An unintended pregnancy is a pregnancy that is mistimed or unwanted at the time of conception, also known as an unplanned pregnancy.
Sexual activity without the use of effective contraception through choice or coercion is the predominant cause of unintended pregnancy. Worldwide, the unintended pregnancy rate is approximately 45% of all pregnancies (for a total of 120 million unintended pregnancies annually), but rates vary in different geographic areas and among different sociodemographic groups. Unintended pregnancies may be unwanted pregnancies or mistimed pregnancies. While unintended pregnancies are the main reason for induced abortions, unintended pregnancies may also result in other outcomes, such as live births or miscarriages.
Unintended pregnancy has been linked to numerous poor maternal and child health outcomes, regardless of the outcome of the pregnancy. Efforts to decrease rates of unintended pregnancy have focused on improving access to effective contraception through improved counseling and removing barriers to contraception access.
Definitions Research on unintended pregnancy rates is challenging, as categorizing a pregnancy as "intended" or "unintended" does not capture the many complex considerations that go into a person's or couple's feelings towards the pregnancy itself or their reproductive plans in general. However, for data collection purposes, an "unintended pregnancy" is defined as a pregnancy that occurs either when a woman wanted to become pregnant in the future but not at the time she became pregnant, or one that occurred when she did not want to become pregnant then or at any time in the future.
Conversely, an "intended pregnancy" is one that is consciously desired at the time of conception or sooner. For research purposes, all pregnancies not explicitly categorized as "unintended" are combined, including those pregnancies where the pregnant woman feels ambivalent or unsure about the pregnancy. Most sources consider only the intentions of the woman when defining whether a pregnancy is unintended, but some sources also consider the intentions of the male partner.
Terming a pregnancy "unintended" does not indicate whether or not a pregnancy is welcomed, or what the outcome of the pregnancy is; unintended pregnancies may end in abortion, miscarriage, or birth.
Epidemiology Global incidence The global rate of unintended pregnancy was estimated at 44% of all pregnancies between 2010 and 2014, corresponding to approximately 62 unintended pregnancies per 1000 women between the ages of 15 and 44 years old. While unintended pregnancy rates have been slowly declining in most areas of the world, different geographic regions have different estimated unintended pregnancy rates. Rates tend to be higher in low-income regions in Latin America and Africa, estimated at 96 and 89 unintended pregnancies per 1000 women, respectively, and lower in higher-income regions such as North America and Europe, estimated at 47 and 41 unintended pregnancies per 1000 women, respectively. Unwanted pregnancies continue to be a major public health issue worldwide, especially in low- and middle-income countries. The annual number of unwanted pregnancies in Asia is estimated to be 53.8 million. It is estimated that between 2010 and 2014, around 5.4% of Asian women ages 15 to 44 had unintended pregnancies.
The United Nations Population Fund, the United Nations sexual and reproductive health agency, explains that nearly half of all pregnancies, totalling 121 million each year throughout the world, are unintended.
Incidence by country/region
Europe From 1990–1994 to 2010–2014, European rates of unintended pregnancy decreased from approximately 66 such pregnancies per 1000 women ages 15–44 years old to 41. These rates vary between different European countries.
Britain According to a 2013 study, approximately 16% of British pregnancies are unplanned, 29% are ambivalent, and 55% are planned.
France In France, 33% of pregnancies are unintended. Of women at risk for unintended pregnancy, only 3% do not use contraception, and 20% use intrauterine devices (IUDs).
Sweden One study from Sweden (2008–2010) showed that the prevalence of unintended pregnancies was 23.2%. One study conducted in Uppsala (2012–2013) found that 12% of pregnancies were fairly or very unplanned.
Russia
According to a 2004 study, current pregnancies were termed "desired and timely" by 58% of respondents, while 23% described them as "desired, but untimely", and 19% said they were "undesired".
Asia From 2010–2014, approximately 5.4% of women aged 15–44 years old got pregnant unintentionally, and the number of unintended pregnancies was 53.8 million each year in Asia.
India India, the number of unintended pregnancies has not changed much or been measured in a specific way in the last ten years. In each of the three rounds of the National Family Health Surveys (NFHS), about a quarter of the women in India had unintended pregnancies. Every year, there are about 121 million or 12.1 crore unintended pregnancies around the world. One of every seven of these happens in India, according to a report from the United Nations Population Fund. India's most populous state, Uttar Pradesh, with a population of about 200 million, has twice as many unwanted births as India as a whole (1.65 vs. 0.80). The level of unmet need for contraception among women in India is consistent with the incidence of unintended pregnancies and the incidence of abortions. These facts highlight the necessity for additional investment to meet the contraceptive needs of women and couples and to ensure access to safe abortion services.
South Korea
South Korea has the most serious problem of unintended pregnancy among developed countries.
The reason lies in South Korea's inadequate sex education. Because South Korea doesn't provide comprehensive sexuality education (CSE), it doesn't provide detailed instruction on contraception methods or the responsibility for responsibility. This is due to the influence of conservative groups, such as parent groups and Christian organizations.
