Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil.

Objectives: To assess time trends in unplanned pregnancy, stratified by sociodemographic status, reproductive history, and inequalities in family income and women's skin color, in Pelotas, Brazil.

Methods: Data from mothers of participants of the 1993 (N = 5264), 2004 (N = 4243), and 2015 (N = 4268) Pelotas birth cohorts were analyzed. Unplanned pregnancy was investigated in the perinatal period, with tests to assess changes over time among different sociodemographic and reproductive history subgroups and inequalities as a function of family income and skin color.

Results: The prevalence of unplanned pregnancy was 62.7% (3299/ 5264), 65.9% (2794/ 4243), and 52.2% (2226/ 4268) in the 1993, 2004, and 2015 cohorts, respectively. Black or brown women and women of lower socioeconomic status had a higher prevalence of unplanned pregnancy in all cohorts. The overall rate of unplanned pregnancy decreased over time in most subgroups. Inequality as a function of family income and skin color increased during the time frame of assessment.

Conclusions: The prevalence of unplanned pregnancies decreased in the period analyzed, but it is still unjustifiably high. Efforts aimed at reducing unplanned pregnancy are vital and will require special attention to the most vulnerable groups.