Professional Documents
Culture Documents
Unintended Pregnancy
Unintended Pregnancy
Unintended Pregnancy
Intention
FACTS
Preclude use of genetic testing to help make deciUnintended pregnancies lead to higher rates of matersions about whether to become pregnant.
nal morbidity, and threaten the economic viability of
[16]
Women with an unintended pregnancy are more families.
likely to suer depression during or after preg- Women with unintended pregnancies have less education
nancy.[13][14]
and participate less in the workforce than women whose
pregnancies are intended.[19]
of
physical
violence
during
3
considerations of psychological impact of abortion have little income, so even though contraceptives are
should be in comparison to potential harm from these highly cost-eective,[35] up front cost can be a barrier.
stressors.[31][32]
Subsidized family planning services improve the health
governments and
[5]
Some nd abortion morally objectionable. This could of the population and saves money for[13]
health
insurers
by
reducing
medical,
education and
be due to religious beliefs, ones own personal beliefs or
other
costs
to
society.
the context of the situation.
3.2
Maternal deaths
Over the six years between 1995 and 2000 there were
an estimated 338 million pregnancies that were unintended and unwanted worldwide (28% of the total 1.2 billion pregnancies during that period).[33] These unwanted
pregnancies resulted in nearly 700,000 maternal deaths It is theorized that reducing unintended pregnancies could
(approximately one-fth of maternal deaths during that help break the cycle of poverty.[37]
period). More than one-third of the deaths were from
problems associated with pregnancy or childbirth, but the
majority (64%) were from complications from unsafe or
5 Epidemiology
unsanitary abortion.[33] Most of the deaths occurred in
less developed parts of the world, where family planning
Note: Numbers and rates are for detected pregnancies.
and reproductive health services were less available.[33]
A large proportion of pregnancies miscarry before the
In cultures that practice honor killing, unintended pregwoman is aware of the pregnancy.
nancy may increase the womans chance of being killed.
Prevention
5.1 Incidence
4
6.1.2
6 BY COUNTRY/REGION
France
6.1.3
Russia
6.2
6.2.1 History
US birth rates declined in the 1970s. Factors that are
likely to have led to this decline include: The introduction of the birth control pill in 1960, and its subsequent
rapid increase in popularity; the completion of legalization of contraceptives in the 1960s and early 1970s; the
introduction of federal funding for family planning in the
1960s and Title X in 1970; increased career and educational gains for women and its consequence of increased
opportunity costs; and the legalization of abortion, which
was completed in 1973. The decline in birth rate was associated with reductions in the number of children put up
for adoption and reduction in the rate of neonaticide.
It is unclear to what extent legalization of abortion may have increased the availability of the
procedure.[5] It is estimated that before legalization about 1 million abortions were performed
annually.[5] Before legalization, abortion was probably one of the most common criminal activities.[5]
Before legalization, an estimated 1,000 to 10,000
women died each year from complications of poorly
performed abortions.[5] Legalization was followed
by a decrease in pregnancy related deaths in young
women, as well as decrease in hospital admissions
for incomplete or septic abortions, conditions more
common than induced abortion.[5]
The infanticide rate during the rst hour of life
dropped from 1.41 per 100,000 during 1963 to 1972
to 0.44 per 100,000 for 1974 to 1983; the rate during the rst month of life also declined, whereas the
rate for older infants rose during this time.[48]
The rate of unintended pregnancy declined signicantly
from 1987 until 1994, due to increased contraceptive
use.[49][50] Since then until 2001 the rate has remained
relatively unchanged.[50]
The proportion of births that were unintended at time of
conception decreased during the 1970s and early 1980s.
