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Unintended pregnancy is a global health problem because it is a cause of maternal and infant mortality as well as a trigger for stress and depression in mothers. In addition, unintended pregnancy will disrupt the marital relationship and can affect the socio-economic conditions of a country. The number of unintended pregnancies worldwide is still high, occurring in 1 in 4 pregnancies. In Indonesia, the prevalence of unintended pregnancies is 15% of the total pregnancies. As far as is known, studies discussing the determinants of unintended pregnancies in Indonesia are still limited. Therefore, this study aims to explore the determinants of unintended pregnancies in Indonesia using data from the 2017 IDHS. The cross-sectional research design includes the entire 2017 IDHS sample totaling 15,316 respondents. The results showed that the prevalence of unintended pregnancies in women with live births in the last 3 – 5 years was around 16%. The highest proportion of unintended pregnancies in Indonesia occurred at 36-49 years old, with diploma/graduate degree, employed, richest, lived in a city, unmarried, grand multiparas, had complications during pregnancy and parturition, had high contraceptive knowledge, and did not know each other's preferences. In the bivariate analysis, age, economic status, place of residence, marital status, parity, complication pregnancy, fertility preference, and contraceptive knowledge were statistically significant with unintended pregnancies. Multivariate analysis showed determinants of unintended pregnancy, including age, education level, type of residence, parity, and fertility preference. Preventing unintended pregnancies can be done through individual or pair family planning counseling, increasing postpartum and male contraception, starting sex education in the family, and avoiding risky sexual relations.
Kehamilan Tidak Diinginkan (KTD) terjadi setidaknya sebanyak 121 juta kasus secara global dari tahun 2015-2019. Tingginya angka prevalens ini menunjukkan bahwa KTD merupakan salah satu masalah kesehatan masyarakat yang dapat membawa banyak dampak negatif baik dalam bidang kesehatan, sosial dan finansial. Dari seluruh KTD yang terjadi secara global, setengahnya berakhir dengan aborsi. Kematian Ibu yang mengalami KTD juga berhubungan dengan karena kurangnya perawatan antenatal yang dapat meningkatkan risiko komplikasi kehamilan akibat ketidaktahuannya tentang kehamilannya. Kunci untuk mencegah KTD adalah menggunakan kontrasepsi dengan begitu WUS dan PUS dapat merencanakan atau menunda kehamilan. Untuk memahami KTD lebih baik dapat dilakukan dengan mengenali faktor apa saja yang berhubungan dengan KTD. Bertujuan untuk mengetahui faktor apa saja yang berhubungan dengan Kehamilan Tidak Diinginkan. Penelitian ini menggunakan desain studi cross-sectional menggunakan data sekunder SDKI 2017. Sampel penelitian adalah Wanita Usia Subur yang sedang hamil saat survei dilakukan. Prevalensi kehamilan tidak diinginkan adalah sebesar 7,5% dengan 6,8% merupakan kehamilan yang tidak tepat waktu dan 0,7% kehamilan tidak diinginkan sama sekali. Faktor Intrapersonal, yakni; Usia, [PR 0,59 CI 95%: 0,37-0,97 p-value 0,036], Status Perkawinan [PR 6,03 CI 95% 3,7-9,9 p-value 0,000] dan Paritas [PR 0,42 CI 95% 0,26-0,67 p-value 0,000) dan Faktor Struktural, yaitu; Wilayah Tempat Tinggal [PR 1,625 CI 95% 1,06-2,57 , nilai p = 0,024] memiliki hubungan yang signifikan dengan Kejadian Kehamilan Tidak Diinginkan di Indonesia tahun 2017. Diperlukan lebih banyak edukasi kesehatan reproduksi yang tak hanya mencakup aspek biologis namun juga akibat dari sosial, mental dan finansial dari KTD. Pemerintah juga perlu menetapkan UU yang lebih ketat terhadap usia minimal perkawinan dan memastikan WUS mendapatkan akses yang baik terhadap kontrasepsi. Selain itu juga surveilans bagi akseptor KB perlu lebih diperhatikan agar perencanaan kehamilan dapat lebih efektif untuk menghindari KTD.
There are approximately 121 million unintended pregnancies globally from 2015 to 2019. Those high numbers show that unplanned pregnancy is still a significant public health problem, especially when half of all unintended pregnancies ended up in abortion. Unwanted pregnancy also brings other negative effects aside from the health aspect, such as social and financial problems. Women who are experiencing unintended pregnancy tend to neglect their, and the fetus’ health such as missing antenatal care, which risks higher pregnancy complications that can lead to maternal death. Maternal and Neonatal Death Rate is one of the indicators for the 3rd SDGs. Contraception is the key to preventing unplanned or unintended pregnancy. It is important to find out what are the factors contributing to Unintended Pregnancies so that we have the correct information that would be considered for making an effective preventative public health policy and health laws. This study aims to recognize the factors related to unintended pregnancy, in hopes that by knowing the risk factors, unintended pregnancy can be prevented. This study was conducted using cross-sectional studies and uses Indonesian DHS 2017 Secondary Data, the sample for this study is women of childbearing age who were currently pregnant during the survey. The prevalence of unintended pregnancy in Indonesia is 7,5%, which consist of 6,8% of mistimed pregnancy and 0,7% of unwanted pregnancy. Intrapersonal Factors such as Age [PR 0,59 CI 95%: 0,37-0,97 p-value 0,036], Marriage Status [PR 6,03 CI 95% 3,7-9,9 p-value 0,001] and Parity [PR 0,42 CI 95% 0,26-0,67 p-value 0,001) and Structural Factor such as Place of Residence [PR 1,625 CI 95% 1,06-2,57 , p value = 0,024] has statistically significant association (p-value <0,05) with the cases of Unintended Pregnancy in Indonesia 2017. More reproductive health education is needed which does not only cover biological aspects but also the social, mental and financial consequences of unwanted pregnancy. The government also needs to enact stricter laws regarding the minimum age for marriage and ensure that women of childbearing age can have good access to contraception. In addition, surveillance for family planning acceptors needs to be paid more attention so that pregnancy planning can be more effective in preventing unwanted pregnancies. Keywords: Unintended Pregnancy, Unwanted Pregnancy, Women of Childbearing Age, Factors related to unintended pregnancy
