Infertility and unintended pregnancy are dual burdens in Malawi, where 41% of pregnancies are unintended and approximately 20% of people report infertility. Although preventing unintended pregnancy has been a focus in public health, infertility has rarely been explored as a factor that may be associated with contraceptive use. Using cross-sectional survey data (2017–2018; N = 749), we report on the prevalence of and sociodemographic characteristics associated with infertility and certainty of becoming pregnant among women in Malawi. We conducted multivariable logistic regressions examining the relationship between infertility, certainty of becoming pregnant, and contraceptive use. Approximately 16% of women experienced infertility, and three-quarters (78%) were certain they could become pregnant within one year. Women who experienced infertility had lower odds of contraceptive use than women who did not (Adjusted Odds Ratio [AOR]: 0.56; 95% Conficence Interval [CI]: 0.39–0.83). Women who said there was “no chance” or they were “unlikely” to become pregnant also had lower odds of contraceptive use compared to women who were certain they would become pregnant (AOR: 0.30; 95% CI: 0.10–0.92). Our findings indicate that experiences and perceptions surrounding fertility are associated with contraceptive use, underscoring their importance in understanding how people manage their fertility to reach their reproductive goals.

中文翻译：

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马拉维的不孕症、怀孕的确定性和避孕药具的使用

不孕症和意外怀孕是马拉维的双重负担，其中 41% 的怀孕是意外怀孕，大约 20% 的人报告不孕。尽管预防意外怀孕一直是公共卫生的重点，但很少有人将不孕症作为可能与避孕药具使用相关的因素进行探索。使用横断面调查数据（2017-2018；N = 749)，我们报告了马拉维妇女不孕症的患病率和与不孕症相关的社会人口特征和怀孕的确定性。我们进行了多变量逻辑回归分析来检验不孕症、怀孕的确定性和避孕药具使用之间的关系。大约 16% 的女性经历过不孕，四分之三 (78%) 的女性确信她们可以在一年内怀孕。经历过不孕症的女性使用避孕药具的几率低于没有经历过的女性（调整后的优势比 [AOR]：0.56；95% 置信区间 [CI]：0.39–0.83）。与确定自己会怀孕的女性相比，表示“没有机会”或“不太可能”怀孕的女性使用避孕药具的几率也较低（AOR：0.30；95% CI：0.10–0.92）。