Kenya is going through a ‘demographic transition’. Contraceptive use rose from 33 per cent of married women in 1993 to 39 per cent in 1998 - one of the highest rates in sub-Saharan Africa. But a large proportion of births are still unplanned. A study by the UK University of Southampton looks at the factors that increase the chance of unplanned pregnancy.

Whether a pregnancy is wanted can influence whether a women seeks antenatal care and professional delivery and thus affects the health of mother and child. In addition, unsafe abortions cause a third of maternal deaths in Kenya.

Childbearing can be ‘unwanted’ if the woman does not want any more children or ‘mistimed’ if she wants more children but not at that time. Using data from the 1993 Kenya Demographic and Health Survey, the study found an increase in both mistimed and unwanted pregnancies in the previous five years. In all, about 60 per cent of the women in the sample had at least one unplanned birth. The study also found that women who have an unplanned birth, especially an unwanted birth, are highly likely to do so again.

Factors linked to unplanned childbearing include:

• location – mistimed births are more common in rural than urban areas
• age – teenagers have the highest rates of mistimed births while women over 35 years old have the greatest proportion of unwanted births
• marital status – 68 per cent of births among single women are mistimed while 14 per cent of the births are unwanted.
• family size – the probabilities of mistimed and unwanted births both increase with the number of children
• birth interval – rates decline with increasing length of time since the last birth.

Surprisingly, women are more likely to have an unwanted birth if they use modern family planning methods. It may be that pregnancies among women who are trying to control their fertility are more likely to be unwanted than if they aim to have a larger family. However, this result may also reveal problems with contraceptive use, including discontinuation or contraceptive failure.

These results suggest that many Kenyan women are aware of the negative effects of too many or too closely spaced births but are unable to prevent them. Maternal healthcare providers should offer family planning advice and services to their clients, especially those with an unwanted pregnancy, to ensure effective contraceptive use in future and to avoid repeated unplanned births.

Source(s):
‘Unplanned childbearing in Kenya: the socio-demographic correlates and the extent of repeatability among women’, Social Science and Medicine 56: 167-178, by M. Magadi, 2003
HINARI subscribers can access the full-text article here. Full document.

Funded by: The Population Council; University of Southampton

id21 Research Highlight: 20 February 2003

Further Information:
Monica Magadi
Department of Social Statistics
University of Southampton
Southampton
SO17 1BJ
UK

Tel: +44 (0) 23 8059 5823
Fax: +44 (0) 23 8059 3846
Contact the contributor: mmagadi@socsci.soton.ac.uk

University of Southampton, UK

Other related links:
'Same difference? Effects of health sector reforms on women’s access to reproductive healthcare'

The mother of invention? New strategies for antenatal care

See id21's collection of links relevant to sexual and reproductive health.

See id21's collection of links relevant to maternal and child health.