How contraceptive use patterns differ by pregnancy intention: Implicationsfor counseling

To increase awareness of issues to include in contraceptive counseling-the objectives of this study were to evaluate: 1) how contraceptive use pattern s (eg, non-use), level of effectiveness of contraceptive method, and sociod emographic characteristics may be associated with the occurrence of uninten ded pregnancy; 2) patterns of health care use for women with intended and u nintended pregnancy; and 3) the association between contraceptive use patte rns and sociodemographic characteristics. In-person interviews were conduct ed with 279 women enrolled in a Medicaid managed care health plan who had b een pregnant in the last 5 years. Self-reported measures of pregnancy inten tion, contraceptive use, and health care use were collected. The relationsh ips of pregnancy intention with contraceptive use patterns, level of effect iveness of contraceptive method used, and patterns of recent health care us e were assessed. Differences in contraceptive use patterns by sociodemograp hic groups were assessed. Seventy-eight percent of women reported an uninte nded pregnancy. Non-use of birth control the month before conception was re ported by 57% of women with unintended pregnancies and 84% of women with in tended pregnancies. Use of birth control of low effectiveness was reported by 20% of women with unintended pregnancies and 8% of women with intended p regnancies. Non-use or use of contraceptive methods Of low effectiveness di d not differ for women in different sociodemographic groups regardless of p regnancy intention status. A majority of women reported recent health care use. Health care providers should be aware that women who have no intention for pregnancy may not be using an effective contraceptive method nor have an effective pattern of contraceptive use.