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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Fertility desires, family planning use and pregnancy experience: longitudinal examination of urban areas in three African countries

Authors: Ilene S. Speizer, Peter Lance

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Many women have inconsistent fertility desires and contraceptive use behaviors. This increases their risk of unintended pregnancies. Inconsistencies may reflect barriers to family planning (FP) use but may also reflect ambivalence toward future childbearing. Using urban data from Kenya, Nigeria, and Senegal, this study examines the role of fertility desires and FP use behaviors on pregnancy experience over a 2-year follow-up period.

Methods

Data come from baseline and 2-year follow-up among urban women interviewed in Kenya, Nigeria, and Senegal. At baseline (2010/2011), women were asked about their future fertility desires (want child soon, want to delay >2 years, does not want) and current FP use. At midterm (2012/2013), women were asked if they were currently pregnant or had a birth in the 2-year period. We examine the association between baseline fertility desires and FP use with pregnancy experience and desirability of an experienced pregnancy.

Results

In the 2-year follow-up period, 27–39 % of women in union experienced a pregnancy or birth. In Kenya and Nigeria, 30–35 % of women using a modern FP method experienced a pregnancy/birth; the percentage with a pregnancy/birth was slightly higher among women not using at baseline (41 % in both countries). In Senegal, the distinction between pregnancy experience between users and non-users was greater (16 % vs. 31 %, respectively). In all countries, pregnancy was less common among users of long-acting and permanent methods; only a small percentage of women use these methods. Women not wanting any(more) children were the least likely to experience a pregnancy in the 2-year follow-up period. No differences were observed between those who wanted to delay and those who wanted soon. Multivariate findings demonstrate distinctions in pregnancy experience by fertility desires among modern FP users. Non-users have similar pregnancy experience by fertility desires.

Conclusions

Fertility desires are not stable; providers need to consider the fluidity of fertility desires in counseling clients. Programs focusing on new FP users may miss women who are the most motivated to avoid a pregnancy and need to switch to a more effective method; this will result in less unintended pregnancies overall.
Footnotes
1
In Nigeria and Senegal, baseline data were collected in six cities and in Kenya five cities; the smaller set of cities listed here had midterm data collected to inform program improvements at midterm and thus are the focus of this analysis.
 
2
In Nigeria, all women were actually tracked in the study cities while only those living in a randomly selected 65 percent of the baseline PSUs were eligible for interview.
 
3
Standard days method (SDM) was grouped with traditional methods at baseline and thus it is not possible to pull it out as a separate method in these analyses; in later surveys, SDM was a separate category.
 
4
Note that field teams felt that there were many women at baseline who were house girls (i.e., unmarried) who had moved and were not possible to track at midterm.
 
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Metadata
Title
Fertility desires, family planning use and pregnancy experience: longitudinal examination of urban areas in three African countries
Authors
Ilene S. Speizer
Peter Lance
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0729-3

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