Date of Award


Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Holly Levine, MD


Unintended pregnancy affects millions of women across the globe and often leads to an increased risk of health complications and socio-economic stress. In Nicaragua, approximately 1 in 6 births are unplanned, a relatively low number in comparison to the United States. However, the rate of unintended pregnancy is particularly problematic within the adolescent age group of Nicaragua, where 50% of women give birth before age 20 and 45% of those births are unplanned. The annual fertility rate of Nicaragua’s adolescents (109 births per 1,000 15-19- year-olds) is the highest in all of North, Central and South America, where the average adolescent birth rate is 61 per 1,000 15-19-year-olds. Upon completion of thorough research on the topic, access to emergency contraception and reproductive rights in Nicaragua is clearly a multi-faceted topic. Given the conservatively Catholic and male-dominated culture, one may be surprised at the rate in which Nicaraguan women are using contraception, both long term and emergency. However, barriers to access are still evident. For now, sexual health and pregnancy prevention remains an issue burdening only women in Nicaragua. Along with the expansion of education programs for women, I believe it is imperative that men are encouraged to join in on the conversation and take their share of responsibility.