education, and family planning services at times of natural disasters and pandemics.

Factors related to pregnancy status and unwanted pregnancy among lebanese women during the COVID-19 lockdown: a cross-sectional study

Background

Home confinement and lockdowns have created challenges and vulnerabilities, causing relevant changes in sexual health and couple stability, particularly in women. The objective of this study was to evaluate the socio-economic and psychological factors related to current pregnancy status and unwanted pregnancy among Lebanese women during the COVID-19 lockdown.

Methods

A cross-sectional online study conducted between June 8 and August 1, 2020, enrolled 369 Lebanese women using the snowball technique for data collection. All married women between 18 and 51, with access to the internet and currently living with their partners, were eligible to participate. Current pregnancy status and unwanted pregnancy were assessed using binary questions. The SPSS software 25 was used for data analysis, and multivariable analysis was performed, taking the pregnancy status and unwanted pregnancy as the dependent variables. The statistical significance was set at a p-value < 0.05.

Results

Our results showed that 11.1% of women were pregnant, of whom 22.0% reported unwanted pregnancies. Having children (ORa = 0.183) and taking contraceptives (ORa = 0.231) were significantly associated with a reduced chance of becoming pregnant. Higher psychological violence would negatively affect pregnancy, but the association was not significant (p = 0.065). Regular visits to the physician for routine checks were also linked to a decreased risk of unwanted pregnancy (ORa = 0.053). Higher psychological violence would affect unwanted pregnancy; however, the association was insignificant (p = 0.056).

Conclusion

The study findings showed that having children and taking contraceptives are associated with a reduced pregnancy. Additionally, psychological violence was found to be related to current pregnancy status and unplanned pregnancy. During a pandemic, vulnerable women should be identified and given adequate care, knowledge, and awareness regarding their reproductive health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00833-2.

Investigating Reproductive Life Plan in Pregnant Women Referred to Teaching Hospitals of Mashhad, Iran

Background:

Reproductive Life Planning (RLP) is a person-centered approach that investigates the reproductive needs, values, and priorities of each person and not only reduces the risk of unwanted pregnancies but also improves pregnancy outcomes and childbirth by investigating the health behaviors and underlying diseases of each individual. Therefore, the present study was conducted to assess RLP in pregnant women.

Materials and Methods:

This descriptive cross-sectional study was carried out on 1019 pregnant women who were referred to outpatient clinics of teaching hospitals in Mashhad, Iran, during May–August 2019. The participants were selected using a convenience sampling method. The data collection tool used was a questionnaire. Data analysis was performed in SPSS software.

Results:

The results of this study showed that about two-thirds of the participants had a plan for their reproductive years. The age range of the participants was 13–47 years. Among the women, 38.60% had experienced failure of contraceptive method, and 32.20% had an unmet need for family planning. Moreover, only one-third of the women had been referred for preconception care, but 88.70% of the pregnant women had their initial prenatal care visit in their first trimester.

Conclusions:

Given the considerable number of unwanted pregnancies and unmet needs for family planning in the present study, the modification of family planning policies seems necessary. Various strategies have been proposed to prevent unintended pregnancies such as RLP. The long-term goals of RLP are to plan pregnancies and improve maternal and infant outcomes.