Why do so many adult women have unplanned pregnancies?
Although studies have long understood the relationship between childhood sexual abuse and physical abuse as a factor for risky sexual behavior and unplanned teen pregnancy the association between these events and the risk of unplanned pregnancy in adulthood has not been previously studied.Analysis of data from the Adverse Childhood Experiences Study (ACE study) indicates that there may be a dose-response association between exposure to childhood abuse or household dysfunction and unintended first pregnancy in adulthood. The survey was mailed to members of a large HMO who visited a clinic in San Diego, CA. The survey had a 63.4% response rate among the target population for this study.
Study participants included 1193 women aged 20 to 50 whose first pregnancy occurred at or after age 20. Women over 50 were excluded because the lack of contraceptive availability may have contributed to any unintended pregnancies they experienced.
The study measured risk of unintended first pregnancy according types of childhood abuse and household dysfunction. The types included psychological abuse, physical abuse, sexual abuse by adults and by peers, physical abuse of the mother by her partner, and substance abuse and mental illness by household members, as well as factors relevant to each type of childhood abuse.
What does 'unintended pregnancy' mean?
For the purpose of the study, 'unintended pregnancy' was determined by the answer to the question: "When your first pregnancy began, did you intend to get pregnant at that time in your life?" Women who responded 'no' were coded as having an unintended first pregnancy, while women who answered 'yes' were coded with an intentional first pregnancy.Of the more than 45% of women who reported their first pregnancy as unintended, 65.8% reported childhood exposure to 2 or more types of abuse or household dysfunction. The strongest associations between childhood experiences and unplanned first pregnancy included frequent psychological abuse, frequent abuse of the mother by her partner, and frequent physical abuse.
Psychological (64.4%) and physical abuse (51.6%) were the most common childhood exposure reported by the participants, while 29.2% reported sexual abuse by an adult, and 36.2% reported substance abuse by someone who lived in the home. Physical abuse of the mother by her partner was reported by 28.5% of the women, 14.3% reported sexual assault by a peer, and mental illness in the home was reported by 26.4% of the survey participants.
Overall, 28.4% of the study target group reported four or more exposures to childhood abuse or household dysfunction. The study found that women who experienced four or more types of abuse or dysfunction were one and half times more likely to have an unintended first pregnancy, than women who did not experience childhood abuse.
The findings of this study indicate that 1in 5 unintended pregnancies are related to childhood abuse or household dysfunction. The researchers suggest that these findings are consistent with other studies which show the associations between physical and sexual abuse and risky teenage sexual behavior. However, they warn that further research is needed to fully understand the vernacular pathway of this association.
More from the Adverse Childhood Experiences StudyAdult Health Problems Linked to Childhood Experiences -From the CDC.
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adulthood-From the American Journal of Preventive Medicine.
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