Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women

Rice, Whitney S.; Turan, Bülent; White, Kari; Turan, Janet M.

doi:10.1080/03630242.2017.1414099

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…The fear of pregnancy among adolescents in Kisumu is driven primarily by fears that their community will discover their sexual activity. Our findings build upon previous research examining social stigma of adolescent SRH by adding nuance to the intensity of the fear and how it affects behaviors, with sometimes fatal consequences (Moseson et al 2019;Smith et al 2017;Rice et al 2018;Kaljee et al 2007;Akwara and Idele 2020;Hall et al 2018;Levandowski et al 2012). Inclusion of perspectives from boys and the FGD format where social norms were intentionally explored provides new insights on SRH stigma and the focus on abortion and suicide prevalence are novel insights.…”

Section: Discussionsupporting

confidence: 60%

“…Social norms are what is considered acceptable behavior within a community, while social stigma is disapproval and retribution when those norms are violated (Bicchieri 2006;Goffman 1959). In general, social stigma does not lead to decreased adolescent sexual activity but rather decreased disclosure of behavior and use of contraceptives, and increased feelings of social isolation (Kinaro et al 2015;Håkansson et al 2020;Rice et al 2018;Kaljee et al 2007). Fearing social stigma, some adolescents conceal their pregnancies, make decisions without social support, seek unsafe abortions, and/or experience suicidal ideation (Smith et al 2017;Crowley, High, and Thomas 2019).…”

Section: Introductionmentioning

confidence: 99%

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“We Don't Fear HIV. We Just Fear Walking around Pregnant.”: A Qualitative Analysis of Adolescent Sexuality and Pregnancy Stigma in Informal Settlements in Kisumu, Kenya

Miller¹,

Zamudio-Haas²,

Otieno³

et al. 2021

Studies in Family Planning

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In Kenya, adolescent pregnancy rates are high, contraception utilization is low, and adolescent sexuality is stigmatized. We describe how perceptions of sexuality and pregnancy stigma influence decision‐making among adolescents in the informal settlements of Kisumu. We used purposive sampling to recruit 120 adolescent boys and girls aged 15–19 for focus group discussions. A semistructured interview guide was used to elicit social norms and community attitudes about sexual and reproductive health. We analyzed the data using the Framework Approach. The social stigma of adolescent sexuality and the related fear of pregnancy as an unambiguous marker of sexual activity emerged as main themes. This stigma led adolescents to fear social retribution but did not lead to more frequent contraception use due to additional stigma. The intensity of this fear was most acutely expressed by girls, leading some to seek unsafe, sometimes fatal, abortions, and to contemplate suicide. Fear of pregnancy outweighed fear of contracting HIV that was viewed as both treatable and less stigmatized. Our findings illustrate how fear of pregnancy among these adolescents is driven primarily by fears that their community will discover that they are sexually active. Interventions are urgently needed to address adolescent sexual stigma and to prevent negative outcomes.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

“We Don't Fear HIV. We Just Fear Walking around Pregnant.”: A Qualitative Analysis of Adolescent Sexuality and Pregnancy Stigma in Informal Settlements in Kisumu, Kenya

Miller¹,

Zamudio-Haas²,

Otieno³

et al. 2021

Studies in Family Planning

View full text Add to dashboard Cite

show abstract

“…The concentration index analyses of the wealth-related inequality of unintended pregnancy showed that unintended pregnancy is more distributed in poor women (pro-poor distribution). This is supported by studies that show that stigma and socio-economic inequalities are common problems of unintended pregnancies [ 19 , 21 ]. Most unintended pregnancies occurred in the poorest women due to raped or commercial sex workers [ 46 ].…”

Section: Discussionmentioning

confidence: 78%

“…Unintended pregnancies can reduce the rate of maternal [ 13 – 16 ] and neonatal [ 17 ] health services utilization, and worsen maternal health outcomes [ 10 , 18 – 20 ]. Even stigma and socio-economic inequalities are common problems of unintended pregnancies [ 19 , 21 ]. Studies reported that unintended pregnancy is associated with pre-eclampsia, obstetrics bleeding and other maternal complications [ 10 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Trend, multivariate decomposition and spatial variations of unintended pregnancy among reproductive-age women in Ethiopia: evidence from demographic and health surveys

