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Introduction of the London Measure of Unplanned Pregnancy at the booking visit

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      Background

      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.

      Objective

      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 associations.

      Methods

      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.

      Results

      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.

      Conclusions

      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.
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