Estimating pregnancy intention is an important public health measure. In the Australian
maternity practice setting, pregnancy intention is not consistently reported. Usually,
this enquiry consists of a single question, with a dichotomous outcome, about whether
the pregnancy was planned or not, with midwives being the health professionals responsible
for asking this question. The London Measure of Unplanned Pregnancy(LMUP) is a psychometrically
validated measure of the degree of intention of a current or recent pregnancy.
The aim of this study is to present the first year of implementation of the LMUP and
examine rates of unwanted, ambivalent and intended pregnancies and their demographic
We performed a retrospective review of the first year of LMUP data entered in the
electronic maternity medical records of women booked for public antenatal care at
the two maternity hospitals in Sydney. Routinely collected data from the antenatal
booking visit along with sociodemographic information, living situation, relationship
status and country of birth were also collected.
We identified that 4993 women who booked in for public antenatal care during the study
period of whom 44.8% (2791) had all six items of the LMUP completed. Primiparous women
accounted for 52% of bookings, and2385 pregnancies were unplanned. 29% of pregnancies
were unintended with an 8-fold higher risk in those having their 4th or more birth
compared to those having their first.
Unintended pregnancies can have serious health, social and financial consequences
and we have identified that women are missing out on access to contraception between
pregnancies. Our findings are critical research in an emerging area of midwifery which
will inform policy and practice and to develop service models that meet women’s needs
and scope of practice of Midwives.