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Four in 10 babies born in L.A. County began as unplanned pregnancies, study finds

March 31, 2010 | 12:58 pm
http://latimesblogs.latimes.com/.a/6a00d8341c630a53ef0120a5ae1ee8970b-320wiAbout 40% of births in Los Angeles County each year are the result of unplanned pregnancies, which can endanger the health of babies, according to a study released Wednesday by the county’s Department of Public Health.

The figure was based primarily on a county survey completed in 2006 of more than 5,200 women ages 13 to 56 who had recently delivered. The percentage of unplanned pregnancies was about the same among women who gave birth and those who suffered stillbirths and miscarriages, according to Dr. Susie Baldwin, chief of the department’s health assessment unit, which produced the study “Healthy Women, Healthy Children.”

The study did not include women whose latest pregnancy ended in abortion, who earlier studies show have a much higher percentage of unplanned pregnancies, Baldwin said.

Although state studies show that for the same time period as the county study about 43% of births were unplanned statewide, the county numbers still trouble public health experts because women who do not realize they are pregnant are likely to delay prenatal care and may smoke or drink alcohol. Women who have had another child within six months of an unplanned pregnancy are at even greater risk, and are more likely to have a child born prematurely with a low birth weight, researchers found.

Statewide and nationally, the number of unplanned pregnancies has remained relatively unchanged in recent years experts said, despite efforts by the U.S. Department of Health and Human Services to reduce all unplanned pregnancies to 30% by this year.

“All pregnancies should be planned. An unplanned pregnancy should be a rare thing,” Baldwin said. “It goes back to education and access.”

A lack of health insurance and regular access to care may have contributed to the number of unplanned pregnancies, Baldwin said.

Researchers found 23% of women of childbearing age lacked health insurance, and 20% said they did not have a regular source of health care. Those percentages were even higher among women who had recently delivered babies — 36% lacked insurance, 33% lacked regular health care.

The lack of regular care may affect women’s ability to plan for pregnancy.

About 80% of those at risk for pregnancy reported using a regular form of birth control the last time they had sex, although that percentage varied by ethnicity — 87% of whites compared with 81% of Asians, 80% of Latinas and 67% of African Americans.

About 82% of women who had recently delivered a baby said they had received information about the importance of prenatal vitamins containing folic acid, but only 57% of them had taken the vitamins before becoming pregnant.

Researchers proposed developing minimum preconception care requirements and extending Medi-Cal benefits for mothers with high-risk pregnancies for two years postpartum.

“The opportunity to impact the health of a baby starts before conception, and the health of a potential mother should be a priority long before pregnancy,” said Jonathan E. Fielding, the county’s public health director.

Worldwide, the rate of unintended pregnancy declined by 20% between 1995 and 2008, from 69 to 55 per 1,000 women aged 15 to 44. The decline was greater in the more developed world, where the rate fell by 29% (from 59 to 42 per 1,000 women), than in the less developed world, where it fell by 20% (from 71 to 57 per 1,000), according to a study by the Guttmacher Institute.

-- Molly Hennessy-Fiske

Photo: Los Angeles Times