Belay

Aragaw

2022

Trop Med Health

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Background The magnitude of unintended pregnancy is unacceptably high and more than half of it end up with abortions. This may limit lower and middle-income countries to achieve the sustainable development goal targets of reduction of neonatal and maternal mortalities. Evidence on trends and spatial distribution of unintended pregnancy is limited. Therefore, this study aimed to assess the trend, multivariate decomposition, and spatial variations of unintended pregnancy among reproductive-age women in Ethiopia from 2000 to 2016. Methods Ethiopian Demographic and Health Data of 2000 to 2016 were used. A total weighted sample of 30,780 reproductive-age women participated. A multivariate decomposition analysis was employed to identify factors contributing to the change in the rate of unintended pregnancy in Ethiopia for 20 years from (1996 to 2016). The concentration index and graph were used to assess wealth-related inequalities, whereas spatial analysis was done to identify the hotspot of unintended pregnancy in Ethiopia. Results The 20-year trend analysis showed that the magnitude of unintended pregnancy among reproductive-age women decreased by 13.19 percentage points (from 39.76% in 2000 to 26.57% in 2016 EDHS). About 84.97% of the overall decrement was due to the difference in coefficient of the variables, whereas the remaining 15.03% was due to the difference in composition of the respondent. The differences in coefficient of the variables were decomposed by living metropolitan cities, having previous terminated pregnancy, and not having exposure to media; whereas, the change due to the composition, was expressed by having a household size of 1–3, living in metropolitan cities, being multipara and grand para, being unmarried and having no terminated pregnancy. Moreover, unintended pregnancies were more clustered in Addis Ababa and disproportionately concentrated in the poor groups. Conclusions In Ethiopia, a substantial decrement in unintended pregnancy was observed in the past decade. More than four-fifths of this overall decrement was due to the difference in the coefficient of the variables. There was spatial clustering of unintended pregnancy in Ethiopia. A program intervention is needed for high-risk regions such as Addis Ababa. Health education and media campaign should perform for high-risk women such as those having terminated pregnancy, and professing Islam faith.

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“…Unintended pregnancy is one of the most serious public health problems that impose major health, economic, and psychosocial costs on individuals and communities, as well as significant emotional damage to women, families, and society ( 32 – 34 ). Besides, unintended pregnancy is associated with preeclampsia, obstetric bleeding, stigma, and socioeconomic inequalities ( 2 , 27 , 35 , 36 ).…”

Section: Introductionmentioning

confidence: 99%

Magnitude of unintended pregnancy and its determinants among childbearing age women in low and middle-income countries: evidence from 61 low and middle income countries

Gashaw

Amare

Teklu

et al. 2023

Front. Reprod. Health

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BackgroundUnintended pregnancy is one of the most serious health issues in low and Middle-Income Countries (LMICs), posing significant health, economic, and psychosocial costs to individuals and communities. However, there is limited evidence on the prevalence of unintended pregnancies and their determinants in LMICs. Hence, this study aimed to assess the prevalence of unintended pregnancy and its associated factors among childbearing-age women in LMICs.MethodData for the study were drawn from a recent 61 Demographic and Health Surveys (DHS) conducted in LMICs. A total sample of 187,347 mothers who gave birth in the five years preceding the survey was included. STATA version 16 was used to clean and analyze the data. Multilevel multivariable logistic regression was employed to identify individual and community-level factors of unintended pregnancy in LMICs. In the multivariable analysis, an adjusted odds ratio with a 95% confidence level was reported to indicate statistical association.ResultsThe pooled magnitude of unintended pregnancy in LMICs was 26.46%% (95% CI: 25.30%, 27.62%), ranging from 19.25%% in Egypt to 61.71% in Bolivia. Working status (AOR = 1.03; 95% CI: 1.01, 1.06), having a husband with no education (AOR = 1.07; 95% CI: 1.00, 1.15), and primary education (AOR = 1.05; 95% CI: 1.01, 1.11), women from male-headed households (AOR = 1.04; 95% CI: 1.00, 1.08), media exposure (AOR = 1.05; 95% CI: 1.02, 1.08), unmet need for contraception (AOR = 1.05; 95% CI: 1.02, 1.08), distance from a health facility (AOR = 1.03; 95% CI: 1.00, 1.06) were significantly associated with unintended pregnancy.ConclusionUnintended pregnancy rates remain high in LMICs. Women whose husband has no education and primary education, women with media exposure, working status, women who live in a household headed by male, women with unmet need for contraception, and women with a big problem of distance to health facilities were variables that were significant predictors of unintended pregnancy. When attempting to minimize unintended pregnancy in LMICs, these factors need to be considered. Furthermore, most of these attempts should be driven by government entities in low and middle-income countries.

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Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women

Abstract: Unintended pregnancy norms and stigma were associated with contraceptive behavior among young women in Alabama. Findings suggest the potential to promote effective contraceptive use in this population by leveraging close relationships and addressing endorsed stigma.

Cited by 8 publications

References 36 publications

“We Don't Fear HIV. We Just Fear Walking around Pregnant.”: A Qualitative Analysis of Adolescent Sexuality and Pregnancy Stigma in Informal Settlements in Kisumu, Kenya

“We Don't Fear HIV. We Just Fear Walking around Pregnant.”: A Qualitative Analysis of Adolescent Sexuality and Pregnancy Stigma in Informal Settlements in Kisumu, Kenya

Trend, multivariate decomposition and spatial variations of unintended pregnancy among reproductive-age women in Ethiopia: evidence from demographic and health surveys

Magnitude of unintended pregnancy and its determinants among childbearing age women in low and middle-income countries: evidence from 61 low and middle income countries

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