Main Article Content

Sundas Gul
Sadia Bibi
Sabiha Jamil
Nadia Khan Jawad
Syeda Seher Iqbal
Muhammad Wasil Rehman


Family Planning, Maternal Outcomes, Neonatal Outcomes, Reproductive Health, Tertiary Care Hospitals, Unintended Pregnancy


Background: Unintended pregnancies have been linked to adverse maternal and neonatal health outcomes, posing significant challenges to healthcare systems worldwide. This study aims to fill this knowledge gap by investigating the association between unintended pregnancy and various health indicators among expectant women.

Methods: This analytical cross-sectional study recruited postpartum women from three tertiary care hospitals in Rawalpindi and Islamabad, Pakistan, using convenience sampling. Inclusion criteria covered women in the postpartum period within five days, who delivered in specified hospitals, and of any age. Exclusion criteria excluded women with certain medical conditions, multiple pregnancies, or incomplete records. A total of 400 participants were planned for data collection using a structured questionnaire to assess pregnancy intention with the LMUP scale and gather maternal and neonatal outcomes data. Statistical analysis involved SPSS version 26, with descriptive statistics and Chi-square tests for comparison. Ethical approval and consent were obtained for the study.

Results: The study included 400 women with an average gestational age of 27 weeks. Of these, 162 (40.5%) reported unintended pregnancies, while 238 (59.5%) reported intended pregnancies. Only 69 (17%) of women reported actual contraceptive use, with low utilization rates for methods like oral contraceptives and condoms. Pregnancy intention was significantly associated with various maternal and neonatal health outcomes, including fetal distress, postpartum complications, prematurity, and neonatal resuscitation (p<0.05), emphasizing the impact of pregnancy planning on health outcomes.

Conclusion: Unintended pregnancies were associated with a range of adverse outcomes, including lower rates of prenatal care utilization, inadequate nutrition, increased risk of complications, and suboptimal birth outcomes. These findings stress the importance of tailored interventions to mitigate risks associated with unintended pregnancies, ultimately aiming to enhance the overall well-being of mothers and infants.

