Trends in prevalence and determinants of unintended pregnancy among Bangladeshi women from 2007 to 2018: A comparative analysis of multiple Demographic Health Surveys

Abstract

Background: Unintended pregnancy is a global challenge, particularly prevalent in developing 20 regions, with significant negative impacts on women's health and well-being. Bangladesh has 21 made progress in fertility decline but still faces challenges due to high rates of unintended 22 pregnancies, unsafe abortions, and limited contraceptive use. 23 Methods: The analysis utilized secondary data from the Bangladesh Demographic and Health 24 Surveys (BDHS) conducted in 2007, 2011, 2014, and 2017-18. The surveys employed a nationally 25 representative sampling frame using a two-stage sampling technique, covering residential 26 households across Bangladesh. The study included 28042 ever-married women aged 15-49 from 27 the four surveys. Descriptive statistics and chi-squared tests examined the relationships between 28 the explanatory and dependent variables. Binary logistic regression was performed to determine 29 the adjusted effects of the selected factors, presenting the results as odds ratios (OR) with 95% 30 confidence intervals (CI). Stata 15 software was used for data analysis, with (p < 0.05) considered 31 statistically significant. 32 Results: The percentage of unintended pregnancies decreased from 29% in 2007 to 21% in 2017- 33 18. Mothers aged 20-29 years had lower likelihood of unintended pregnancy (OR: 0.73-0.81), 34 compared to aged 30 years and above (OR: 1.40). Mothers with secondary education were more 35 likely to have unintended pregnancy in 2007 (OR: 1.28), but less likely in 2011 (OR: 0.75). 36 Employed mothers had higher likelihood of unintended pregnancy (OR: 1.19-1.31), while Muslim 37 mothers had higher likelihood in 2011 and 2014 (OR: 1.33-1.53), but lower likelihood in 2017-18 38 (OR: 0.73). Unmet need for contraception was consistently associated with higher odds of 39 unintended pregnancy (OR: 2.12-3.94). Conclusion: Unintended pregnancies in Bangladesh have decreased over the past decade, but still 41 pose challenges for women's reproductive health. Targeted efforts are needed to address factors 42 such as poverty, education, contraception access, and cultural norms to further reduce unintended 43 pregnancies and improve maternal and child well-being.