Unintended Pregnancy Risk & Contraceptive Use among Women Aged 45 to 50 Years - Massachusetts, 2006, 2008, and 2010
BACKGROUND:
Little
is known about unintended pregnancy (UIP) risk and current contraceptive use
among women aged 45 years and over in the United States (US).
OBJECTIVES:
To
describe the prevalence of women aged 45-50 years at risk for UIP and their
current contraceptive use and to compare these findings to those of women in
younger age groups.
STUDY DESIGN:
We
analyzed 2006, 2008 and 2010 Massachusetts Behavioral Risk Factor Surveillance
System data, the only US state to routinely collect contraceptive data from
women beyond age 44 years. Women aged 18-50 years (n=4,930) were considered at
risk for UIP unless they reported current pregnancy, past hysterectomy, not
being sexually active in the past year, having a same sex partner, or wanting
to become pregnant. Among women considered at risk (n=3,605), we estimated the
prevalence of current contraceptive use by age group. Among women considered at
risk and aged 45-50 years (n=940), we examined characteristics associated with
current method use. Analyses were conducted on weighted data using SUDAAN.
RESULTS:
Among
women aged 45-50 years, 77.6% were at risk for UIP, which was similar to other
age groups. As age increased, hormonal contraceptive use (shots, pills, patch,
or ring) decreased, while permanent contraception (tubal ligation or vasectomy)
increased as did non-use of contraception. Of women aged 45-50 years at risk
for UIP, 66.9% reported using some contraceptive method; permanent
contraception was the leading method reported by 44.0% and contraceptive
non-use was reported by 16.8%.
CONCLUSION:
A
substantial proportion of women aged 45-50 years were considered at risk for
UIP. Permanent contraception was most commonly used by women in this age group.
Compared with other age groups, more women aged 45-50 years were not using any
contraception. Population-based surveillance efforts are needed to follow trends
among this age group and better meet their family planning needs. Although
expanding surveillance systems to include women through age 50 years requires
additional resources, fertility trends showing increasingly delayed
childbearing, uncertain end of fecundity, and potential adverse consequences of
unplanned pregnancy in older age may justify these expenditures.
- 1Department of Family Medicine, University of Washington, Box 354696, Seattle, WA 98105 USA; Division of Reproductive Health, Centers for Disease Control and Prevention, NCCDPHP/DRH/WHFB, 4770 Buford Hwy, NE, MS F-74, Atlanta GA 30341 USA. Electronic address: godfreye@uw.edu.
- 2Division of Reproductive Health, Centers for Disease Control and Prevention, NCCDPHP/DRH/WHFB, 4770 Buford Hwy, NE, MS F-74, Atlanta GA 30341 USA.
- 3Department of Public Health, St. Catherine University, 2004 Randolph Avenue, St. Paul, MN 55105.
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