Unintended Pregnancy

Unintended Pregnancy in United States

United States

Unintended pregnancy is either unwanted (occurring when no children are desired) or mistimed (occurring at a different time than desired). Delayed or lack of prenatal care among women with unintended pregnancies can pose health risks to mother and baby. Births resulting from unintended pregnancies are associated with adverse health outcomes for mother and baby, including:

• Low birthweight.
• Shorter duration of breastfeeding.
• Increased risk of postpartum depression and parental stress.
• Physical or psychological abuse.  
• Public insurance programs such as Medicaid pay for 68% of unplanned births and 38% of planned births. In 2010, expenditures on unintended pregnancies by Medicaid and other public programs were estimated to be $21 billion.

Public insurance programs such as Medicaid pay for 68% of unplanned births, compared with 38% of planned births. In 2010, expenditures on unintended pregnancies by Medicaid and other public programs were estimated to be $21 billion.

Nearly half of U.S. pregnancies are unintended. The percentage of unintended pregnancies is higher among:

• Non-Hispanic Black women, who have a prevalence more than twice that of non-Hispanic white women.
• Women with incomes below 200% of the federal poverty level compared with women with higher incomes. 
• Women without a high school education compared with women with higher educational attainment.
• Unmarried and cohabiting women, who have a prevalence more than four times that of married women.

About 95% of unintended pregnancies occur in women who do not use contraception or use it inconsistently or incorrectly. Strategies to reduce unintended pregnancy among sexually active women include: 

• Increasing access to contraception: In 2014, family planning services helped women avoid approximately two million unintended pregnancies that would likely have resulted in 900,000 births, nearly 700,000 abortions and close to 300,000 miscarriages.
• Improving correct and consistent use of contraception: The Centers for Disease Control and Prevention (CDC) recommend that health care providers encourage their patients to consider long-acting and reversible contraceptive (LARC) methods such as intrauterine devices (IUDs) and implants. Using LARCs instead of short-acting contraceptive methods reduces the risk of unintended pregnancies and rapid repeat pregnancies.
• Educating male partners about pregnancy planning could also strengthen efforts toward preventing unintended pregnancies.

The Guttmacher Institute estimates that 1.3 million unintended pregnancies were averted in 2014 by publicly-funded clinics. Every public dollar spent helping women avoid unintended pregnancies saves about $5 in Medicaid expenditures for pregnancy-related care, for a net government saving of $10.5 billion per year.

Planned Parenthood and the CDC provide resources on proper contraceptive use.

Healthy People 2030’s goals include increasing the proportion of women and girls who use effective birth control and decreasing the proportion of unintended pregnancies. 

Cheng, Diana, Eleanor B. Schwarz, Erika Douglas, and Isabelle Horon. 2009. “Unintended Pregnancy and Associated Maternal Preconception, Prenatal and Postpartum Behaviors.” Contraception 79 (3): 194–98. https://doi.org/10.1016/j.contraception.2008.09.009.

Finer, Lawrence B., and Mia R. Zolna. 2016. “Declines in Unintended Pregnancy in the United States, 2008–2011.” New England Journal of Medicine 374 (9): 843–52. https://doi.org/10.1056/NEJMsa1506575.

Frost, Jennifer J., Lori F. Frohwirth, and Mia R. Zolna. 2016. “Contraceptive Needs and Services, 2014 Update.” Report. New York: Guttmacher Institute. https://www.guttmacher.org/report/contraceptive-needs-and-services-2014-update.

Guterman, Kai. 2015. “Unintended Pregnancy as a Predictor of Child Maltreatment.” Child Abuse & Neglect 48 (October): 160–69. https://doi.org/10.1016/j.chiabu.2015.05.014.

Kost, Kathryn, and Laura Lindberg. 2015. “Pregnancy Intentions, Maternal Behaviors, and Infant Health: Investigating Relationships With New Measures and Propensity Score Analysis.” Demography 52 (1): 83–111. https://doi.org/10.1007/s13524-014-0359-9.

Qiu, Xing, Senmao Zhang, Xin Sun, Haiou Li, and Donghua Wang. 2020. “Unintended Pregnancy and Postpartum Depression: A Meta-Analysis of Cohort and Case-Control Studies.” Journal of Psychosomatic Research 138 (November): 110259. https://doi.org/10.1016/j.jpsychores.2020.110259.

Shah, Prakesh S., Taiba Balkhair, Arne Ohlsson, Joseph Beyene, Fran Scott, and Corine Frick. 2011. “Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review.” Maternal and Child Health Journal 15 (2): 205–16. https://doi.org/10.1007/s10995-009-0546-2.

Sonfield, Adam, Kinsey Hasstedt, and Rachel Benson Gold. 2014. “Moving Forward: Family Planning in the Era of Health Reform.” Report. New York: Guttmacher Institute. https://www.guttmacher.org/report/moving-forward-family-planning-era-health-reform.

Sonfield, Adam, and Kathryn Kost. 2015. “Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010.” New York: Guttmacher Institute. https://www.guttmacher.org/report/public-costs-unintended-pregnancies-and-role-public-insurance-programs-paying-pregnancy.