2025 Publication – Factors associated with unplanned pregnancy among Malaysian women of reproductive age: evidence from

Background About one third of women have experienced unplanned pregnancy in Malaysia, an upper middle-income country, which is greater than what is reported in high income countries. Use of effective contraception has been proven to reduce the likelihood of a subsequent unplanned pregnancy, but there are limited data on contraceptive choices, and other socio-demographic factors among women across various districts in Malaysia who have had an unplanned pregnancy. Aim We investigated factors associated with a history of unplanned pregnancy, and intention to become pregnant in the near future, among reproductively aged women in Malaysia. Study setting and methodology Retrospective study based on data collected from the Mothers and Infants in SEACO (South East Asian Community Observatory) Segamat Project (MISS-P) between 2013 and 2021. Women who were known to have given birth were approached by trained data collectors within 0–16 weeks after childbirth. Multivariable backward stepwise logistic regression was used to assess socio-demographic factors associated with unplanned pregnancy and pregnancy spacing with a p value significance level of <0.05. A total of 4278 Malaysian postpartum mothers completed a survey, with a range of measures, including sociodemographic questions and contraceptive behaviours. Results Approximately 29% of women aged 15 to 47 had a history of unplanned pregnancy and 41% reported not currently using any type of contraception. Around 94% of women reported not having ready access to contraception. The most commonly used method of contraception was the oral contraceptive pill. Being older than 25 years was associated with a reduced likelihood of a history of unplanned pregnancy, while not currently using contraception was associated with a greater likelihood of having had a previous unplanned pregnancy. Women using long acting reversible contraception and the contraceptive injection were less likely to be planning a pregnancy in the near future (< 3 years). Conclusions There is low contraceptive use in this sample, particularly among women who have had a history of unplanned pregnancy, with lack of access to contraception cited as the main driver. Mothers, as well as young women, in Malaysia may benefit from health promotion activities to further inform contraceptive counselling interventions to reduce the risk of subsequent unplanned pregnancies and improve pregnancy planning.