Women with unwanted pregnancies, their psychosocial problems, and contraceptive use in primary care in Northern Netherlands: insights from a primary care registry database

Abstract

Abstract Introduction Globally an estimated 1 in 16 women per year experience an unwanted pregnancy (UWP). In the Netherlands, general practitioners (GPs) play an important role in providing care for women with UWP; however, it is unknown how many of these women consult their GP about the pregnancy. UWPs are a major life experience with a possible influence on mental health. Data that GPs register about UWPs, psychosocial problems, and contraceptive use could give more insight into care needs. Aims To create an overview of (i) the prevalence of UWPs in general practice, (ii) the prevalence of psychosocial problems in women with UWP, and (iii) contraceptive use of women with UWP. Methods GP registration data were analysed from 58 general practices located in Northern Netherlands between 2015 and 2019. Patient files were checked for registration of ICPC and ATC codes concerning pregnancy, psychosocial health, and contraceptive use. Chi-square and Fisher’s exact test were used to calculate differences between women with a UWP and women with a wanted pregnancy (WP). An analysis of registration dates was conducted to determine when the psychosocial problems were registered in relation to the pregnancy. Results Of female patients of reproductive age, 1.6% had a UWP and 11.8% had a WP. Women with a UWP reported statistically significantly more psychosocial problems. Furthermore, statistically significantly more contraceptive methods were prescribed to women with UWP compared with both women with WP and women without pregnancy. Discussion and conclusion The finding that women with UWP experience more psychosocial problems can be used to improve aftercare and can be incorporated into current guidelines for GPs.