Contraceptive failure and its role in unplanned pregnancies: new estimates using Demographic and Health Survey calendar data

Sarah E.K. Bradley, Macro International Inc.

Demographic and Health Survey (DHS) calendar data has a wealth of contraceptive use dynamics information, which can help to understand the levels of contraceptive failure and the role of contraceptive failure on unplanned pregnancies. We estimate levels of contraceptive failure and the effect of contraceptive failure on unplanned pregnancies. Data come from the most recent DHS surveys in Armenia, Bangladesh, Colombia, the Dominican Republic, Egypt, Indonesia, Kenya, and Zimbabwe. We use competing risks estimates to determine the cumulative incidence of failure, overall and by method. We also estimate the attributable risk of contraceptive failure on unplanned pregnancies. Large proportions of unwanted pregnancies are the result of contraceptive failure. Results will help policymakers and program managers understand the impact of contraceptive failure on unplanned pregnancies and provide useful information on prevention of unwanted pregnancies.