Reasons for current pregnancy amongst grand multiparous Gambian women - a cross sectional survey

BACKGROUND While grand multiparity is now relatively rare in the developed world it is still common in Sub Saharan Africa. Although significant resources have been committed to providing modern contraceptive methods in the Gambia, the total fertility rate is still high at 5.6. Determining the reasons grand multiparous women proffer for the current pregnancy may help in understanding this trend and tailoring appropriate messages to address any specific concerns. METHOD A cross sectional survey of grand multiparous women was carried out at the Royal Victoria Teaching Hospital (now Edward Francis Small Teaching Hospital) to determine the reasons for the current pregnancy. RESULTS The prevalence of grand multiparity was 26.5 % while the average parity among the study population was 7.2 (sd 1.8). The most common reasons given for the current pregnancy were: the desire for another child (22.8 %), the pregnancy was unplanned - a "mistake" (18.4 %) and the need to replace a dead child (15.4 %). CONCLUSION Grand multiparity is still very common in The Gambia. Additional efforts are required to target those with unplanned pregnancies. Improving child survival may also decrease the prevalence of grand multiparity.