Factors associated with contraceptive nonuse among US women ages 35–44 years at risk of unwanted pregnancy

BackgroundWomen ages 35 years and older have the greatest proportion of contraceptive nonuse and unintended pregnancies ending in abortion.Study DesignWe conducted a population-based case-control study among women ages 35–44 years at risk of unwanted pregnancy using the National Survey of Family Growth (NSFG) data to investigate risk factors for contraceptive nonuse.ResultsAt last intercourse, 9.8% of women reported not using any contraceptive method. Contraceptive nonusers, as compared to users, were more likely to be ages 40–44 years (OR=2.0, 95% CI 1.1–3.7), foreign-born (OR=4.3, 95% CI 1.9–9.7), black (OR=2.8, 95% CI 1.1–7.0), with household incomes 100–249% of the federal poverty level (FPL) (OR=2.5, 95% CI 1.1–5.8). Women who received contraceptive counseling in the past year had an 80% decreased risk of nonuse (95% CI 0.1–0.5).ConclusionPublic health strategies to reduce unintended pregnancy, particularly among women ages 35 years and older, should focus on addressing disparities in contraceptive use and promoting contraceptive counseling.