Avoiding Unintended Pregnancy in Peru: Does the Quality of Family Planning Services Matter?

An analysis linking data on pregnancy intentions from the 1991-1992 Peru Demographic and Health Survey with information from a 1994 follow-up survey found that among 1,093 women from Nor-Oriental del Marañón and Lima who participated in both surveys, 20% had a mistimed or unwanted pregnancy in the 29 intervening months. In all, 15% had an unintended pregnancy ending in a live birth and 5% an unintended pregnancy with another outcome. The proportion having an unintended pregnancy was 32% in rural Nor-Oriental, 24% in urban Nor-Oriental and 13% in Lima. Unintended pregnancies were predominantly attributable to failure of a traditional contraceptive method (35% of such pregnancies) or nonuse of any method (26%). The proportion of women who failed to meet their reproductive goals between surveys declined as their education and the quality of available family planning services, as measured by a 1992 situation analysis, improved. The effect of quality of care on women's ability to avoid unwanted fertility was significant in logistic regression models including only service factors and women's demographic characteristics. In models including rural-urban residence and region, neither these variables nor quality of care had a significant effect.