Pregnancy intentions and outcomes among young married women in Nepal

• Published in: AJOG global reports 2024-11, Vol.4 (4), p.100403, Article 100403
• Main Authors: Lansdale, Aimee J., Puri, Mahesh C., Diamond-Smith, Nadia
• Format: Article
• Language: English
• Subjects: barriers; contraception; Nepal; Original Research; pregnancy; pregnancy intention; pregnancy outcome; reproductive health; unintended
• ISSN: 2666-5778; 2666-5778
• DOI: 10.1016/j.xagr.2024.100403

•To better understand how women's pregnancy intentions relate to their pregnancies at a future standpoint in Nepal.•After adjusting for covariates, women intending to become pregnant right away had significantly higher odds of becoming pregnant. Over 70% of women who were not intending immediate pregnancy became pregnant.•Using longitudinal data, this study adds missing evidence on measuring changing intentions to the current literature which is limited by studies using cross-sectional data or longitudinal data with only two time points. Approximately 44% of Nepalese women ages 15–49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually. This study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies. Data were collected longitudinally from 200 recently married women ages 18–25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, “When would you like to have a child in case you were to have one?” Participants were recategorized into a dichotomous variable for analytical purposes: “Right away” or “Not right away.” A total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51–6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals. Young, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.