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O'Connell is a smart twentysomething who treats her pregnancy like a new project, researching and planning. She envisions a natural birth and a year of wholesome breast feeding. But things do not go as she expects. Life throws curveballs, and after 40 hours of contractions, she opts for a C-section. She manages to nurse for a year but resents her baby's control over her body. This is not a book about the wonders of motherhood but about the tension between culturally inherited ideals and the realities of lived, bodily experience.

Periodic estimation of the incidence of global unintended pregnancy can help demonstrate the need for and impact of family planning programs. We draw upon multiple sources of data to estimate pregnancy incidence by intention status and outcome at worldwide, regional, and subregional levels in 2012 and to assess recent trends using previously published estimates for 2008 and 1995. We find that 213 million pregnancies occurred in 2012, up slightly from 211 million in 2008. The global pregnancy rate decreased only slightly from 2008 to 2012, after declining substantially between 1995 and 2008. Eighty-five million pregnancies, representing 40 percent of all pregnancies, were unintended in 2012. Of these, 50 percent ended in abortion, 13 percent ended in miscarriage, and 38 percent resulted in an unplanned birth. The unintended pregnancy rate continued to decline in Africa and in the Latin America and Caribbean region. If the aims of the London Summit on Family Planning are carried out, the incidence of unwanted and mistimed pregnancies should decline in the coming years.

\"[This book tells] the story of a Great Female Chef--a chef who was celebrated as one of the best in a world where men dominate, and the way that her pursuit of love, pleasure, and gustatory delights helped shape her life and career. Told from the perspective of her former assistant (and unrequited lover), now an aged chef himself, here is the story of a woman's quest to the front of the kitchen--and the extraordinary journey she takes along the way\"--Publisher marketing.

Background. The estimated lifetime prevalence of physical or sexual intimate partner violence (IPV) is 30% among women worldwide. Understanding risk and protective factors is essential for designing effective prevention strategies. Objectives. To quantify the associations between prospective–longitudinal risk and protective factors and IPV and identify evidence gaps. Search methods. We conducted systematic searches in 16 databases including MEDLINE and PsycINFO from inception to June 2016. The study protocol is registered with PROSPERO (CRD42016039213). Selection criteria. We included published and unpublished studies available in English that prospectively analyzed any risk or protective factor(s) for self-reported IPV victimization among women and controlled for at least 1 other variable. Data collection and analysis. Three reviewers were involved in study screening. One reviewer extracted estimates of association and study characteristics from each study and 2 reviewers independently checked a random subset of extractions. We assessed study quality with the Cambridge Quality Checklists. When studies investigated the same risk or protective factor using similar measures, we computed pooled odds ratios (ORs) by using random-effects meta-analyses. We summarized heterogeneity with I 2 and τ 2 . We synthesized all estimates of association, including those not meta-analyzed, by using harvest plots to illustrate evidence gaps and trends toward negative or positive associations. Main results. Of 18 608 studies identified, 60 were included and 35 meta-analyzed. Most studies were based in the United States. The strongest evidence for modifiable risk factors for IPV against women were unplanned pregnancy (OR = 1.66; 95% confidence interval [CI] = 1.20, 1.31) and having parents with less than a high-school education (OR = 1.55; 95% CI = 1.10, 2.17). Being older (OR = 0.96; 95% CI = 0.93, 0.98) or married (OR = 0.93; 95% CI = 0.87, 0.99) were protective. Conclusions. To our knowledge, this is the first systematic, meta-analytic review of all risk and protective factors for IPV against women without location, time, or publication restrictions. Unplanned pregnancy and having parents with less than a high-school education, which may indicate lower socioeconomic status, were shown to be risk factors, and being older or married were protective. However, no prospective–longitudinal study investigated the associations between IPV against women and any community or structural factor outside the United States, and more studies investigated risk factors related to women as opposed to their partners. Public health implications. This review highlights that prospective evidence for perpetrator- and context-related risk and protective factors for women’s experiences of IPV outside of the United States is lacking and urgently needed to inform global policy recommendations. The current evidence base of prospective studies suggests that, at least in the United States, education and sexual health interventions may be effective targets for preventing IPV against women, with young, unmarried women at greatest risk.

