Determinants and consequences of unintended pregnancy amongst young couples in Nepal

Abstract

This thesis describes, a population based study conducted in 2003 to explore the definitions of terminologies related to pregnancy intentions, to identify the determinants of unintended pregnancy, and to examine the decision making processes associated with abortion and the consequences of unintended pregnancy in five districts of Nepal.  The study used both qualitative and quantitative research methods.

The study revealed that the terminologies related to pregnancy intention used in previous research were generally not understood easily by the respondents.  The definition used for measuring unintended pregnancy in the DHS surveys is inadequate.  The prevalence of unintended pregnancy in the Nepal DHS was under estimated mainly due to the use of inadequate definition.  One in two young women in Nepal ever experienced unintended pregnancy before the age of 24 years, which is quite high.  Those women and men who have younger age, higher number of children, smaller desired family size, less methods known, higher level of education, living in the western region, high exposure to mass media, and poor household wellbeing were more likely to experience unintended pregnancy.  Despite high prevalence of unintended pregnancy, abortion is low.  However, the procedure used for abortion was generally unsafe in the first instance.  Multiple factors affect the decision making stage.  Various socioeconomic factors, cultural and religious beliefs and health concerns were the major reasons for not terminating an unintended pregnancy.  The study revealed that unintended pregnancies have multiple impacts on women’s health and their social and family life.

The findings suggest that pregnancy intendedness should not only be measured by the timing of childbearing as used by the most DHS studies;  instead, it should include some additional personal, inter-personal, and context specific questions.  The results highlighted the need for a comprehensive response to improve the reproductive and sexual health of young couples in Nepal.

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