Cost of unintended pregnancy in Norway: a role for long-acting reversible contraception

Henry, Nathaniel; Schlueter, Max; Lowin, Julia; Lekander, Ingrid; Filonenko, Anna; Trussell, James; Skjeldestad, Finn Egil

doi:10.1136/jfprhc-2014-100878

Cited by 26 publications

(30 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is a single rod, containing 68mg of Etonogestrel to offer contraception for three years [1]. Contraceptive discontinuations contribute substantially to the total fertility rate, unwanted pregnancies,and induced abortions [2,3]. An estimated 13% of maternal mortality from unsafe abortion is due to unintended pregnancy [4].…”

Section: Introductionmentioning

confidence: 99%

Implanon Discontinuation Rate and Associated Factors among Women who ever Used Implanon in the Last Three Years in Debre Markos Town, Northwest Ethiopia, 2016, Cross Sectional Study

Siyoum¹,

Mulaw²,

Abuhay³

et al. 2017

ARC Journal of Public Health and Community Medicine

View full text Add to dashboard Cite

Abstract:Introduction: Contraceptive discontinuations contribute substantially to the total fertility rate, unwanted pregnancies and induced abortions.In developing countries, contraceptive discontinuation rate is very common. While the Ethiopian government emphasizes onthe provision of long-acting contraceptive methods, women who start to use the method were discontinuing it and the rate of discontinuation is understudied.

show abstract

Section: Introductionmentioning

confidence: 99%

Implanon Discontinuation Rate and Associated Factors among Women who ever Used Implanon in the Last Three Years in Debre Markos Town, Northwest Ethiopia, 2016, Cross Sectional Study

Siyoum¹,

Mulaw²,

Abuhay³

et al. 2017

ARC Journal of Public Health and Community Medicine

View full text Add to dashboard Cite

show abstract

“…Neither motor nor attentional impulsivity was associated with pregnancy intentionality. This research suggests that nonplanning impulsivity may be a potential novel risk factor for unplanned pregnancy, an important finding given the adverse effects on maternal and infant health 4,5 and on health care costs 2,3 associated with unplanned pregnancies.…”

Section: Discussionmentioning

confidence: 79%

“…1 Unintended pregnancies are associated with high financial costs, 2,3 maternal depression and stress, and poorer infant health. 4,5 Unintended pregnancies typically result from failure to use contraception in women who are not purposefully trying to achieve pregnancy, inconsistent or incorrect use of effective contraceptives, or lack of contraceptive availability.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Unintended pregnancies typically result from failure to use contraception in women who are not purposefully trying to achieve pregnancy, inconsistent or incorrect use of effective contraceptives, or lack of contraceptive availability. 6 Understanding risk factors for unintended pregnancies is an important step towards reducing the proportion of unintended pregnancies, their associated costs 2 and consequences for maternal and child health. 4,5 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy intentionality in relation to non-planning impulsivity

Godiwala

Appelhans

Simas

et al. 2016

Journal of Psychosomatic Obstetrics & Gynecology

View full text Add to dashboard Cite

Background Half of US pregnancies are unintended. Understanding risk factors is important for reducing unintended pregnancy rates. Aim We examined a novel risk factor for unintended pregnancies, impulsivity. We hypothesized that nonplanning impulsivity, but not motor or attentional impulsivity, would be related to pregnancy intention. Methods Pregnant women (N=116) completed self-report measures during their second or third trimester. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS-15); subscales measured motor, attentional and nonplanning impulsivity (subscale range: 5–20). On each subscale, high impulsivity was indicated by a score of ≥11. Pregnancy intention was assessed by asking women whether they were trying to become pregnant at the time of conception (yes or no). Crude and multivariable-adjusted logistic regression models estimated the cross-sectional association between impulsivity and unplanned pregnancy. Results Thirty-four percent of women reported that their current pregnancy was unplanned, and 32% had high nonplanning impulsivity. Fifty-one percent of women with high nonplanning impulsivity reported an unplanned pregnancy versus 25% of women with low impulsivity. Women with high nonplanning impulsivity had 3.53 times the odds of unplanned pregnancy compared to women with low nonplanning impulsivity (adjusted OR=3.53, 95% CI: 1.23–10.14). Neither motor (adjusted OR=0.55, 95% CI: 0.10–2.90) nor attentional (adjusted OR=0.84, 95% CI: 0.25–2.84) impulsivity were related to pregnancy intentionality. Conclusions High nonplanning impulsivity may be a risk factor for unplanned pregnancy. Further research should explore whether increasing the use of long-acting reversible contraceptives or integrating if-then planning into contraceptive counseling among women with higher nonplanning impulsivity can lower unplanned pregnancy rates.

show abstract

“…6 Increasing IUC use may help to decrease the rates of adherence-related UP and the cost burden associated with these pregnancies. Studies in the USA 1 and Norway 8 have found that increasing LARC uptake may result in reduced rates of UP and hence a significant cost savings. To date, there is no study that has quantified the direct cost of UP in Canada or the proportion of this cost that can be attributed to imperfect contraceptive adherence.…”

Section: Introductionmentioning

confidence: 99%

The Cost of Unintended Pregnancies in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives

Black

Guilbert

Hassan³

et al. 2015

Journal of Obstetrics and Gynaecology Canada

Self Cite

View full text Add to dashboard Cite

Objective Unintended pregnancies (UP) are associated with a significant cost burden but the full cost burden in Canada is not known. The objectives were to quantify the direct cost of UPs in Canada, the proportion of UPs and cost attributable to imperfect contraceptive adherence, and the potential cost-savings with increased uptake of long-acting reversible contraceptives (LARCs). Methods A cost model was constructed to estimate the annual number and direct costs of UP in women aged 18–44 years. Adherence-associated UP rates were estimated using perfect- and typical-use contraceptive failure rates. Change in annual number of UPs and impact on cost-burden were projected in 3 scenarios of increased LARC usage. One-way sensitivity analyses were conducted to assess the impact of key variables on scenarios of increased LARC use. Results There are over 180,700 UPs annually in Canada. The associated direct cost was over $320 million. Fifty-eight percent (58%) of UPs occurred in women aged 20–29 years at an annual cost of $175 million; 82% of this cost ($143 million) was attributable to contraceptive non-adherence. Increased LARC uptake produced cost savings of over $34 million in all three switching scenarios; the largest savings ($35 million) occurred when 10% of oral contraceptive users switched to LARCs. The minimum duration of LARC usage required before cost savings was realized was 12 months. Conclusions The cost of UPs in Canada is significant and much of it can be attributed to imperfect contraceptive adherence. Increased LARC uptake may reduce contraceptive non-adherence thereby reducing rates of UP and generating significant cost savings, particularly in women aged 20–29.

show abstract

Cost of unintended pregnancy in Norway: a role for long-acting reversible contraception

Cited by 26 publications

References 8 publications

Implanon Discontinuation Rate and Associated Factors among Women who ever Used Implanon in the Last Three Years in Debre Markos Town, Northwest Ethiopia, 2016, Cross Sectional Study

Implanon Discontinuation Rate and Associated Factors among Women who ever Used Implanon in the Last Three Years in Debre Markos Town, Northwest Ethiopia, 2016, Cross Sectional Study

Pregnancy intentionality in relation to non-planning impulsivity

The Cost of Unintended Pregnancies in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives

Contact Info

Product

Resources

About