Of the estimated 210 million pregnancies that occur throughout the world each year, about 38 % are unplanned. The percentage of unplanned pregnancies occurring in Anguilla is not known but it is estimated that it is significant and tends to occur at certain peak times in the year like the August festivities.

Factors linked to unplanned pregnancies

Unplanned pregnancies occur in all age groups, but teenagers have the highest rates of unplanned pregnancies, while women over 35 years old have the greatest proportion of unwanted pregnancies.
Surprisingly, women are more likely to have an unplanned birth if they use modern family planning methods. This reveals the problems with contraception use, including discontinuation or contraception failure. Many health professionals, including some doctors, still tell women to stop one method of contraception and do not provide an alternative method.

Unplanned teenage pregnancy
Approximately one in every five births in Anguilla occurs in teenagers. The proportion of unplanned teenage pregnancies is not known but it is estimated that it is significant. Many adolescents who become pregnant often fail to seek medical care during their pregnancy, leading to an increased risk of medical complications. Pregnant teenagers require special understanding, medical care and education particularly about nutrition, infections, substance abuse and complications of pregnancy. All pregnant teenagers should have medical care beginning very early in their pregnancy.

Preventing unplanned pregnancies
Preventing unplanned pregnancies is not an easy task. Strategies will be different for teenagers and non-teenagers.

Teenagers
Research indicates that sex education and access to effective contraception are essential in preventing unplanned pregnancies in the teenage population. Adult parents can help prevent teenage pregnancy through open communication and by providing guidance to their children about sexuality, contraception and the risks and responsibilities of intimate relationships and pregnancy.

A comprehensive sex and relationship education package for all primary and secondary schools is needed. This package should be drawn up with the participation of all stakeholders including teenagers.

We must empower youths to delay sexual relations until they feel they are ready to accept sexual responsibility. We must also help young people to develop decision-making skills and feel confident and empowered to follow through on decisions.

There must be more male involvement in programmes to prevent teenage pregnancies. Young men must be more responsible in their actions and be aware of the consequences of their actions.
Teenagers must be aware of the many different types of contraceptives available in Anguilla.

Non teenagers
Many of the unplanned pregnancies in the older woman are related to problems with contraception or failure to use contraceptives. Many individuals are still not sure what to do if they miss more than one pill. Many individuals still feel they must give they body a “rest” before using another method of contraception.
Many adults and teenagers still feel they can engage in sexual activity and will not become pregnant. Some individuals sometimes make faulty decisions while under the influence of excessive alcohol and drugs resulting in unplanned pregnancies.

Methods of contraception available in Anguilla
There are a variety of methods of contraception available in Anguilla. You can get more information by visiting or contacting the Anguilla Family Planning Association office, your doctor, family planning clinic or any other health professional.

Emergency contraception
The purpose of emergency contraception is to prevent unplanned pregnancies. It is not to be used as an ongoing method of birth control.It should be used when other methods of contraception, such as a broken condom, or a series of forgotten birth control pills have failed. Emergency contraception is also appropriate after forced sex such as rape. Emergency contraception must be used with 72 hours of sexual intercourse.

Options for an unplanned pregnancy
An unplanned pregnancy can be a crisis for the individual. Common reactions include anger, guilt and denial. If the father is young, similar reactions can occur to him as well. Sensitive counseling is important. Various options should be discussed. These may include continuation of the pregnancy, adoption, foster care for the baby and abortion.

Conclusion
Being a parent is often described as one of the most challenging and rewarding experiences in life, but an unplanned pregnancy can be very stressful and can lead to long term problems in many major areas of an individual’s life. It is important for individuals to prevent unplanned pregnancies as much as possible. Primary preventative measures must be encouraged as much as possible. Strategies for this will involved many government agencies and non-government groups such as the Anguilla Family Planning Association. If an unplanned pregnancy occurs the individual and her family deserves honest and sensitive counseling about options available to them. The pregnant woman must be supported in her decision at this difficult time in her life.

Ask Your Doctor is a health education column and is not a substitute for medical advise from your physician. Dr. Brett Hodge is an obstetrician/gynecologist and family doctor who has over 20 years in clinical practice.

Dr. Hodge has a medical practice in the Johson Building in The Valley.

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