Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey

Abstract Objective: Mistimed, unexpected or unwanted pregnancies occur in Australia, despite widespread contraception use. The objective was to estimate prevalence and ascertain modifiable social factors for prevention of unintended pregnancy. Methods: National population‐based survey of women and men aged 18–51 years recruited from a random sample of electors on the Australian Electoral Roll in 2013. Data were weighted to reduce non‐response bias. Factors associated with unintended pregnancy were identified in multivariable analyses. Results: Data from 2,235 completed questionnaires were analysed (Women: 69%; Men: 31%). Of those ever pregnant or partner in pregnancy (59%), 40% had experienced an unintended pregnancy. Adjusting for other risks, ever having experienced sexual coercion (AOR, 95%CI=Women 1.948; 1.458–2.601; Men 1.657, 1.014–2.708); socioeconomic disadvantage (AOR, 95%CI=Women 1.808, 1.373, 2.381; Men 1.360, 1.004–1.841), living in a rural area (AOR, 95%CI=Women 1.403, 1.056–1.864; Men 1.583, 1.161–2.159), and for men being born overseas (AOR, 95%CI 1.989, 1.317–3.002) were significantly associated with unintended pregnancy. Conclusions: Experiences of sexual coercion, social disadvantage, rural residence and overseas birth are independently associated with unintended pregnancy in Australia. Implications: Public health policy and health service initiatives should prioritise prevention of sexual coercion, reduction of social inequality and reduction of geographic inequality for those in rural areas

Barriers to managing fertility: findings from the understanding fertility management in contemporary Australia Facebook discussion group

BACKGROUND: As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men.&nbsp;OBJECTIVE: To identify public opinion about sexual and reproductive health in Australia.&nbsp;METHODS: To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically.&nbsp;RESULTS: There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management.&nbsp;CONCLUSIONS: Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health.</div

Post-bushfire relocation decision-making and personal wellbeing: a case study from Victoria, Australia

Abstract not available

The role of anger and ongoing stressors in mental health following a natural disaster

Objective: Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia’s worst natural disaster in over 100 years. Method: This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes. Results: Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men (p = .069), but remained significant (b = .234, p < .001) for women. Conclusions: Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences