Levels, trends and predictors of unintended pregnancy among adolescents and young women aged 15-14 in India: An analysis from NFHS-4 and 5 Survey

Abstract Background Unintended pregnancy is an important reproductive health issue among women. Little is known about the prevalence of unintended pregnancy and its associated factors among Indian adolescents and young women in India. The present study aims to determine the prevalence of unintended pregnancy, its association with sociodemographic and behavioural characteristics and identify the important determinants among female adolescents and young women aged 15–24 in India from NFHS-4 to 5. Methods Data from the fourth and fifth rounds of the National Family Health Survey conducted in 2015-16 and 2019–2021 are used for the analysis. Ever-married adolescents and young women of age 15–24 who have given at least one birth in the last 5 years were taken into the analysis with a finalized sample of 62,079 women in NFHS-4 and 53,635 women in NFHS-5. Univariate and bivariate analysis was used to examine the association of unintended pregnancy with the explanatory variables. Further, a binary logistic regression analysis was employed to identify the predictors of unintended pregnancy among adolescents and young women aged 15–24 from NFHS-4 to 5. Results The results revealed that at least seven per cent of the pregnancies during both surveys (NFHS-4 & 5) were unintended in India. The trend shows a slight increase (7.29–7.52%) in unintended pregnancy among adolescents and young women aged 15–24 from NFHS-4 to NFHS-5. Covariates like age, religion, education, region, birth in last five years, the ideal number of children, knowledge of the ovulatory cycle, heard about family planning, interaction with family planning worker, age at birth and unmet need put forth a strong influence upon unintended pregnancy in India. In contrast, factors like wealth index, media exposure, body mass index and caste were not significant predictors of unintended pregnancy in India. Conclusions The present study discloses that unintended pregnancy among adolescents and young women is a significant obstacle to achieving commendable reproductive health in India. The study reports important findings which can be beneficial for the policymakers and health care providers to formulate target-based programmes to reduce unintended pregnancy among the young population in India.