Sexual Behaviours and Unintended Pregnancy Among the Female Undergraduates of Niger Delta University: Prevalence and Associated Factors

High levels of sexual activity among young adults, coupled with inconsistent contraceptive use, increase the risk of unintended pregnancy and adverse reproductive outcomes. This study examined sexual behaviour, unintended pregnancy prevalence, and associated factors among university students. A cross-sectional study was conducted among undergraduate students of Niger Delta University. Data were collected via structured questionnaires. Descriptive statistics estimated the prevalence of sexual activity and unintended pregnancy, while logistic regression identified predictors of pregnancy intentionality. A high proportion of students (85.2%) reported being sexually active. Among those with pregnancy experience, 46.8% reported a pregnancy, and 60.6% of these pregnancies were unintended. The major reasons for unintended pregnancy included desire to continue education, unmarried status, and economic constraints. Age, marital status, and residence were significant predictors of unintended pregnancy (p < 0.05). Contraceptive non-use or inconsistent use was commonly reported before pregnancy. High sexual activity combined with suboptimal contraceptive uptake contributes to increased unintended pregnancy among university students. Strengthened youth-friendly reproductive health services and targeted pregnancy-prevention strategies are urgently needed to mitigate academic and socioeconomic consequences.

Adolescents and young adults (youths) constitute the majority of the global population, with youths making up one quarter of the world’s population [1]. Globally, this group of individuals are usually faced with several reproductive health challenges due to their high sexuality, early sexual debut, sexual assault, contraceptive failure, inadequate sex education, being single, poor or non-use of contraception, long periods of education, health issues, poverty, dysfunctional families, with resultant unintended pregnancies and unsafe abortions [1-9].

Amongst female undergraduates of tertiary institutions in Nigeria, unintended sexual intercourse is said to be the major cause of unintended pregnancy, many of which end up in abortions, and because abortion is still illegal except in terms of saving a woman’s life it is carried out by unskilled personnel in unhygienic environment and also by unscientific methods thus resulting in severe consequences such as sepsis, haemorrhage, pelvic inflammatory disease, uterine perforation, etc. thereby increasing the maternal morbidity and mortality indices of the nation as well as other adverse effects on the educational, sexual and reproductive health of these youths [10].

Study Area

This study was carried out amongst the female undergraduates of Niger Delta University, Wilberforce Island, located in Bayelsa State.11,12 The institution has two campuses, the Yenagoa campus, which contains the Law Faculty, and the main campus in Amassoma (Wilberforce Island). The institution has nine faculties and forty-three departments. The faculties are: Faculty of Science, Faculty of Arts, Faculty of Social Sciences, Faculty of Agricultural Technology, Faculty of Engineering, Faculty of Medicine, Faculty of Pharmacy, Faculty of Nursing, and Faculty of Law.

Study Population

The study population consisted of female undergraduates of the institution, both married and unmarried. This consisted of sexually active females between the ages of 15 and 35 years.

Study Design

A descriptive cross-sectional study design was used. 

Sample Size Determination

The sample size was determined using the Fisher formula13 with a contraceptive prevalence of 30% 5,16,26 among female undergraduates. Accordingly, the calculated sample size was 323. Adjusting for 10% attrition (for non-response and missing data): N = 323 + 48 =371 participants. However, a total of 500 respondents were enrolled in the study.

Sampling Technique

A multi-stage, sampling method was used in enrolling participants for the study.

Step 1: The students were first grouped according to their faculties to ensure adequate coverage and generalizability of the results to the entire University.

Step 2: Informed consent was then obtained from the participants, and a systematic random sampling technique was used to choose the number of participants from each of the faculties to participate in the study.

Step 3: From the sampling frame, every fourth person starting from the beginning was chosen to participate in the study, and the self-administered questionnaire was distributed to them.

Study Instrument

The study utilized a structured, self-administered questionnaire adapted from validated reproductive health survey instruments (NDHS 2013 and NARHS 2012). The tool was pretested among twenty female students of Bayelsa State College of Health Technology to ensure appropriateness and reliability. The questionnaire included: Sexual history (including age at sexual debut), History of pregnancy, Reasons for unintended pregnancy, Contraceptive use prior to pregnancy, Outcome of last pregnancy

Data Analysis

Data were analyzed using IBM SPSS Version 21.0 (SPSS Inc., Chicago, IL, USA). Frequencies and percentages were used to describe sexual behaviour patterns, pregnancy experience and reproductive outcomes. Associations between socio-demographic variables and unintended pregnancy (including pregnancy readiness) were assessed using the Chi-square test. Variables demonstrating statistical significance were entered into a multivariable logistic regression model to determine independent predictors of unintended pregnancy and pregnancy readiness. Adjusted odds ratios with 95% confidence intervals were calculated, and statistical significance was defined as p < 0>

Section A: Socio-Demographic Characteristics

Table 1: Demographic profile of the respondents.

Mean age = 24.1 ± 9.1 years, Others include Benin, Kalabari, Ikwere, Ogoni, Anioma, Igalla, Efik, and Adoni.

A total of 494 respondents participated in the study with a response rate of 98.8%. The mean age of the respondents was 24.1 ± 9.1 years. Two hundred and eight (42.1%) of the respondents were aged 25 years and above while 137 (27.7%) were aged 15- 19 years. Two thirds 327 (66.2%) were single while 135 (27.3%) were married. Almost half, 243 (49.2%) of the respondents resided in urban areas while 111 (22.5%) resided in rural areas. More than three-quarters 415 (84.0%) of the respondents were Christians and one-third 165 (33.4%) of them were Ijaw while 88 (17.8%) were Igbo.

