Unintended pregnancy in the United States: incidence and disparities, 2006

Abstract

Background: The incidence of unintended pregnancy is among the most essential health status indicators in the field of reproductive health. One ongoing goal of the US Department of Health and Human Services is to reduce unintended pregnancy, but the national rate has not been estimated since 2001.

Study design: We combined data on women's pregnancy intentions from the 2006-2008 and 2002 National Survey of Family Growth with a 2008 national survey of abortion patients and data on births from the National Center for Health Statistics, induced abortions from a national abortion provider census, miscarriages estimated from the National Survey of Family Growth and population data from the US Census Bureau.

Results: Nearly half (49%) of pregnancies were unintended in 2006, up slightly from 2001 (48%). The unintended pregnancy rate increased to 52 per 1000 women aged 15-44 years in 2006 from 50 in 2001. Disparities in unintended pregnancy rates among subgroups persisted and in some cases increased, and women who were 18-24 years old, poor or cohabiting had rates two to three times the national rate. The unintended pregnancy rate declined notably for teens 15-17 years old. The proportion of unintended pregnancies ending in abortion decreased from 47% in 2001 to 43% in 2006, and the unintended birth rate increased from 23 to 25 per 1000 women 15-44 years old.

Conclusions: Since 2001, the United States has not made progress in reducing unintended pregnancy. Rates increased for nearly all groups and remain high overall. Efforts to help women and couples plan their pregnancies, such as increasing access to effective contraceptives, should focus on groups at greatest risk for unintended pregnancy, particularly poor and cohabiting women.

Copyright © 2011 Elsevier Inc. All rights reserved.

Figures

Fig. 1. Unintended Pregnancy Rates by Income and Demographic Characteristics, 2006

A. Unintended pregnancy rates for poor women were inversely related to educational attainment, but rates among women in the highest-income bracket varied little across education levels. a Rates for educational attainment are among women aged 20—44. bRates for college graduates at <100% and 100—199% of poverty are combined to account for small sample sizes. B. Among poor women, Hispanics had the highest unintended pregnancy rate, and among the low- and higher-income groups, black women had the highest rate. Note: Figure excludes women who self-identify as other non-Hispanic race/ethnic groups.

Fig. 2. Unintended Pregnancy Rates by Relationship Status and Demographic Characteristics, 2006

A. Teens had relatively high unintended pregnancy rates among married and cohabiting women, but noncohabiting teens had a low unintended pregnancy rate. a The rate for married women aged 15—19 is not available. B. Women in lower-income groups had relatively high unintended pregnancy rates regardless of relationship status. Cohabiting women had the highest rates across all income levels, and among them, poor or low-income women had very high rates. Unmarried women include never-married and formerly-married women. Cohabiting women were not married.