The prevalence and variations in unintended pregnancy by socio-demographic and health-related factors in a population-based cohort of young Australian women.

Objective: The aim of this study is to estimate the prevalence of unintended pregnancy and associated socio-demographic and health-related factors among a national cohort of young Australian women.

Methods: Secondary analysis of three waves (2013-2015) of the Australian Longitudinal Study on Women's Health new young cohort. Women born between 1989 and 1995 were recruited through internet and traditional media, and peer referral. Respondents completed a baseline web-based survey in 2013 (n=17,010) on their health and healthcare use and were followed up annually. This analysis uses data from women reporting ever having vaginal sex in waves 2 (n=9,726/11,344) and 3 (n=6,848/8,961). We assessed correlates of lifetime and recent unintended pregnancy using multivariable regression models.

Results: At wave 2, among women aged 19-24, lifetime prevalence of unintended pregnancy was 12.6%, rising to 81.0% among ever pregnant women. Pregnancy outcomes among women with a history of unintended pregnancy differed by geographical residence. Disparities in odds of unintended pregnancy were seen by relationship and educational status, contraceptive use, sexual coercion and risky alcohol use.

Conclusions: Unintended pregnancy among young Australians is disproportionally experienced by women with structural disadvantages and exposure to sexual coercion.

Public Health Implications: Service improvements to achieve equitable distribution of contraception and abortion services must be integrated with initiatives responding to sexual coercion.