The Burden of Poor Reproductive Health in England: Results From a Cross-Sectional Survey.

Abstract

To quantify the burden of poor reproductive health in England by age, ethnicity, and financial security. Cross-sectional survey. England. 59 332 women and people assigned female at birth aged 16-55 years. The Reproductive Health Survey for England 2023 (RHSE2023) used an online convenience sampling strategy and a self-completion questionnaire. 13 indicators of reproductive health organised into three domains: reproductive morbidities (including endometriosis, fibroids); menstrual health (severely painful and/or heavy periods; menopausal symptoms); and pregnancy-related adverse experiences (pregnancy loss, infertility, unplanned pregnancy) in the last year. Compared to the general population, our sample over-represented those with higher education levels and under-represented minority ethnic groups. 28.0% of participants reported at least one reproductive morbidity; 61.9% reported menstrual-related issue(s); and 5.5% reported pregnancy-related adverse experience(s) in the last year, with considerable variation by age. Compiling the three domains, 73.7% reported at least one indicator of poor reproductive health. Inequalities were observed: Black British, Caribbean, and African women had increased odds of reporting reproductive morbidity (aOR: 1.69); heavy and/or severely painful periods (aOR: 1.28); and pregnancy-related adverse experience (aOR: 1.50). Financial insecurity was also associated with poor reproductive health. As the first study to simultaneously examine this broad range of indicators of reproductive health within a single sample, we highlight the substantial burden of poor reproductive health in England, with evident ethnic and financial inequalities.