Table 2: Respondents’ age at coitarche and use of contraception.

Most, 421 (85.2%) of the respondents were sexually active. Of this proportion, 139 (33.0%) had their first sexual intercourse at 10-15 years and 198 (47.0%) had it at 16-20 years. One hundred and thirty-nine (33.0%) used contraception and of this proportion, 90 (64.7%) reported condom as the type of contraception used. One hundred and seventy (40.4%) reported having sex a week prior to the survey while 112 (26.6%) reported having sex two weeks prior. Three hundred and seventeen (75.3%) respondents used contraception at their last sexual intercourse.

Table 3: Respondents’ unintended pregnancy prevalence and reasons for it.

*Multiple responses

About half of the respondents 231 (46.8%) had been pregnant before. Of this proportion, 20 (8.7%) were pregnant in the last one year prior to the survey and 95 (41.1%) were pregnant two years ago. Ninety-one (39.4%) were ready for their last pregnancy while 140 (60.6%) were not. Eighty-four (60.0%) of the respondents reported that their desire to continue their education was their reason for not being ready for their last pregnancy while 64 (45.7%) stated that they’re not being married was the reason.

Table 4: Respondents’ contraceptive use at last pregnancy and reasons for failure.

About half of the respondents with a pregnancy experience, 97 (42.0%) stated that they had used contraception before their last pregnancy. Of this proportion, 70 (72.2%) stated poor method as the reason for failure of the contraception.

However, 55 (41.0%) of the respondents stated that not having thought of the possibility of pregnancy was the reason for not using contraception before last pregnancy while 39 (29.1%) stated that their partner disapproved of it.

Table 5: Socio-demographic characteristics of the respondents and their readiness for their last pregnancy (n = 231).

*Significant

Thirty-six (51.4%) of the respondents aged 25 years and above were ready for their last pregnancy compared to 25 (30.5%) of those aged 15-19 years. There was an increased tendency to be ready for their last pregnancy among the older respondents. This association was statistically significant (p = 0.030). There was no statistically significant relationship between the respondents’ religion and their readiness for their last pregnancy (p = 0.775). None of the single respondents were ready for their last pregnancy compared to 78 (65.0%) of their married counterparts. This association was statistically significant (p < 0.001). Thirty-eight (52.8%) of the respondents residing in urban areas were ready for their last pregnancy compared to 22 (39.3%) of their rural counterparts. This association was also statistically significant (p = 0.010). There were no statistically significant relationships between the respondents’ faculty, level, and knowledge of contraception with their readiness for their last pregnancy (p = 0.439, 0.686, and 0.128, respectively).

Table 6: Logistic regression for predictors of respondents’ pregnancy readiness.

*Reference value, **Significant 

Reference category, R2 (coefficient of determination) = 43.1% to 70.1%. Married respondents were 18.572 times more likely to be ready for their last pregnancy compared to their unmarried counterparts. This was statistically significant (p < 0.001).

Table 7: Outcome of respondents’ last pregnancy

*Multiple responses

Of the 99 that terminated their last pregnancy, 26 (26.3%) did it at patent medicine stores while 22 (22.2%) did it at private clinics. However, 12 (12.1%) had complications from the procedure of which all of them complained of bleeding, 10 (83.3%) complained of high fever, while 9 (75.0%) complained of pain.

A high proportion of respondents (85.2%) reported being sexually active, similar to NARHS-PLUS-2012 (83%) and other Niger Delta studies.13 This rate exceeds findings from some Nigerian and international studies [1,3,17], likely reflecting regional sociocultural influences and early independence from parental supervision [18,19,13].

Three-quarters had sexual debut before age 20, with over a quarter before age 15, consistent with national and previous reports [1,3,13,17] Early initiation underscores the need for reproductive health interventions beginning in primary and secondary schools, including parental involvement.

Despite high sexual activity, two-thirds did not use contraception at first intercourse, increasing risks of unintended pregnancy and STIs [1,18,13,17] Even among users, reliance was mainly on condoms, pills, and natural methods, consistent with other studies [2,19,13,20-22]. These user-dependent methods have higher failure rates, highlighting the need to promote long-acting reversible and dual methods.

Nearly half (47%) had experienced pregnancy, with 60.6% unintended—comparable to reports from Nigeria and other regions [23,13,24,10,25]. Fear of side effects, partner disapproval, and low perceived pregnancy risk were common reasons for non-use among those with unintended pregnancies [26].

More than half (54.7%) of unintended pregnancies ended in induced abortion, and 63% were unsafe, similar to findings in Tanzania [17]. Unsafe abortion exposes youths to severe complications and long-term reproductive harm.

A high level of sexual activity (85.2%) was observed among students of Niger Delta University; however, this did not correspond with optimal contraceptive uptake. The high pregnancy rate (46.8%) and substantial prevalence of unintended pregnancy (60.6%) among those with pregnancy experience reflect significant gaps in effective pregnancy prevention.

The primary reasons cited for unintended pregnancies included the desire to continue education, unmarried status, and economic constraints. Age, marital status, and residence were significant determinants of unintended pregnancy.

1. The university should implement targeted programs aimed at reducing unintended pregnancy through improved access to effective contraception and reproductive counseling services.
2. Policy interventions should prioritize students who are unmarried and economically vulnerable, given their increased risk of unintended pregnancy.
3. Comprehensive reproductive health strategies should integrate pregnancy prevention education with academic counseling services to support students who wish to continue their education.
4. Broader governmental reproductive health reforms should focus on preventing unintended pregnancies among adolescents and young adults through youth-centered and culturally sensitive approaches.