Women who've had 'accidents' are likely to have more 'accidents'

The American Journal of Obstetrics and Gynecology published a rather interesting study in the November 2008 issue which was picked up by Reuters Health.

The study Is a previous unplanned pregnancy a risk factor for a subsequent unplanned pregnancy? concludes, yes it is. The full text is only available by subscription, but you can find a PDF of the summary here.

The researchers found that although education and age emerged as the two risk factors most likely to predict an initial unplanned pregnancy, the strongest factor for a second unplanned pregnancy was the mere occurrence of the first. Reuters explains,

Researchers found that of 542 women and teenage girls enrolled in a study to encourage contraceptive use, those with a history of unplanned pregnancy were twice as likely as other women to have another unplanned pregnancy over the next two years.

The study followed women and teenage girls ages14 to 35 for two years. Over that period, 23% of all the women experienced an unplanned pregnancy, more than one in five. Of the women who had experienced a previous unplanned pregnancy, 27% became pregnant again during the two year period versus 17% of the women became pregnant who had never experienced a unplanned pregnancy.

So what's the big deal? The study explains,

Women experiencing unintended pregnancies often do not initiate early prenatal care and are more likely to engage in unhealthy behavior, such as binge drinking, smoking, illicit drug use, and lack of vitamin intake, during their first trimester of pregnancy. Consequently, birth outcomes for unplanned pregnancies place the newborn at increased risk for premature birth, low birthweight, infant abuse, and neonatal death.

Which makes sense, right? If you're not expecting to be pregnant, why would you stop going out, doing body shots and smoking crack?
(Side note: The effects of prenatal cocaine exposure have been hotly debated in the last decade, and it's more or less understood that nicotine, alcohol and the poor health practices that often accompany maternal cocaine usage pose much greater threats to prenatal development than the actual crack itself. See this Systematic Review from 2001.)

The researchers suggest that the key to tackling the issue of repeat unplanned pregnancies is

Figuring out which women are at particularly high risk of unplanned pregnancies is key to preventing them, Kuroki's team writes. Based on the current findings, they say, asking a woman about her history of unplanned pregnancy is a good way to estimate her risk of one in the future -- and whether she needs more help with family planning.

Right, obviously. I wonder, though, who should be asking these questions? Is it the primary care physician? Planned Parenthood? Teachers? Friends? Family? Practically speaking, the study is vague, explaining only that

Efforts should focus on improving patient awareness of the associated risk factors, ensuring access to family planning services, promoting effective contraception use, and providing appropriate support and resources to women who experience an unintended pregnancy.

Ok then. It's somebody else's problem. I also wanted to highlight some of them more interesting statistics from the study:

• 49% of all US pregnancies are unintended (excluding miscarriages)
• 28% of women under 20 had an unplanned pregnancy, compared to 23% of women 20-24 and 12% of women over 24.
• 30% of African American women experienced an unplanned pregnancy, compared to 24% of Hispanic women and 17% of white women.
• 32% of women with less than a high school education experienced an unplanned pregnancy compared to 12% of women with a high school education or more.
  

I never would have guessed that the numbers would be so high. It would be interesting to look at the percentages over time to see if half of all pregnancies 50 years ago were unplanned... but I seriously doubt that data exists.

And speaking of unplanned pregnancies: Ashlee Simpson-Wentz gave birth to a baby boy today! Welcome, little Bronx Mowgli Wentz.

Wait, is that Mowgli as in The Jungle Book? Why, yes it is.