1. Contraception use and pregnancy intention: a survey of young women Pamela Lotke 1, Kirsten Black 2, Josefina Lira 3, Nikki Zite 4 1 Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Tucson, AZ 2 Discipline of Obstetrics, Gynaecology, and Neonatology, University of Sydney, Sydney, Australia 3 Department of Adolescent Gynecology, Instituto Nacional de Perinatologia, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico 4 Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN Background Unintended pregnancies remain common in virtually all countries of the world. Depending on circumstances, these pregnancies may result in abortion or live birth. Prior unplanned pregnancy (UPP) and future fertility plans may alter a woman’s choice of contraceptive method. Objectives A strategy to reduce the number of unintended pregnancies and abortions is to increase uptake of long acting reversible contraception (LARC) We sought to determine if a self-reported history of UPP, or future pregnancy intentions altered current contraception use. Methods Using data from an anonymous, online survey of women aged 20 to 30 years old in 17 countries, we examined current contraceptive use, pregnancy intention, and history of UPP. The survey was conducted in February and March 2012 by the global marketing research company GfK, with funding from Bayer Healthcare. The countries were US, Canada, Germany, France, UK, Italy, Switzerland, Austria, Belgium, Sweden, Ukraine, Mexico, Brazil, Colombia, Argentina, S Korea, and Australia. Results 8,837 young women participated in the survey, with 750 from the US, 4,967 from Canada/Europe, 1,953 from Latin American, and 1,167 from Asia/Pacific. Overall 69.5% were nulliparous, and evenly divided in age 20- 24, and 25-30 years old. Results Most respondents had used some form of contraception in the past, with male condoms (79%) being most commonly reported. 62% had used combined oral contraceptives (COC) and 30% had taken emergency contraception. Contraceptive method % women reporting current use COCs31.4% Male condoms25.7% LARC IUC Implants 6.2% 4.5% 1.7% None22.3% Current contraceptive use among ever users Unplanned pregnancy by parity and country 23.5% of respondents reported a prior UPP, 10% of nulliparous women and 55% of parous women. Women who reported UPP were more than twice as likely to be using LARC, nonetheless, over 20% of women, with and without history of UPP, were not using any method. Parous women were also more than twice as likely to use LARC than nulliparas, and in multivariate regression the difference in LARC use was due to parity, not UPP LARCNo contra Past UPP Yes No 10.2% 4.3% (p<0.001) 21.2% 22.8% (NS) Parity Parous Nulliparous 11.3% 3.4% (p<0.001) 21.1% 22.9% (NS) UPP now? V. unhappy Neutral/happy 5.8% 5.8% (NS) 19.9% 23.2% (p=0.004) Future pregnancy? Never Yes/ unsure 10.6% 5.2% (p<0.001) 16.8% 23.0% (p<0.001) Results There was no difference in LARC use by women who stated they would be very unhappy with UPP now, but more of these women were using some method. Women who never want a future pregnancy were twice as likely to use LARC and also more likely to be using some form of contraception. Conclusions UPP is very common, resulting in many abortions and unplanned births. While a history of UPP, or no desire for a future pregnancy seem to influence LARC utilization, many women who do not desire pregnancy are still not using contraception, and the overall number of LARC users remains small. Education is needed to improve contraception use for those at risk for UPP, and increase the percentage of women using the most effective methods. INTRA is a group of independent physicians with expertise in contraception, whose creation was facilitated by Bayer Healthcare.