Reports on interviews conducted in rural Giza and urban Cairo with 20 ever-married women who had unintended pregnancies. Based on these interviews, a survey of 1,300 women who had been previously interviewed in the 1993 Egypt Use Effectiveness of Contraception Survey and the 1997 Social and Behavioral Effects of Unintended Pregnancy Survey.

Egypt

More than half the married women in Egypt use some method of family planning. However, unplanned pregnancies are a concern for many women. Sixty-two percent of women who report an unplanned pregnancy say they became pregnant while using a contraceptive method. Unintended pregnancies can mean health and financial problems for the woman and her family. Previous studies outside of Egypt also have shown that children born as the result of an unintended pregnancy may have lower birth weight and lower education levels and may suffer from parental neglect.

Research Findings

In-depth interviews were conducted in rural Giza and urban Cairo with 20 ever-married women who had unintended pregnancies. These interviews were used to construct a questionnaire, which was administered to 1,300 women who had been previously interviewed in the 1993 Egypt Use Effectiveness of Contraception Survey and the 1997 Social and Behavioral Effects of Unintended Pregnancy Survey. Researchers found:

• Attitudes about an unintended pregnancy differed between women and their husbands. Although few of the women were pleased at the news of their unintended pregnancy, 42 percent of them said their husbands were pleased. The main reason the women gave for their husbands' happiness was fondness for children.

• Couples who did not want another child cited the expense of childrearing, the infant's demand for time and attention, a "mistimed" pregnancy, the advanced age of the mother, health problems for the mother and fetus, and too many children of the same sex.

• The majority of study participants said an unintended pregnancy did not affect whether they sought prenatal care during the pregnancy. Nearly 80 percent of women said they sought prenatal care, as they had during other pregnancies, and gave birth in the same setting. Most of the infants weighed the same or more than their older siblings, were breastfed, and received the same or a greater number of immunizations.

• In the long-term, most women did not view an unintended pregnancy as an unwanted pregnancy. Once a child was born, women said they made no distinctions among their children. Nearly 60 percent of parents said unplanned children received the same amount of affection as other children in the family, while 38 percent said they received more. Parents said they expected that unplanned children would receive the same education as other children.

• Women said an unintended pregnancy most affected their ability to look after their own health. Other concerns were: additional financial burdens, added household duties, no personal time, and less time to spend socially or with other children. Women reported that their quality of life was reduced because of the extra time that the unplanned child required.

Recommendations

• Nearly two-thirds of Egyptian women reporting an unplanned pregnancy said they became pregnant while using a contraceptive method, including oral contraceptives and intrauterine devices. Because these methods are highly effective, at least some of the failures are likely due to user error. Health workers should offer better education and more contraceptive counseling to help Egyptian women understand how to use contraceptives correctly.

• More than one-third of women with unintended pregnancies said they tried to terminate their pregnancies through abortion. Because abortion is illegal in Egypt, many women sought clandestine or unsafe abortion. Women need information on the risks of unsafe abortion, and physicians need training in treating abortion complications.

• Thirty-eight percent of women were using no contraceptive method at all, although they did not want to become pregnant, because they wanted a "rest" from contraception, because they did not believe they could become pregnant, or because they feared side effects. Providers and women's advocates should educate women about the importance of correct and consistent use of contraception, as well as provide basic information about fertility and menstrual cycles.

Study Details

This study was conducted by F.A. Kader and Hesham Maklouf of the Cairo Demographic Center. Dr. Cynthia Waszak of Family Health International (FHI) served as technical monitor. This study was supported by the Women's Studies Project at FHI, through a Cooperative Agreement funded by the U.S. Agency for International Development with field support for the USAID Mission in Egypt.