Association of socioeconomic status with unintended pregnancy and induced abortion in married couples: An analysis of the 2021 national survey data in Japan

Background: An association of the major indicators of socioeconomic status with unintended pregnancy and induced abortion in married couples has not been investigated in Japan, and we investigated it using recent nationwide survey data in Japan. Methods: Data from the National Fertility Survey in 2021 in Japan, which evaluated the outcomes and intentions of previous pregnancies in married couples, were used. Number of unintended pregnancies, induced abortions, and unintended pregnancies ending in induced abortion was used as outcomes, and the number of unintended pregnancies ending in induced abortion was analyzed among couples who experienced an unintended pregnancy. Associations with current educational attainment, employment status, and household income were investigated using Poisson regression analysis. A complete-case analysis was conducted for dealing with missing data, as well as an analysis using multiple imputation. Results: The average number of unintended pregnancy and induced abortion per pregnancy of junior high school graduates was the highest among educational attainments of wives and husbands. The adjusted regression analysis showed that junior high school graduate in husbands was significantly associated with higher number of unintended pregnancies and induced abortions, regardless of the missing data analysis methods. In addition, high school or training school graduate in husbands was significantly associated with higher number of induced abortions. A significant association between socioeconomic status and the unintended pregnancy ending in induced abortion was not observed. Conclusion: This study showed that a lower educational attainment in husband was associated with higher number of unintended pregnancies and induced abortions in Japan.