A hospital-based study was undertaken in Harare, Zimbabwe to estimate
the proportion of unplanned or unintended pregnancy among mothers who
delivered at the referral hospital and to analyse their socio-demograp
hic pattern and sexual relationships. A case-referent study design was
used with systematic sampling of maternity records of mothers who had
delivered. Interviews were performed before discharge using a semi-st
ructured questionnaire. Mothers who reported that the index pregnancy
was unplanned or unintended constituted the cases, and the referents w
ere those reporting the pregnancy as planned. Out of 923 deliveries, 4
1% were unplanned and 9% unwanted. The mean age of the mothers was 25
years and women aged 19 or below [Odds Ratio (OR)= 2.2, 95% CI = 1.5-3
.2] and 35 or above (OR = 2.8, 95% CI = 1.7-4.6) were significantly mo
re likely to present with unplanned pregnancy. Nulliparous women (OR =
2.4) and mothers with five or more pregnancies (OR = 8.2) had a signi
ficantly increased likelihood of the pregnancy being unplanned. Level
of education in the mothers studied had no independent association to
planning of pregnancy. Unemployed (OR = 14) and single (OR = 7.8), or
divorced/separated/widowed (OR = 5.1) women as well as those with low
income (OR = 2.1) and whose partner earned no income (OR = 2.2), were
more at risk of unplanned pregnancy. Those living with their own paren
ts despite being pregnant were also more likely to report an unplanned
pregnancy. In conclusion, there are documentable social and reproduct
ive factors underlying unwanted pregnancy. Risk factors for unplanned
pregnancy form a pattern similar to those for maternal mortality. Thus
unplanned pregnancy is a major indicator of the presence of factors k
nown to increase the risk of maternal death. Policy makers and health
education should address factors contributing to unplanned pregnancy a
nd its prevention in order to prevent reproductive mortality and morbi
dity. The presence of those factors associated with unplanned pregnanc
y at booking or delivery should also alert service providers to the ne
ed for appropriate contraceptive counselling as part of post delivery
care. (C) 1997 Elsevier Science Ltd.