Abstract
BACKGROUND: Approximately 44% of Nepalese women ages 15-49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually. OBJECTIVES: This study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies. STUDY DESIGN: Data were collected longitudinally from 200 recently married women ages 18-25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, "When would you like to have a child in case you were to have one?" Participants were recategorized into a dichotomous variable for analytical purposes: "Right away" or "Not right away." RESULTS: A total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51-6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals. CONCLUSIONS: Young, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.