Prevalence and factors associated with unplanned pregnancy among women of childbearing age in Ceará, Brazil: a cross-sectional study with population representativeness

We found a high prevalence of unplanned pregnancy among women in Ceará. Intimate partner violence was a key risk factor, and multiple dimensions of socioeconomic vulnerability (low education, being single, food insecurity, urban marginalization) and certain reproductive behaviors (multiple partners, STI history, suboptimal contraception use, IUD or emergency contraception ever use) were independently associated. These findings highlight the need for integrated interventions that address violence prevention within reproductive health, reduce social inequalities, and improve education and access to consistent, effective contraceptive methods. Comprehensive policies strengthening women's autonomy and ensuring safe reproductive choices - including access to safe, legal abortion when needed - are urgently required to reduce unplanned pregnancies and support women's health in Ceará.