Africa A quarter of unintended pregnancies happen in Africa, and the average unintended pregnancy rate in Sub-Saharan Africa is 33.9%.
North America From 1990–1994 to 2010–2014, North American rates of unintended pregnancy decreased from approximately 50 such pregnancies per 1000 women ages 15–44 years old to 47.
United States According to the Guttmacher Institute, 45% of U.S. pregnancies in 2011 were unintended, approximately 2.8 million pregnancies per year. In 2006, most states' rates were between 40 and 65 unintended pregnancies per 1,000 women. The state with the highest rate of unintended pregnancies was Mississippi, with 69 per 1,000 women, followed by California, Delaware, the District of Columbia, Hawaii, and Nevada (66 to 67 per 1,000). New Hampshire had the lowest rate, 36 per 1,000 women, followed by Maine, North Dakota, Vermont, and West Virginia (37 to 39 per 1,000 women). JournalistsResource.org, retrieved 20 March 2012
Over 92% of abortions are the result of unintended pregnancy, and unintended pregnancies result in about 1.3 million abortions per year. In 2001, 44% of unintended pregnancies resulted in births, 42% resulted in induced abortion, and the rest in miscarriage. It is estimated that more than half of US women have had an unintended pregnancy by age 45. One 2012 study found over one-third of living people in the US under 31 years of age (born since 1982) were the result of unintended pregnancies, a rate virtually unchanged from 2002. + Unintended pregnancies and births in the United States Rate per 1000 women.YearUnintended pregnanciesUnintended births 1981 54.2 25 1987 53.5 27 1994 44.7 21 2001 48 23 2008 51 27
Factors associated with unintended pregnancy Unintended pregnancy typically occurs after sexual activity without the use of contraception, or not using it correctly. Such pregnancies may still occur despite using contraception correctly, but are uncommon. For example, in the United States, of all the unintended pregnancies that occurred in 2008, women who used modern contraception consistently accounted for only 5% of the unintended pregnancies, while women who used contraception inconsistently or not at all accounted for 41% and 54% of all unintended pregnancies, respectively.
Many factors may influence a person or couple's consistent use of contraception; a woman may not understand her risk of unintended pregnancy, and/or may not be able to access effective birth control to prevent pregnancy. Similarly, she may also not be able to control when/how she engages in sexual activity. Thus, many factors have been associated with a higher likelihood of having an unintended pregnancy, as follows.
Younger age
Studies across the globe consistently find that younger age (adolescence or young adulthood) increases the likelihood of a pregnancy being unintended or unplanned.
In the US, younger women who are sexually active are less likely to use contraception than other age groups, and thus are more likely to have unintended pregnancies. Approximately 18% of young women aged 15–19 years old at risk of unintended pregnancy do not use contraception, compared with 13% of women aged 20–24 and 10% of women aged 25–44.
Of the estimated 574,000 teen pregnancies (to young women aged 15–19) in the US in 2011, 75% were unintended. In 2011, the unintended pregnancy rate was 41 per 1,000 women aged 15–19. Because many teens are not sexually active, these estimates understate the risk of unintended pregnancy among teens who are having sex. Calculations that account for sexual activity find that unintended pregnancy rates are highest among sexually active women aged 15–19 years old compared to other age groups. About one-third of unintended teen pregnancies end in abortion.
The unintended pregnancy rate among teens has been declining in the US. Between 2008 and 2011, the unintended pregnancy rate declined 44% among women aged 15–17 years old and 20% among women aged 18–19 years old. This decline is attributed to improved contraceptive use among sexually active teens, rather than changes in sexual activity.
Relationship status Relationship status has a strong correlation with unintended pregnancy, but measures for relationship status vary by study. Some studies find that being single increases the likelihood of experiencing an unintended pregnancy, some find that not living with a partner increases the likelihood, and others find cohabitation with a partner to increase the risk of unintended pregnancy.
In the US, women who are unmarried but live with their partners (cohabiting) have a higher rate of unintended pregnancy compared with both unmarried noncohabiting women (141 vs. 36–54 per 1,000) and married women (29 per 1,000).
Lower income Poverty, lower income, and/or economic hardship increase a woman's risk of unintended pregnancy across the globe.
Poverty and lower income increase a woman's risk of unintended pregnancy. Unintended pregnancy rates among women with incomes less than 100% of the poverty line were 112 per 1,000 in 2011, more than five times higher than the rate among women with incomes of at least or greater than 200% of poverty (20 per 1,000 women).
Minority racial background/ethnicity Women living in countries where they belong to a racial or ethnic minority group frequently have higher unintended pregnancy rates compared to women of the regional majority.
In the US, women who identify as racial minorities are at increased risk of unintended pregnancy. In 2011, the unintended pregnancy rate for non-Hispanic black women was more than double that of non-Hispanic white women (79 versus 33 per 1,000).
Lower education level