New research reveals the reasons behind UK’s high rates of unintended pregnancy
Marie Stopes International calls for better contraceptive awareness amongst British women and better advice and choice from health professionals.
London: A new research report into the contraceptive habits of women attending Marie Stopes International centres in the UK for abortion services reveals that many were largely unaware of the full range of contraceptive options. Others have misunderstood how to use their chosen contraceptive method correctly, resulting in unintended pregnancy, whilst over one fifth of those taking part in the study (22%) reported not using a method regularly.
Leading sexual and reproductive health charity Marie Stopes International (MSI) is calling for greater effort, through public education campaigns and advertising of family planning methods and services, to increase women’s awareness of their contraceptive options and regular use of a method suitable to their lifestyles. Interestingly, and of relevance to recent debates in the media, a huge majority of research respondents (94.7%) agreed that family planning methods should be advertised on television and/or radio.
MSI is also calling for healthcare professionals to provide women with comprehensive contraceptive information and access to the full range of modern methods via dedicated client consultations, and for more investment in training for healthcare professionals in fitting long acting reversible contraceptive methods (LARCs), which are a critical part of the Government’s strategy to reduce the number of unintended pregnancies and abortions in the UK.
“The UK has high levels of unintended pregnancy with approximately 200,000 women in England and Wales seeking abortions every year,” comments Louise Bury, a Research Manager at MSI, who carried out the research.
“Since contraception in the UK is free of charge and easily available, and since the UK has high levels of reported contraceptive use, it is puzzling why more unintended pregnancies are not avoided. This research sheds some light on the reasons why women requesting abortion have fallen pregnant unintentionally and the actions women and healthcare professionals can take to prevent unplanned pregnancies occurring in the future.”
The research – “The Condom Broke!” Why Do Women in the UK Have Unintended Pregnancies? – was carried out by telephone interview during the summer of 2008 among almost two thousand women who were booking appointments to attend a Marie Stopes centre for abortion services.
The study found that a lack of awareness of all contraceptive options is linked to why women have unintended pregnancies. In the UK, there are more than 15 contraceptive methods available, but when asked to name these only four methods (the pill, male condom, IUD, and injection) were remembered by more than half of respondents. Less than one in 10 women (8.4%) independently recalled emergency contraception, which is of particular concern given the ease with which it can be obtained over-the-counter at pharmacies, and the role it plays in preventing unintended pregnancy should unprotected sex have taken place or following a contraceptive accident.
“Women in the UK should have a wide range of contraceptive options available to them,” explains Pauline Beddoes, Nurse Manager at Marie Stopes International. “Yet some may find the vast array of modern contraceptives confusing, and therefore only request a method familiar to them, even when an alternative method may better suit their lifestyle. Others may have their options limited by a prescribing healthcare practitioner because it is convenient or financially advantageous to limit the range of methods offered, or because the healthcare practitioners are not trained to fit long-acting reversible contraceptive (LARC) methods such as the IUD or contraceptive implant.”
Failure to choose the most suitable option may result in women not using contraception at all, or using their chosen method incorrectly or inconsistently, resulting in the method being ineffective. Since no method of contraception is 100% effective, unintended pregnancies may also result from method failure. These three factors are the most likely contributors to unintended pregnancies, as identified by the research.
“The research revealed that over one third of women who were considering an abortion when interviewed (36.9%) had chosen not to use contraception when they became pregnant,” said Louise Bury.
“However, reasons for non-use of contraception are not always due to blasé attitudes regarding unprotected sex. While some of these women - 42.1% - said that they didn’t use contraception because of user-related issues such as lack of thought or a perceived low risk of becoming pregnant, 8.3% and 8.7% respectively cited access or cost issues. 10% and 9.5% respectively cited relationship or partner issues, such as their belief that their partner was sterile, or a partner’s preference not to use a condom. This reveals that reasons for not using contraception are not always within a woman’s control.”
While not using contraception may seem an obvious cause of unintended pregnancy, almost two thirds (62%) of women reported using contraception at the time of getting pregnant. While 34% of respondents suggested that contraceptive failure was due to method technical difficulties such as ‘the condom broke’ or ‘slipped off’, 41.1% did not know why their contraception had failed to prevent pregnancy.
“It is not uncommon for women approaching Marie Stopes International for an abortion to be completely shocked that they are pregnant, since they were using contraception at the time of pregnancy,” explains Pauline. “However, contraception needs to be used consistently and correctly to be effective. For example, some types of pill have to be taken at exactly the same time every day - if taken more than three hours late a woman may fall pregnant. Some women do not understand this or ignore such instructions. They therefore think they are using contraception when strictly speaking they are not.”
“The findings of the research highlight the cross-cutting links between a woman’s knowledge of and access to contraceptive services, and her likelihood of facing an unintended pregnancy,” Pauline concludes. “Experiencing an unplanned pregnancy can present a significant emotional, physical and financial cost to women and society. Moving forward, women must be encouraged to consider their contraceptive choices, and healthcare professionals must provide women and their partners with the information and services they need to select the most suitable contraceptive method and use it appropriately. If both women and healthcare professionals prioritise contraceptive choice, many unplanned pregnancies may be prevented.”
For a research brief or full copy of the research report, please contact Emily James: 020 7034 2307 / emily.james@mariestopes.org.uk
Categories: United Kingdom; Europe; Abortion; Contraception
15/07/2009