Determinants of Unplanned Pregnancy among Teenagers in Eastern Region
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Unplanned pregnancies are pregnancies that are mistimed, or unwanted at the time of conception (WHO, 2013). Unplanned pregnancies result from rape, incest or various other forms of forced or unwanted sex. The incorrect use of a contraceptive method and failure of the method also contribute to unplanned pregnancies. Available contraception methods include use of pills, intrauterine device, contraceptive implants (implanon/nexplanon), hormonal patch, hormonal ring, cervical caps, diaphragms spermicides (CDC, 2013). According to World Health Organization (WHO), 40% of the pregnancies worldwide are unwanted and unplanned. This rate declined from 57% since 2008 to 40% in 2014(WHO, 2014)Despite the drop in global rates, statistics further indicate that the rate is higher in the developing countries most especially in Africa(48%), South America (19%) and Asia (25%). Unwanted pregnancies are as a result of high poverty rates, among different households, lack of health care centers, lack of contraceptives, and early initiation to sexual debut among others (WHO, 2014). In developing countries for every 1000 women with pregnancies, 48 only are wanted and planned and the rest are unwanted while in developed countries, for every 1000 pregnancies, 189 are planned (Guttmacher, 2014). In sub-Saharan Africa, rate of unwanted pregnancies is high and overwhelming where by 14 million unwanted pregnancies occur every year. The major cause of this high rate is due to lack and improper use of contraceptives (Hubacher & Trussell, 2015). Unplanned pregnancies are common in Uganda (50%), and this has led to high levels of unplanned births, unsafe abortions, and maternal injury and death (UBOS, 2016). A quarter (25%) of teenagers or adolescents age 15-19 in Uganda has begun childbearing;19 percent of women age 15-19 have given birth, and another 5 percent were pregnant with their first child(UBOS &ICF, 2016).According to UNICEF, approximately 35% of girls drop out of school because of unplanned pregnancies. Most pregnancies that end in abortion are unwanted or unplanned, nearly all ill health and mortality resulting from unsafe abortion is preventable. Adolescents and young adults are at risk of unplanned pregnancies and this can be associated to the premarital sex which is common in Uganda. Adolescents aged 15–19,who have ever had sex, half of the boys (50.4%)reported using a condom at last sex episode compared with just 27.5% of the girls (Amin et al., 2013). Moreover, the average age at first sex among women aged 15–19 is about a year and half younger than the average age at first marriage, an age gap that has increased during the last decade. One study of rural Ugandan secondary students found that 43% of girls who had ever had sex had been “very unwilling” to have their first sexual experience (Kiwanuka & Korchmaros, 2012). In another study, 20% of women in rural areas of Uganda reported that they had been threatened or forced into having their first sexual experience (Polis & Wawer, 2009). In such situations, women and girls are less likely to be prepared to negotiate contraceptive use than they are in consensual situations, and therefore are at increased risk for unwanted pregnancy; indeed, the study found that women who had been sexually coerced were more likely than other women to have ever attempted to have an abortion.