Unintended Pregnancy in Kansas

Kansas

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 birth weight.
• Shorter duration of breastfeeding.
• Increased risk of postpartum depression.
• Physical or psychological aggression and parental maltreatment. 

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.

Since the overturn of Roe v. Wade in 2022, abortion has been banned in many states, leaving nearly 30% of women of reproductive age living in states where abortion is unavailable or severely restricted. These new abortion restrictions could deepen inequalities in abortion access, contributing to more 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 $6 in Medicaid expenditures for pregnancy-related care, for a net government saving of $10.5 billion per year.

The percentage of unintended pregnancies is higher among:

• Women ages 18-29 years compared with older women.
• Non-Hispanic Black women, who have a prevalence more than twice that of non-Hispanic white women.
• Women with incomes below the federal poverty level compared with women with higher incomes. 
• Women without a high school education compared with women with higher educational attainment.
• Unmarried but cohabiting women compared with currently 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 2 million unintended pregnancies that would likely have resulted in 900,000 births, nearly 700,000 abortions and close to 300,000 miscarriages. The Centers for Disease Control and Prevention (CDC) recommend that health care providers educate patients on the benefits of long-acting and reversible contraceptive (LARC) methods such as intrauterine devices (IUDs) and implants.
• Improving correct and consistent use of contraception: Once inserted, LARCs don't require the user to do anything, making them far more consistent and easy to use than short-acting contraceptive methods. Increasing LARC use could also generate significant health care cost savings.

Educating male partners about pregnancy planning could also strengthen efforts toward preventing unintended pregnancies. Planned Parenthood and the CDC provide more resources on proper contraceptive use.

Healthy People 2030 family planning objectives include:

• Reducing the proportion of unintended pregnancies. 
• Increasing the proportion of women at risk for unintended pregnancy who use effective birth control.

Cheng, Diana, Eleanor B. Schwarz, Erika Douglas, and Isabelle Horon. “Unintended Pregnancy and Associated Maternal Preconception, Prenatal and Postpartum Behaviors.” Contraception 79, no. 3 (March 2009): 194–98. https://doi.org/10.1016/j.contraception.2008.09.009.

Finer, Lawrence B., and Mia R. Zolna. “Declines in Unintended Pregnancy in the United States, 2008–2011.” New England Journal of Medicine 374, no. 9 (March 3, 2016): 843–52. https://doi.org/10.1056/NEJMsa1506575.

Frost, Jennifer J., Lori F. Frohwirth, and Mia R. Zolna. “Contraceptive Needs and Services, 2014 Update.” Report. New York: Guttmacher Institute, September 27, 2016. https://www.guttmacher.org/report/contraceptive-needs-and-services-2014-update.

Fuentes, Liza. “Inequity in US Abortion Rights and Access: The End of Roe Is Deepening Existing Divides.” Guttmacher Institute, January 17, 2023. https://www.guttmacher.org/2023/01/inequity-us-abortion-rights-and-access-end-roe-deepening-existing-divides.

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

Kost, Kathryn, and Laura Lindberg. “Pregnancy Intentions, Maternal Behaviors, and Infant Health: Investigating Relationships With New Measures and Propensity Score Analysis.” Demography 52, no. 1 (February 2015): 83–111. https://doi.org/10.1007/s13524-014-0359-9.

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

Shah, Prakesh S., Taiba Balkhair, Arne Ohlsson, Joseph Beyene, Fran Scott, and Corine Frick. “Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review.” Maternal and Child Health Journal 15, no. 2 (February 2011): 205–16. https://doi.org/10.1007/s10995-009-0546-2.

Sonfield, Adam, Kinsey Hasstedt, and Rachel Benson Gold. “Moving Forward: Family Planning in the Era of Health Reform.” Report. New York: Guttmacher Institute, March 1, 2014. https://www.guttmacher.org/report/moving-forward-family-planning-era-health-reform.

Sonfield, Adam, and Kathryn Kost. “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, February 1, 2015. https://www.guttmacher.org/report/public-costs-unintended-pregnancies-and-role-public-insurance-programs-paying-pregnancy.

Trussell, James, Nathaniel Henry, Fareen Hassan, Alexander Prezioso, Amy Law, and Anna Filonenko. “Burden of Unintended Pregnancy in the United States: Potential Savings with Increased Use of Long-Acting Reversible Contraception.” Contraception 87, no. 2 (February 2013): 154–61. https://doi.org/10.1016/j.contraception.2012.07.016.