Percent of births that are reported as unintended

Percent of births that resulted from pregnancies that were reported to be either unwanted (i.e., they occurred when no children, or no more children, were desired) or mistimed (i.e., they occurred earlier than desired).  In this case, intentions are only measured for pregnancies ending in a live birth.    

This indicator is calculated as:

(# of births reported as unintended / total # of births reported) x 100

Percent of births occurring in the last five years that respondents reported were unwanted or mistimed.  In the DHS, a birth is reported as unintended if the respondent answers “No” to the following question: “When you got pregnant with (NAME), did you want to get pregnant at that time?” (MEASURE DHS, 2010).

Population-based survey

Knowledge of proportion of births reported as unintended is essential for those supporting women’s ability to determine whether and when to have children (Santelli, 2003).  Assessing pregnancy intentions is important in understanding fertility-related behaviors, forecasting fertility, estimating unmet need for contraception, understanding the impact of pregnancy intentions on maternal and child health, designing family planning programs and evaluating their effectiveness, and creating and evaluating community-based programs that prevent unintended pregnancy (Klerman, 2000).

Identifying whether a birth was intended or not can be rather complex with a host of factors affecting a woman’s response.  A major problem with measuring unintended pregnancy is that it measures women’s intentions after a birth has occurred, when the intentions are likely influenced by the presence of the baby (Santelli, 2003). Since retrospectively reported intentions generally become more positive over time, after the mother has bonded with the infant, the data tends to be skewed downwards. Secondly, if the pregnancy of interest was reported as mistimed, the indicator does not specify to what extent it was mistimed.  A pregnancy that occurs a few months earlier than wanted or planned will likely have less of an impact on a woman or couple compared with one that comes several years too soon (Santelli, 2003). Although mistimed and unwanted pregnancies are grouped together in the analysis, they have different effects on women depending on their age and stage in their reproductive life. Furthermore, a pregnancy reported as mistimed does not necessarily imply that the woman was unhappy about it, which leads back to intentions being influenced by the baby’s presence.  Due to conflicting emotional, psychological, and cultural factors, including a male partner’s attitudes and behaviors, it is not uncommon for a woman to feel ambivalent about her child’s birth and therefore fail to form an intention about her pregnancy. 

family planning

MEASURE DHS, 2010. Demographic and Health Surveys Model Woman’s Questionnaire.  ICF Macro, Calverton, MD.

Santelli, J., Rochat, R., Hatfield-Timajchy, K., Colley Gilbert, B., Curtis, K., Cabral, R., Hirsch, J., and Schieve, L. 2003. “The Measurement and Meaning of Unintended Pregnancy.”  Perspectives on Sexual and Reproductive Health 35 (2): 94-101.

Klerman, LV. 2000.  “The intendededness of pregnancy: a concept in transition.” Maternal and Child Health Journal 4 (3): 155-162.

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