Thinking of the children: Unintended Pregnancy and Inadequate Antenatal Care (ANC) in the Philippines Open Access

Karch, Lydia Burnett (2012)

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Objective: This research examines the association between self-reported
unintended pregnancy in women in the Philippines between the ages of 15 to
49 who reported being pregnant in the 5 years prior to the DHS survey
implementation, and late or inadequate antenatal care (ANC) for that same
pregnancy. The researcher hypothesizes a positive association between
reporting an unintended pregnancy (both mistimed and unwanted) and
receiving late or inadequate ANC.
Method: Using 2008 Demographic Health Survey (DHS) data from the Philippines,
the researcher evaluated the prevalence of and risk factors for unintended
pregnancy among women ages 15-49 who reported a live birth in the 5 years
prior to the survey. The researcher also evaluated the association between
unintended pregnancy and ANC in this population.
Results: This assessment reveals a high frequency of unintended, unwanted, and
mistimed pregnancies among women ages 15-49 in the Philippines. More than
a third of all women reported having an unintended pregnancy, while 1 in 5
reported having a mistimed pregnancy, and 16% reported having an unwanted
pregnancy. This study also reveals significant associations between unintended
pregnancy and late or inadequate ANC; the associations persisted even after
accounting for identified differences in risk characteristics and behaviors,
including wealth, education, religion, age, parity, and modern method
contraceptive use.
Conclusion: Unintended pregnancy was found to be significantly associated with
late or inadequate antenatal care (ANC) in the Philippines. Mistimed
pregnancies were found to have a higher odds of late or inadequate ANC than
unwanted pregnancies, which suggests that more research should be done to
examine the perceived and reported differences between these two categories,
particularly over time. The associations presented in this study are a small
piece of evidence that might be used to advocate for greater access to highly
effective contraceptives, in order to protect the health of future generations.
Where women's rights arguments have failed to expand contraceptive access,
an argument in favor of better care for future babies might have more of an
impact. More research is necessary, however, to ful y explore this association
and determine any causality before it can be brought into the public arena.

Table of Contents

Table of Contents Chapter 1. Introduction - 1 Problem Statement - 1 Purpose Statement - 2 Research Question - 3 Significance Statement - 3 Definition of Terms - 5

Chapter 2: A Global Review of Unintended Pregnancy: Frequency, Risk Factors, and Consequences - 7

Multi-country studies - 7 The United States - 9 Latin America - 11 Africa - 13 Asia - 15 The Philippines - 17

Co-occurrence of unintended pregnancy and late or inadequate ANC - 20

Summary of the Current Problem and Study Relevance - 23

Chapter 3. Methodology - 24 Study Setting - 24 Population and Sample - 26 Research Design - 26

Procedures and Instruments - 27

Variable Definitions - 28 Data Analysis - 30

Limitations and Delimitations - 31

Chapter 4. Results - 32 Introduction - 32 Findings - 32 Summary - 35 Chapter 5. Discussion - 36

Frequency of Unintended Pregnancy - 36

Risk factors of Unintended Pregnancy - 37

Unintended Pregnancy as a risk factor for Late or Inadequate ANC - 38

Unintended Pregnancy Measurement Flaws - 39

Future Research Directions - 40

Policy Recommendations - 40 Conclusion - 42 References - 43 Tables and Figures - 52

Table 1. Demographic Characteristics of the Study Population - 52

Table 2. Prevalence of Unintended Pregnancy and Adequate Antenatal Care (ANC) in the Philippines - 55

Table 3. Demographic Predictors and Unintended Pregnancy - 56

Table 4. Behavioral Predictors and Unintended Pregnancy - 58

Table 5. Frequency of Late or Inadequate ANC among Unintended, Mistimed, and Unwanted Pregnancies - 59

Table 6. Crude and Adjusted Associations between Unintended Pregnancy and Late or Inadequate ANC - 60

Figure 1: Conceptual model of risk for an unintended pregnancy and late or inadequate antenatal care (ANC) - 61

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