Esther Ann Hicks--Essie--is the youngest child on Six for Hicks, a reality television phenomenon. She's grown up in the spotlight, both idolized and despised for her family's fire-and-brimstone brand of faith. When Essie's mother, Celia, discovers that Essie is pregnant, she arranges an emergency meeting with the show's producers: Do they sneak Essie out of the country for an abortion? Do they pass the child off as Celia's? Or do they try to arrange a marriage--and a ratings-blockbuster wedding? Meanwhile, Essie is quietly pairing herself up with Roarke Richards, a senior at her school with a secret of his own to protect. As the newly formed couple attempt to sell their fabricated love story to the media--through exclusive interviews with an infamously conservative reporter named Liberty Bell--Essie finds she has questions of her own: What was the real reason for her older sister leaving home? Who can she trust with the truth about her family? And how much is she willing to sacrifice to win her own freedom?

The premise that unintended childbearing has significant negative effects on the behavior of mothers and on the health of infants strongly influences public health policy and much of current research on reproductive behaviors. Yet, the evidence base presents mixed findings. Using data from the U.S. National Survey of Family Growth, we employ a measure of pregnancy intentions that incorporates the extent of mistiming, as well as the desire scale developed by Santelli et al. (Studies in Family Planning, 40, 87-100, 2009). Second, we examine variation in the characteristics of mothers within intention status groups. Third, we account for the association of mothers' background characteristics with their pregnancy intentions and with the outcomes by employing propensity score weighting. We find that weighting eliminated statistical significance of many observed associations of intention status with maternal behaviors and birth outcomes, but not all. Mistimed and unwanted births were still less likely to be recognized early in pregnancy than intended ones. Fewer unwanted births received early prenatal care or were breast-fed, and unwanted births were also more likely than intended births to be of low birth weight. Relative to births at the highest level of the desire scale, all other births were significantly less likely to be recognized early in pregnancy and to receive early prenatal care.

Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08–2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

Abstract Perinatal depression is common, affecting approximately 7–13% of women. Studies have shown an association between unplanned pregnancy and perinatal depressive symptoms, but many used a cross-sectional design and limited postnatal follow-up. The current study investigated the association of unplanned pregnancy with perinatal depressive symptoms using a longitudinal cohort study that followed women from the first trimester until 12 months postpartum. Pregnant women (N = 1928) provided demographic and clinical data and information about pregnancy intention at the first trimester. Depressive symptoms were assessed during each trimester of pregnancy and five times postpartum using the Edinburgh Postnatal Depression Scale (EPDS) until 12 months postpartum. Mixed model analyses were used to investigate the association between an unplanned pregnancy and the level of depressive symptoms. Women with an unplanned pregnancy (N = 111, 5.8%) reported persistently higher levels of depressive symptoms during the entire perinatal period compared to women with a planned pregnancy, after adjustment for confounders (p < 0.001). However, the course of depressive symptom scores over time in women with an unplanned pregnancy was similar to that of women with a planned pregnancy. Lower age (p = 0.006), unemployment (p = 0.004), and history of depression (p < 0.001) were significantly associated with higher levels of perinatal depressive symptoms. An unplanned pregnancy may have a long-lasting negative impact on a woman’s perinatal mental health. Therefore, women with an unplanned pregnancy may benefit from systematic follow-up during the perinatal period with contingent mental health support.

