October 2018

No one to turn to: Low social support and the incidence of undesired pregnancy in the United States

Moseson H, Dehlendorf C, Gerdts C, Vittinghoff E, Hiatt RA, Barber J. No one to turn to: Low social support and the incidence of undesired pregnancy in the United States. Contraception. 2018 Oct;98(4):275-280.

OBJECTIVE: Young women may experience social barriers to achieving their reproductive goals. This analysis explored whether low socialsupport may contribute to the high incidence of undesired pregnancy in young women in the United States.

STUDY DESIGN: Using 6 months of data from a prospective cohort of 970 women ages 18-22 years in the United States, we described contraceptive use and applied multivariable logistic regression and standardization to estimate adjusted odds and absolute risk of undesiredpregnancy among women reporting low social support versus higher social support. We investigated several measures of contraceptive use as possible explanations for this pathway.

RESULTS: Sixty-five pregnancies were reported in the 6 months of the study, of which 30 (46%) were classified as undesired prior to conception. Among young women who reported low social support, 8% reported an undesired pregnancy during the study period as compared to 3% of the young women who reported higher levels of social support. Among non-black women, those who reported low socialsupport had nearly seven times the odds of an undesired pregnancy as compared to women who reported higher social support (aOR: 6.8, 95%CI: 1.7, 27.1). We found no association between social support and undesired pregnancy among young black women. Contraceptive method use differed by social support at baseline, and throughout follow-up.

CONCLUSIONS: Low social support - defined as the feeling of not having anyone to turn to - may be a risk factor for persistently high levels of undesired pregnancy among young women in the U.S. This association may be driven by differences in contraceptive use by level of socialsupport.

IMPLICATIONS: Interventions to increase young women's perceptions of social support may reduce the risk of undesired pregnancy for some individuals.