Abstract 48 | PDF Downloads 29


1. Yazdkhasti M, Pourreza A, Pirak A, Fatemeh AB. Unintended pregnancy and its adverse social and economic consequences on health system: a narrative review article. Iranian journal of public health. 2015 Jan;44(1):12.
2. Bain LE, Zweekhorst MB, de Cock Buning T. Prevalence and determinants of unintended pregnancy in sub–saharan Africa: a systematic review. African Journal of Reproductive Health. 2020 Jul 24;24(2):187-205.``
3. Teshale AB, Tesema GA. Magnitude and associated factors of unintended pregnancy in Ethiopia: a multilevel analysis using 2016 EDHS data. BMC Pregnancy and Childbirth 2020; 20(1): 1–8.
4. Karim RA. Reproductive health, including adolescent reproductive health: progress and challenges in Asia and the Pacific. Asia Pac Popul J 2009; 24(1): 153–196.
5. Bearak J, Popinchalk A, Ganatra B, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health 2020; 8(9): e1152–e1161.
6. Pakistan Demographic and Health Survey (PDHS). (2018). Key Indicators Report. Islamabad, Pakistan: NIPS.
7. Tsui AO, McDonald-Mosley R, Burke AE. Family planning and the burden of unintended pregnancies. Epidemiol Rev. 2010;32(1):152–74.
8. Trussell J. The cost of unintended pregnancy in the United States. Contraception. 2007;75(3):168–70.
9. Omani-Samani, R., Ranjbaran, M., Mohammadi, M., Esmailzadeh, A., Sepidarkish, M., Maroufizadeh, S. and Almasi-Hashiani, A., 2019. Impact of unintended pregnancy on maternal and neonatal outcomes. The Journal of Obstetrics and Gynecology of India, 69, pp.136-141. 10.1007/s13224-018-1125-5
10. Ticona, D.M., Huanco, D. and Ticona-Rendón, M.B., 2023. Impact of unplanned pregnancy on neonatal outcomes: findings of new high-risk newborns in Peru. International Health, p.ihad018.
11. Habib MA, Raynes-Greenow C, Nausheen S, Soofi SB, Sajid M, Bhutta ZA, Black KI. Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan. BMC pregnancy and childbirth. 2017 Dec;17(1):1-0.
12. Barrett G. Conceptualisation, development, and evaluation of a measure ofunplanned pregnancy. J Epidemiol Community Heal. 2004;58(5):426–33.
13. UNFPA. (2020). Global Estimates of Unintended Pregnancy and Unsafe Abortion 2020: Executive Summary. United Nations Population Fund.
14. Bearak, J., Popinchalk, A., Ganatra, B., Moller, A.-B., Tunçalp, Ö., Beavin, C., ... & Gomperts, R. (2018). Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. The Lancet Global Health, 6(11), e1164-e1171.
15. Singh, S., Sedgh, G., & Hussain, R. (2013). Unintended pregnancy: worldwide levels, trends, and outcomes. Studies in Family Planning, 44(3), 301-314.
16. Todd, C. S., Mansoor, G. F., Haider, S., Hashimy, P., Mustafa, G., & Nasir, A. (2010). Prevalence of unintended pregnancy and its impact on maternal and neonatal health in Afghanistan: a facility-based survey. Reproductive Health Matters, 18(35), 152-161.
17. Ali SA, Rabbani U. Unintended Pregnancies among Married Women in Sindh Pakistan: Role of Lady Health Workers. EC Gynaecology. 2017;6(4):120.
18. Goossens, J., Verhaeghe, S., Van Hecke, A., & Barrett, G. (2016). Prevalence and determinants of unintended pregnancy in Belgium and the Netherlands: does abortion legislation matter? BMC Public Health, 16(1), 1-10.
19. Beguy, D., Mumah, J. N., Gottschalk, L. B., Wawire, S., & Muindi, K. (2018). Status and determinants of adolescent pregnancy in Kenya: evidence from DHS data. BMC Pregnancy and Childbirth, 18(1), 1-12.
20. Jalali, R., Mohammadi, M., Vaisi-Raygani, A. et al. Prevalence of unwanted pregnancy in Iranian women: a systematic review and meta-analysis. Reprod Health 16, 133 (2019).
21. Wellings, K., Jones, K. G., Mercer, C. H., Tanton, C., Clifton, S., Datta, J., ... & Sonnenberg, P. (2013). The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). The Lancet, 382(9907), 1807-1816.
22. Crossby, R. A., Leichliter, J. S., & Brackbill, R. (2003). Longitudinal prediction of sexually transmitted diseases among adolescents: Results from a national survey. American Journal of Preventive Medicine, 25(2), 155-162.
23. Santelli, J. S., Morrow, B., Anderson, J. E., & Lindberg, L. D. (2003). Contraceptive use and pregnancy risk among US high school students, 1991-2003. Perspectives on Sexual and Reproductive Health, 35(3), 106-111.
24. Coleman, P. K., Reardon, D. C., & Cougle, J. (2005). Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy. British Journal of Health Psychology, 10(2), 255-268.
25. Hellerstedt, W. L., Pirie, P. L., Lando, H. A., Curry, S. J., McBride, C. M., Grothaus, L. C., & Nelson, J. C. (1998). Differences in preconceptional and prenatal behaviors in women with intended and unintended pregnancies. American Journal of Public Health, 88(4), 663-666.
26. Pryor J, Patrick SW, Sundermann AC, Wu P, Hartmann KE. Pregnancy Intention and Maternal Alcohol Consumption. Obstet Gynecol. 2017 Apr;129(4):727-733. doi: 10.1097/AOG.0000000000001933.
27. Ranjbaran M, Jafary-Manesh H, Sajjadi-Hazaneh L, Eisaabadi S, Talkhabi S, Sadat Khoshniyat A. Prevalence of low birth weight and some associated factors in Markazi province, 2013-2014. World J Med Sci. 2015;12(3):252-8. DOI: 10.5829/idosi.wjms.2015.12.3.93203
28. Gebremariam Weldearegawi G, Tekola KB, Fseha Teklehaymanot B. Magnitude and Associated Factors of Unintended Pregnancy among Pregnant Women at Saesie Tsaeda Emba Woreda Eastern Zone of Tigray, North Ethiopia, 2018. J Pregnancy. 2019 Dec 24;2019:1694808. doi: 10.1155/2019/1694808
29. Ahmed, F. A., Moussa, K. M., Petterson, K. O., & Asamoah, B. O. (2012). Assessing knowledge, attitude, and practice of emergency contraception: a cross- sectional study among Ethiopian undergraduate female students. BMC public health, 12, 110.
30. Adu-Bonsaffoh K, Seffah JD. LINKING UNINTENDED PREGNANCY TO THE BURDEN OF PRE-ECLAMPSIA IN A TERTIARY HOSPITAL IN GHANA. J West Afr Coll Surg. 2015 Oct-Dec;5(4):17-29. PMID: 27738618; PMCID: PMC5020890.
31. Shah PS, Balkhair T, Ohlsson A, Beyene J, Scott F, Frick C. Intention to become pregnant and low birth weight and preterm birth: a systematic review. Matern Child Health J. 2011 Feb;15(2):205-16. doi: 10.1007/s10995-009-0546-2.
32. Singh A, Singh A, Mahapatra B. The consequences of unintended pregnancy for maternal and child health in rural India: evidence from prospective data. Matern Child Health J. 2013 Apr;17(3):493-500. doi: 10.1007/s10995-012-1023-x.
33. Mohamed EA, Hamed AF, Yousef F, Ahmed EA. Prevalence, determinants, and outcomes of unintended pregnancy in Sohag district, Egypt. Journal of the Egyptian Public Health Association. 2019 Dec;94(1):1-9.
34. WHO. (2017). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-Friendly Hospital Initiative 2018. World Health Organization.
35. Patel A, Bucher S, Pusdekar Y, Esamai F, Krebs NF, Goudar SS, Chomba E, Garces A, Pasha O, Saleem S, Kodkany BS. Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: a prospective cohort study. Reproductive Health. 2015 Dec;12(2):1-1.
36. Shah PS, Balkhair T, Ohlsson A, Beyene J, Scott F, Frick C. Intention to become pregnant and low birth weight and preterm birth: a systematic review. Maternal and child health journal. 2011 Feb;15:205-16. DOI 10.1007/s10995-009-0546-2
37. Vakilian K, Ranjbaran M, Khorsandi M, Sharafkhani N, Khodadost M. Prevalence of preterm labor in Iran: A systematic review and meta-analysis. Int J Reprod Biomed. 2015 Dec;13(12):743-8. PMID: 27141533; PMCID: PMC4827509.
38. Sharifi N, Khazaeian S, Pakzad R, Fathnezhad Kazemi A, Chehreh H. Investigating the Prevalence of Preterm Birth in Iranian Population: A Systematic Review and Meta-Analysis. J Caring Sci. 2017 Dec 1;6(4):371-380. doi: 10.15171/jcs.2017.035. PMID: 29302576; PMCID: PMC5747595..