BackgroundThe rate of unintended pregnancy in the United States increased slightly between 2001 and 2008 and is higher than that in many other industrialized countries. National trends have not been reported since 2008. MethodsWe calculated rates of pregnancy for the years 2008 and 2011 according to women’s and girls’ pregnancy intentions and the outcomes of those pregnancies. We obtained data on pregnancy intentions from the National Survey of Family Growth and a national survey of patients who had abortions, data on births from the National Center for Health Statistics, and data on induced abortions from a national census of abortion providers; the number of miscarriages was estimated using data from the National Survey of Family Growth. ResultsLess than half (45%) of pregnancies were unintended in 2011, as compared with 51% in 2008. The rate of unintended pregnancy among women and girls 15 to 44 years of age declined by 18%, from 54 per 1000 in 2008 to 45 per 1000 in 2011. Rates of unintended pregnancy...

https://www.nejm.org/doi/suppl/10.1056/NEJMsa1506575/suppl_file/nejmsa1506575_appendix.pdf

Declines in Unintended Pregnancy in the United States, 2008–2011

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

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.

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

https://www.who.int/reproductivehealth/topics/unsafe_abortion/article_unsafe_abortion.pdf

Unsafe abortion: the preventable pandemic

Periodic estimation of the incidence of global unintended pregnancy can help demonstrate the need for and impact of family planning programs. We draw upon multiple sources of data to estimate pregnancy incidence by intention status and outcome at worldwide, regional, and subregional levels in 2012 and to assess recent trends using previously published estimates for 2008 and 1995. We find that 213 million pregnancies occurred in 2012, up slightly from 211 million in 2008. The global pregnancy rate decreased only slightly from 2008 to 2012, after declining substantially between 1995 and 2008. Eighty-five million pregnancies, representing 40 percent of all pregnancies, were unintended in 2012. Of these, 50 percent ended in abortion, 13 percent ended in miscarriage, and 38 percent resulted in an unplanned birth. The unintended pregnancy rate continued to decline in Africa and in the Latin America and Caribbean region. If the aims of the London Summit on Family Planning are carried out, the incidence of unwanted and mistimed pregnancies should decline in the coming years.

/pdf/intended-and-unintended-pregnancies-worldwide-in-2012-and-4iiskd9hvb.pdf

Intended and unintended pregnancies worldwide in 2012 and recent trends.

Unintended pregnancy can carry serious consequences for women and their families. We estimate the incidence of pregnancy by intention status and outcome at worldwide, regional, and subregional levels for 2008, and we assess recent trends since 1995. Numbers of births are based on United Nations estimates. Induced abortions are estimated by projecting from recent trends. A model-based approach is used to estimate miscarriages. The planning status of births is estimated using nationally representative and small-scale surveys of 80 countries. Of the 208 million pregnancies that occurred in 2008, we estimate that 41 percent were unintended. The unintended pregnancy rate fell by 29 percent in developed regions and by 20 percent in developing regions. The highest unintended pregnancy rates were found for Eastern and Middle Africa and the lowest for Southern and Western Europe and Eastern Asia. North America is the only region in which overall and unintended pregnancy rates have not declined. We conclude with a brief discussion of global and regional program and policy implications.

/pdf/unintended-pregnancy-worldwide-levels-trends-and-outcomes-43xwasuz4e.pdf

Unintended Pregnancy: Worldwide Levels, Trends, and Outcomes

The Guttmacher Institute gratefully acknowledges the general support it receives from individuals and founda-tions—including major grants from The William and Flora Hewlett Foundation, the David and Lucille Packard Foundation, the Ford Foundation and others—which undergirds all of the Institute's work.

/pdf/abortion-worldwide-a-decade-of-uneven-progress-1gy2k5h8tb.pdf

Abortion Worldwide: A Decade of Uneven Progress

The level of unmet need for contraception -- an important motivator of international family planning programs and policies -- has declined only slightly in recent decades. This study draws upon data from 51 surveys conducted between 2006 and 2013 in Africa Asia and Latin America and the Caribbean to provide an updated review of the reasons why many married women having unmet need are not practicing contraception. We examine the reasons for contraceptive nonuse and how these reasons vary across countries and according to national levels of unmet need and contraceptive use. We present specific findings regarding the most widespread reasons for nonuse particularly infrequent sex and concerns regarding side effects or health risks. Our findings suggest that access to services that provide a range of methods from which to choose and information and counseling to help women select and effectively use an appropriate method can be critical in helping women having unmet need overcome obstacles to contraceptive use.

/pdf/reasons-for-contraceptive-nonuse-among-women-having-unmet-l1050k54mw.pdf

Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries.

The concept of unmet need for contraception has been central to international family planning efforts for decades and it is perhaps more relevant to programs now than ever. This report provides a review of the literature addressing the measurement of unmet need the obstacles faced by women with unmet need and the potential impact of meeting unmet need. We also provide current estimates of the level of unmet need regionally and nationally and among key population subgroups and briefly review how the level of unmet need has changed over the past decade in the developing world. We present in-depth analyses at the regional and national levels and among key subgroups within countries of the reasons why women who do not wish to become pregnant do not use contraceptives. International family planning which took shape as a movement more than 50 years ago was motivated at first by concerns about population growth. The field has since shifted its priorities and is now focused on enabling women and couples to meet their own fertility aspirations. Meeting womens unmet need for contraception is thus central to the international family planning program efforts. Moreover studies of the potential demographic impact of addressing unmet need have demonstrated that while family planning and reproductive health programs might focus on supporting the well-being of individuals meeting unmet need can also serve broader agendas of social and economic development. (excerpt)

/pdf/women-with-an-unmet-need-for-contraception-in-developing-3x4wbg5tbu.pdf

Rubina Hussain

Papers

Intended and unintended pregnancies worldwide in 2012 and recent trends.

Unintended Pregnancy: Worldwide Levels, Trends, and Outcomes

Abortion Worldwide: A Decade of Uneven Progress

Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries.

Women with an Unmet Need for Contraception in Developing Countries and Their Reasons for Not Using a Method