Background
Little is known about unintended pregnancy risk and current contraceptive use among
women ≥45 years old in the United States.
Objectives
The purpose of this study was to describe the prevalence of women ages 45-50 years
old at risk for unintended pregnancy and their current contraceptive use, and to compare
these findings to those of women in younger age groups.
Study Design
We analyzed 2006, 2008, and 2010 Massachusetts Behavioral Risk Factor Surveillance
System data, the only state in the United States to collect contraceptive data routinely
from women >44 years old. Women 18-50 years old (n = 4930) were considered to be at
risk for unintended pregnancy unless they reported current pregnancy, hysterectomy,
not being sexually active in the past year, having a same-sex partner, or wanting
to become pregnant. Among women who were considered to be at risk (n = 3605), we estimated
the prevalence of current contraceptive use by age group. Among women who were considered
to be at risk and who were 45-50 years old (n = 940), we examined characteristics
that were associated with current method use. Analyses were conducted on weighted
data using SAS-callable SUDAAN (RTI International, Research Triangle Park, NC).
Results
Among women who were 45-50 years old, 77.6% were at risk for unintended pregnancy,
which was similar to other age groups. As age increased, hormonal contraceptive use
(shots, pills, patch, or ring) decreased, and permanent contraception (tubal ligation
or vasectomy) increased as did non-use of contraception. Of women who were 45-50 years
old and at risk for unintended pregnancy, 66.9% reported using some contraceptive
method; permanent contraception was the leading method reported by 44.0% and contraceptive
non-use was reported by 16.8%.
Conclusion
A substantial proportion of women who were 45-50 years old were considered to be at
risk for unintended pregnancy. Permanent contraception was most commonly used by women
in this age group. Compared with other age groups, more women who were 45-50 years
old were not using any contraception. Population-based surveillance efforts are needed
to follow trends among this age group and better meet their family planning needs.
Although expanding surveillance systems to include women through 50 years old requires
additional resources, fertility trends that show increasingly delayed childbearing,
uncertain end of fecundity, and potential adverse consequences of unplanned pregnancy
in older age may justify these expenditures.
Key words
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Article info
Publication history
Published online: December 13, 2015
Accepted:
December 7,
2015
Received in revised form:
November 11,
2015
Received:
August 10,
2015
Footnotes
E.M.G. reports research funding from Bayer and personal fees from Teva and Merck Pharmaceuticals, outside the submitted work. There are no other conflicts of interest.
The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
The authors thank E. Hawk and M. McKenna of the MA Department of Public Health for providing the data.
Cite this article as: Godfrey EM, Zapata LB, Cox CM, et al. Unintended pregnancy risk and contraceptive use among women 45-50 years old: Massachusetts, 2006, 2008, and 2010. Am J Obstet Gynecol 2016;214:712.e1-8.
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