A comparative cross-sectional study of planned and unplanned pregnancies, their outcomes, predictors, and health-seeking behaviours among women in Odisha, India.

BACKGROUND

Unplanned pregnancy continues to pose a major challenge to public health, frequently resulting in negative maternal outcomes and delayed healthcare utilization. In developing nations, its occurrence is influenced by restricted access to contraception, cultural and societal norms, and inadequate awareness of reproductive health. This study primarily aimed to assess the prevalence and factors associated with unplanned pregnancies with a comparative group of planned pregnancies. Secondary objectives included exploring pregnancy outcomes and health-seeking behavior in unplanned pregnancies.

METHODS AND MATERIALS: An analytical cross-sectional study was conducted with 430 ever-married women who conceived in the last three years, recruited using convenient sampling from rural and urban areas of Khordha District, Odisha. Data were collected via face-to-face interviews. Descriptive statistics were used to describe the sociodemographic and obstetric characteristics, and bivariate and multivariate logistic regression were used to identify associated factors, outcomes, and health-seeking behavior in unplanned pregnancies.

RESULTS

Nearly one-fourth of women (26%) had unplanned pregnancy, 64% continued their pregnancy, while 36% opted for termination. Age at pregnancy ≥ 30 years, gravidity > 2, birth spacing ≤ 24 months, history of induced abortion, and both induced & spontaneous abortions were factors associated with unplanned pregnancies. Secondary findings indicated that unplanned pregnancies were associated with higher rates of complications during pregnancy and puerperium, as well as delayed Urine Pregnancy Test and Antenatal Care registration.

CONCLUSION

Unplanned pregnancies were significantly associated with advanced maternal age, higher gravidity, short birth intervals, and a prior history of abortion. These pregnancies were more likely to result in adverse maternal outcomes and were marked by delayed healthcare utilization, including late antenatal registration and reliance on unsafe abortion methods. Enhancing access to contraception, fostering early engagement with maternal healthcare services, and strengthening reproductive health education are crucial steps toward reducing the incidence and consequences of unplanned pregnancies.