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Abstract Conclusions and recommendations Unintended pregnancy is a worldwide urgent problem which is accompanied by many problems at the country level as well as at the family level. It increases the maternal complications during pregnancy, risk of LBW and risk of decreased breast feeding. There is no doubt that estimating the determinants of unintended pregnancy will lead to improvements in efforts to avoid those pregnancies, and improve the well-being of women and children (Santelli et al., 2003). Studying unintended pregnancy gives public health practitioners and demographers the chance to understand fertility patterns and to plan more efficient and successful interventions to improve maternal and child health. Results of the current study identified predictors of unintended pregnancy in women in Sohag district and provide a basis for future research into these associations. Prevalence of unintended pregnancy in Sohag district is higher than that measured in Beheira Governorate (23.6%) (Youssef et al., 2002).Based on the findings of the study, we recommend more interventions concerning reproductive health programs and services, especially qualitative aspects of the programs and more care given to Upper Egypt. Health services don’t differ only between lower and upper Egypt, but also between urban and rural places in the same governorate. The increased rate of unintended pregnancy among rural women reflects the poor health conditions and the ignorance of rural areas. Unintended pregnancy is more common among families living in lower economic level. This indicates deficiency of family planning programs to reach all population sectors. Cultural beliefs such as appreciation of male gendered kids are strong risk factors in unintended pregnancy. The increased risk of unintended pregnancy with decreased birth interval reflects the failure of using methods for spacing which are usually non long acting methods -which need awareness about usage to be efficacious- and reflects the lack of health education to those women. Unmet needs of contraception are high among women in Sohag district. The most common cause of non-use is side effects or fear of side effects. Most women stop the method if any complication happened and they take their information from neighbors which are usually wrong. Effective family planning programs should satisfy the needs of all women during their reproductive life. Health programs should take into consideration the qualitative aspects and more care should be given to promote health awareness of the women. Researchers have proposed some policy recommendations based on the findings of the present study that could be useful in developing strategy to reduce unintended pregnancy among married women of the reproductive age in Sohag: More logistic, educational and health support is needed to be offered to Upper Egypt. More care is needed to be directed to rural areas. Increasing economic level of the struggling population. Increasing educational sessions trying to change the cultural beliefs of preferring male gender. Women need to get more information about contraception, its complications and its proper use, beside better access to contraceptive services. So family planning program should aim to raise awareness about effective use as well as to reduce the unmet need of contraception. Summary The rate at which the world population is growing creates a great challenge to the international community. The world population reached 7.4 billion at mid-2016 and is still predicted to increase to reach about 9.7 billion in 2050 and 11.2 billion in 2100. Only 17% of the world population lives in the more developed countries. Seventy percent or more of the world’s population growth between 2010 and 2050 will occur in 24 of the world’s poorest countries with the highest fertility rates. Unintended pregnancy is an important worldwide public health problem that affects not only women and their families but also affects society. Unintended pregnancies is classified into mistimed i.e. occurring earlier than desired or unwanted i.e. occurring when no children, or no more children, were desired. About 85 million pregnancies were unintended (40%) in 2012, Africa had the highest rate and Europe had the lowest one. This study aimed to explore the determinants of unintended pregnancy and its relationship with adverse pregnancy outcomes. A cross-sectional study was carried out among 600 women at Sohag city, Tunis village and El-Sheikh Makram village. Analysis of the collected data revealed the following: Sociodemographic risk factors: Approximately 13.2 percent of women in the study reported that their most recent pregnancy was unwanted. Approximately 17.5 percent of pregnancies were mistimed, with total 30.7 percent representing unintended pregnancy. At the bivariate level, unintended pregnancy was found to be significantly affected by residence; women at rural areas are more liable to unintended pregnancy by 1.5 times more than urban ones. Working mothers were two folds more prone to unintended pregnancy than non-working mothers Families with higher income complain 40% less of unintended pregnancy compared to those with income below the standard level. Obstetric risk factors: The more deliveries and number of living children, the more liability for unintended pregnancy will happen. Women who achieved their desired family size were more liable for unintended pregnancy than who didn’t achieved ideal size by 39 folds. Women who spaced between kids 1-2 years carries 34% less risk in developing unintended pregnancy compared to those spaced less than one year. Also it was found that 22.5% of women who didn’t use any methods had unintended pregnancy and the most common cause of non- contraception usage was side effects/fear of side effects followed by husband opposing method usage. Outcomes of unintended pregnancy: Women with unintended pregnancy were 4.38 times more susceptible to start ANC after 1st trimester. They were 80% more liable to complications than those with intended pregnancies. Unintended babies were one and half times more liable to be of low birth weight compared to being of average birth weight. Unintended babies were more than two folds more liable not to be fed by their mothers milk compared to being breast fed. Recommendations: More logistic, educational and health support is needed to be offered to Upper Egypt. More care is needed to be directed to rural areas. Increasing economic level of the struggling population. Increasing educational sessions trying to change the cultural beliefs of preferring male gender. Women need to get more information about contraception, its complications and its proper use, beside better access to contraceptive services. So family planning program should aim to raise awareness about effective use as well as to reduce the unmet need of contraception. |