The context of unintended pregnancy among married women in the USA.

BACKGROUND AND METHODOLOGY Unintended pregnancy is a concern in the USA due to its association with adverse physical, mental, social and economic outcomes. Few studies have examined this issue among married women from a social and contextual perspective. This study targeted married women to examine factors associated with unintended pregnancy using the ecological model of health promotion that focuses attention on both individual and social environmental factors. Data from the National Survey of Family Growth (NSFG) were merged with NSFG contextual files to examine the major predictive factors. RESULTS Multilevel logistic regression modelling revealed that married women of lower socioeconomic status, higher parity, who lived in communities with a high rate of marital dissolution had a higher probability of an unintended pregnancy. Women reported that their husbands were likely to concur with the unintended designation of the pregnancy. DISCUSSION AND CONCLUSIONS This study utilised a unique perspective to examine contextual factors related to unintended pregnancy among married women. The results support the need to focus on the couple as a unit for prevention efforts. Social policies to enhance access to family planning services are necessary to improve outcomes and prevent unintended pregnancies.