Background and objectives An unintended pregnancy can lead to an unfavorable relationship between the mother and infant and also include pregnancies that, although unintended, become wanted and may not have the same risks. This study aimed to investigate the effect of attachment training on maternal and fetal attachment in women with unintended pregnancy. Method This clinical trial study was conducted in 2019 on 84 women (two groups of 42 subjects) with unintended pregnancies (at least 28 weeks in the third trimester of pregnancy) in selected clinics affiliated with Shiraz University of Medical Sciences. Cranley’s Maternal–Fetal Attachment Scale (MFAS) was completed before and after the intervention in both groups; a demographic information questionnaire was filled out and written consent forms were signed before the intervention in both groups. Then, attachment training classes were conducted for 6 sessions of 90 min in the intervention group, while the control group received only routine pregnancy care. Chi-square, Fisher and independent t-test were used to analyze the data. Findings The mean scores of maternal–fetal attachment before attachment training in the experimental (57. 24 ± 5.03) and control groups (57.29 ± 6.96) were not significantly different ( P  = 0.86). Based on the results of independent t-test, the mean scores of maternal–fetal attachment after training in the intervention (66.43 ± 1.76) and control (57.14 ± 5.03) groups were significantly different ( P  = 0.0001). Conclusion The findings of this study showed the positive effect of education on the attachment behaviors of mothers with unintended pregnancies. Therefore, it is recommended that attachment skills training should be used in prenatal training programs. Trial registration Iran Randomized Clinical Trial Center registration IRCT20130710013940N5, Date of first trial registration: 2019.02.02.

Background A comprehensive understanding of women’s lived experiences and perceived needs during unplanned pregnancy in abortion-restricted settings is essential for designing effective, context-sensitive interventions. This study aimed to explore Iranian Azari women’s experiences and perceptions of encountering an unplanned pregnancy. Methods This qualitative study employed a conventional content analysis approach. Purposive sampling was conducted from May to November 2024, in Tabriz, Iran. Data were collected through in-depth, semi-structured individual interviews with 13 pregnant women (gestational age 16–39 weeks) experiencing an unplanned pregnancy. Data collection and analysis were conducted concurrently using the Graneheim and Lundman (2004) content analysis method. Results The analysis revealed four main themes reflecting the participants’ experiences. The first theme, Encountering and Adapting to Unplanned Pregnancy , included initial shock, disbelief, resistance to acceptance, and gradual adaptation to the new condition. The second theme, Perceived Threats , encompassed intense personal, familial, and social concerns regarding the unplanned pregnancy. The third theme, Facilitators of Continuation Decision , reflected the influence of factors such as time passage, religious beliefs, hearing the fetal heartbeat, and social support in fostering pregnancy acceptance and reducing the desire for abortion. The final theme, Inadequacy of Healthcare and Support Systems , highlighted women’s feelings of isolation, being misunderstood, and dissatisfaction due to lack of adequate support from their families, healthcare systems, and social institutions, which exacerbated their emotional distress. Conclusion The findings suggest that women with unplanned pregnancies experience a range of emotional responses and initial resistance rooted in perceived personal, familial, and societal threats. In the context of legal and religious restrictions on abortion, many women feel compelled or choose to continue the pregnancy. In this process, perceived spousal and social support, along with adequacy and quality of antenatal care, plays a crucial role in shaping their experience. Trial registration Not applicable. Plain english summary Unplanned pregnancy refers to pregnancies that are either unwanted at the time of conception or mistimed, meaning the woman intended to become pregnant later. This study explored how Iranian Azari women experience and make sense of unplanned pregnancies, with the goal of identifying their challenges and unmet needs. A total of 13 women with unplanned pregnancies were purposefully selected with maximum variation. Data were collected through in-depth, semi-structured interviews guided by open-ended questions. The findings revealed four main themes: (1) emotional responses and adaptation to unplanned pregnancy, (2) perceived threats and concerns, (3) factors that facilitated the decision to continue the pregnancy, and (4) inadequacy of healthcare services and social support. By understanding these experiences, more responsive and supportive interventions can be designed to improve experiences and outcomes for women facing unplanned pregnancies.