Unplanned pregnancies of women with chronic health conditions in New Zealand.

Aim: Chronic health conditions can pose risks for pregnancy and childbearing which may be mitigated by preconception care and pregnancy planning. The objective of this study is to identify the proportion of pregnancies reported as unplanned among women in New Zealand with chronic health conditions and the co-occurrence of these pregnancies with socioeconomc disadvantage. Method: This study included 6,822 pregnant women in the Growing Up in New Zealand study. Nearly 15% identified a chronic health condition, including diabetes, heart disease, asthma, depression and anxiety.

Results: Pregnancies were reported as unplanned by 45% of women with chronic health conditions, as compared to 39% of women without these conditions. Among women with chronic conditions, those who identified as Māori or Pacific Islander reported two-thirds of their pregnancies as unplanned, and those who were younger, had less education, were lower-income or did not have a co-resident partner reported between 50-80% of their pregnancies as unplanned.

Conclusion: Obstetricians and midwives in New Zealand should be prepared to provide care for women with chronic conditions who may have surprise pregnancies. Comprehensive family planning services, preconception care and systemwide reduction in health inequities are needed to help women with chronic health conditions enter pregnancy as healthy as possible.