Shifts in Intended and Unintended Pregnancies in the United States, 2001–2008

Abstract

Objectives. We monitored trends in pregnancy by intendedness and outcomes of unintended pregnancies nationally and for key subgroups between 2001 and 2008. Methods. Data on pregnancy intentions from the National Survey of Family Growth (NSFG) and a nationally representative survey of abortion patients were combined with counts of births (from the National Center for Health Statistics), counts of abortions (from a census of abortion providers), estimates of miscarriages (from the NSFG), and population denominators from the US Census Bureau to obtain pregnancy rates by intendedness. Results. In 2008, 51% of pregnancies in the United States were unintended, and the unintended pregnancy rate was 54 per 1000 women ages 15 to 44 years. Between 2001 and 2008, intended pregnancies decreased and unintended pregnancies increased, a shift previously unobserved. Large disparities in unintended pregnancy by relationship status, income, and education increased; the percentage of unintended pregnancies ending in abortion decreased; and the rate of unintended pregnancies ending in birth increased, reaching 27 per 1000 women. Conclusions. Reducing unintended pregnancy likely requires addressing fundamental socioeconomic inequities, as well as increasing contraceptive use and the uptake of highly effective methods.

Adolescence and the next generation

“…There is little doubt that a reorientation of service systems towards preconception would be of value 133 . However, given continuing high rates of unintended pregnancy 134,135 and the difficulty of modifying chronic health risks, addressing obesity, mental disorders and substance dependence earlier in adolescence will be essential. It requires a broadening of adolescent health beyond a traditional emphasis on sexual and reproductive health, extending the engagement of health service systems with adolescents and creating health-promoting environments in the families, schools, workplaces and communities in which adolescents are growing up 11 .…”

Repeat Abortions in New York City, 2010

“…Approximately 95 % of elective abortions (hereafter Babortion^) in the USA result from unintended pregnancies, 1 and half of abortion patients have had one or more prior abortions. 2 Repeat abortions can be viewed as a proxy for repeat unintended pregnancies and may indicate persistent challenges accessing health information and services or using contraception consistently and correctly.…”

Abortion Surveillance — United States, 2013

“…Comparatively high abortion rates and ratios among non-Hispanic black women have been attributed to higher unintended pregnancy rates and a greater percentage of unintended pregnancies ending in abortion (49,50). Data from certain reports suggest that differences in abortion indicators between non-Hispanic black women and women of other groups narrowed during 1994-2008 (4,9), but have remained steady since 2008 (10).…”

“…Data reported to CDC for 2013 and in previous years suggest similar declines in abortion rates among non-Hispanic white and black women. Higher abortion rates among Hispanic compared with non-Hispanic white women have been attributed to higher pregnancy rates, including intended and unintended pregnancies, among Hispanic women (49,50). However, abortion ratios for these two groups have been more comparable: Hispanic women have had a slightly higher percentage of pregnancies that are unintended but are no more likely than non-Hispanic white women to end unintended pregnancies in abortion (49,50).…”