Unintended pregnancy, defined as mistimed (occurring earlier than desired) or unwanted (occurring when no more children are desired) is estimated to account for 80 million of the 210 million pregnancies that occur worldwide each year . Whilst there is no accurate data on the intendedness of births in Australia, a recent cross-sectional survey of a nationally representative sample of Australian women of reproductive age found 51% had experienced an unintended pregnancy in their lifetime . Weisberg’s study of 811 Australian women (as a part of the Australian Longitudinal Study of Women’s Health) found that 32% of first pregnancies were unplanned and 29% were unwanted .
In 2008, there was a call to action by key sexual and reproductive health organizations in Australia, which highlighted a significantly higher teenage birth abortion rates compared to other developed countries. Also identified were unacceptably high levels of reproductive ill health defined by inconsistent access to, and use of, a full range of available contraceptive methods .
Access to, and utilization of, pregnancy planning services including proper use of safe and effective contraception, plays an important role in combating the problem of unintended pregnancy. Key players in the prevention of unintended pregnancies are doctors, particularly General Practitioners, who see 85% of the population yearly . A recent meta-analysis evaluating 26 randomized controlled pregnancy prevention programs (school based, family planning, community based programs) showed that none had a significant impact in improving the use of contraception or in reducing the number of pregnancies among adolescents . However there is evidence that brief counselling interventions by doctors are effective in modifying health behaviours, especially in adolescents .
Whilst it seems intuitive to then encourage all doctors to ask every woman about their contraceptive and sexual behaviours, in reality this is not feasible for time-limited doctors with multiple demands on their attention. There is a need for population and setting specific information that better identifies women at greater vulnerability of unintended pregnancy that can be used by local health professionals to benefit the sexual health of women.