Determinants of Unwanted Pregnancies Among Pregnant Women Attending Primary Health Care Centres in Kirkuk, Iraq: A Cross-Sectional Study

Abstract

Objective: This study aimed to determine the prevalence of unwanted pregnancies and examine associated socio-demographic and contraceptive-related factors among pregnant women attending primary healthcare centres in Kirkuk, Iraq, between December 2024 and February 2025.

Methods: A cross-sectional analytical study was conducted involving 500 pregnant women selected through purposive sampling across 20 primary healthcare centres and three hospitals. Data were collected via a structured, pretested questionnaire administered through face-to-face interviews. Descriptive and inferential statistics were performed using SPSS version 27. Statistical significance was set at p < 0.05 with a 99% confidence interval.

Results: The prevalence of unwanted pregnancies was 30.4%. Most women in this group were aged 24–29 years, resided in urban areas, and had lower educational and income levels compared to those with planned pregnancies. Despite 82.0% of women with unwanted pregnancies reporting previous contraceptive use, over half (52.0%) relied on withdrawal, and 9.6% used lactational amenorrhea methods with high failure rates. A significant association was found between contraceptive method type, duration of use, and pregnancy intention (p = 0.003 to 0.008).

Conclusion: Unwanted pregnancies remain a significant concern in Kirkuk, with a substantial proportion linked to reliance on less effective contraceptive methods. Enhanced access to long-acting reversible contraceptives, improved counselling, and integration of comprehensive family planning education into antenatal care are recommended to reduce unintended pregnancies and support reproductive autonomy.