Trends in prevalence and determinants of unintended pregnancy among Bangladeshi women from 2007 to 2018: A comparative analysis of multiple Demographic Health Surveys

Background Unintended pregnancy is a global challenge, particularly prevalent in developing regions, with significant negative impacts on women’s health and well-being. Bangladesh has made progress in fertility decline but still faces challenges due to high rates of unintended pregnancies, unsafe abortions, and limited contraceptive use. Methods The analysis utilized secondary data from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 2007, 2011, 2014, and 2017-18. The surveys employed a nationally representative sampling frame using a two-stage sampling technique, covering residential households across Bangladesh. The study included 28042 ever-married women aged 15-49 from the four surveys. Descriptive statistics and chi-squared tests examined the relationships between the explanatory and dependent variables. Binary logistic regression was performed to determine the adjusted effects of the selected factors, presenting the results as odds ratios (OR) with 95% confidence intervals (CI). Stata 15 software was used for data analysis, with (p < 0.05) considered statistically significant. Results The percentage of unintended pregnancies decreased from 29% in 2007 to 21% in 2017-18. Mothers aged 20-29 years had lower likelihood of unintended pregnancy (OR: 0.73-0.81), compared to aged 30 years and above (OR: 1.40). Mothers with secondary education were more likely to have unintended pregnancy in 2007 (OR: 1.28), but less likely in 2011 (OR: 0.75). Employed mothers had higher likelihood of unintended pregnancy (OR: 1.19-1.31), while Muslim mothers had higher likelihood in 2011 and 2014 (OR: 1.33-1.53), but lower likelihood in 2017-18 (OR: 0.73). Unmet need for contraception was consistently associated with higher odds of unintended pregnancy (OR: 2.12-3.94). Conclusion Unintended pregnancies in Bangladesh have decreased over the past decade, but still pose challenges for women’s reproductive health. Targeted efforts are needed to address factors such as poverty, education, contraception access, and cultural norms to further reduce unintended pregnancies and improve maternal and child well-being.