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    Rates of unintended pregnancy in US at historic low


    Data from the National Center Health Statistics (NCHS) show that rates of unintended pregnancy in the United States have a hit a 3-decade low. In 2011, 45% of pregnancies (2.8 million) were unintended compared with 51% in 2008 and the authors of a new report in The New England Journal of Medicine  believe that changes in contraceptive use, particularly long-acting methods, may have contributed to the downward trends.

    To calculate the incidence of unintended pregnancy in 2011, researchers from The Guttmacher Institute used US data on pregnancy intentions released in December 2014 by NCHS. They estimated the total number of pregnancies that ended in birth, miscarriage, and inducted abortion and calculated the percentages of each of the outcomes that were unintended and then divided the total number of unintended pregnancies by the population of women and girls aged 15 to 44.

    Pregnancy intention was based on a woman’s answers to questions on a retrospective survey about the desire to become pregnant right before each pregnancy occurred. A pregnancy was considered mistimed if a woman wanted to become pregnant in the future but not when the current pregnancy occurred. A pregnancy was unwanted if a woman did not want to become pregnant at any time. Unintended pregnancies comprised those that were mistimed or unwanted.

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    The rate of unintended pregnancy, the researchers found, declined by 18% over the period from 2008 to 2011, the first substantial decline since 1981. At the same time, the rate of intended pregnancy increased from 51 to 53 per 1000 women and the overall rate of pregnancy decreased from 106 to 98 per 1000 women.

    In 2011, women aged 20 to 24 had the highest rates of unintended pregnancy, followed by those aged 18 to 19 and aged 25 to 29. Rates of unintended pregnancy declined across most demographic groups, with the largest reduction in Hispanics. The higher a woman’s income and the greater her educational level, the less likely she was to have an unintended pregnancy. No substantial variation was seen in rates of abortion of unintended pregnancies by age group, although among girls aged 15 to 17, the percentage did increase.

    Commenting on the reasons for the trends, the authors noted that “overall use of any method of contraception among women and girls at risk for unintended pregnancy increased slightly between 2008 and 2012. More important, the use of highly effective long-acting methods, particularly intrauterine devices, among U.S. females who used contraception increased from 4% to 12% between 2007 and 2012.” They also speculated that during the recession, some women may have postponed childbearing and then had intended pregnancies between 2008 and 2011.

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    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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