Between 1982 and 1988 the proportion of births that were
unintended began increasing.[5] In 1990 about 44% of
births were unintended at time of conception.[5] The fraction of births that were unintended at time of conception was even higher among lower class women (almost
60%), never-married women (73%) and unmarried teens
(86%).[5]
Among lower class women, the rate of unintended pregnancy and unintended birth rose from 1994 to 2001,
while it declined for the more auent women (those
>200% of federal poverty level).[50] (Unintended pregnancy rose almost 30% and unintended births rose 50%
for those below federal poverty level.) Contraceptive use
had been increasing for years, but stopped in the 1990s,
and began to decline among lower class women.[51] Cuts
in federal and state family planning programs may ac-
5
count for the decreased use of contraceptives and increase nancies result from couples not using contraception in the
in unintended pregnancies.[51]
month the woman got pregnant, and 43% result from inconsistent or incorrect contraceptive use; only 5% result
from contraceptive failure, according to a report from the
6.2.2 Costs and potential savings
Guttmacher Institute.[6] Contraceptive use saved an estimated $19 billion in direct medical costs from unintended
The public cost of unintended pregnancy is estimated to pregnancies in 2002.[52]
be about 11 billion dollars per year in short term medical costs.[19] This includes costs of births, one year of In 2006, publicly funded family planning services (Title
infant medical care and costs of fetal loss.[19] Prevent- X, medicaid, and state funds) helped women avoid 1.94
ing unintended pregnancy would save the public over 5 million unintended pregnancies, thus preventing about
[59]
billion dollars per year in short term medical costs.[19] 860,000 unintended births and 810,000 abortions.
Savings in long term costs and in other areas would be Without publicly funded family planning services, the
much larger.[19] By another estimate, the direct medi- number of unintended pregnancies and abortions in the
cal costs of unintended pregnancies, not including infant United States would be nearly two-thirds higher among
medical care, was $5 billion in 2002.[52] The Brookings women overall and among teens; the number of unamong lower class women would
Institution conducted a research and their results show intended pregnancies
[59]
nearly
double
The
services
provided at publicly funded
that taxpayers spend more than $12 billion each year on
clinics
saved
the
federal
and
state governments an estiunintended pregnancies. They also nd that, if all unmated
$5.1
billion
in
2008
in
short
term medical costs.[59]
intended pregnancies were prevented, the resulting savings on medical spending alone would equal more than Nationally, every $1.00 invested in helping women avoid
expendithree quarters of the federal FY 2010 appropriation for unintended pregnancy saved $3.74 in Medicaid
[59]
tures
that
otherwise
would
have
been
needed.
the Head Start and Early Head Start programs and would
be roughly equivalent to the amount that the federal gov- Reducing unintended pregnancy in the United States
ernment spends each year on the Child Care and Devel- would be particularly desirable since abortion is such a
opment Fund (CCDF).[53]
politically divisive issue.[5]
6.2.3
Teens
6.2.5 Rape
7 History
6.2.4
Prevention
10
See also
Contraceptive mandate
Demographic dividend
Epidemiology of teenage pregnancy
Feminization of poverty
Healthy People
International Conference on Population and Development
Legalized abortion and crime eect
The Impact of Legalized Abortion on Crime
Millennium Development Goals
Miscarriage
REFERENCES
9 Additional reading
Eisenberg, Leon; Brown, Sarah Hart (1995). The
best intentions: unintended pregnancy and the wellbeing of children and families. Washington, D.C:
National Academy Press. ISBN 0-309-05230-0.
Mosher, William D., Jo Jones, and Joyce C. Abma.
(2012). Intended and unintended births in the
United States, 1982-2010. Hyattsville, Md.: U.S.
Department of Health and Human Services, Centers
for Disease Control and Prevention, National Center
for Health Statistics.
10 References
[1] Unintended Pregnancy Prevention. Centers for Disease
Control and Prevention. Retrieved November 13, 2013.
[2] Dawn Stacey: Contraception. About.com. Retrieved 11
October 2009.
[3] Wyatt, Kirk D; Anderson, Ryan T; Creedon, Douglas;
Montori, Victor M; Bachman, John; Erwin, Patricia;
LeBlanc, Annie (2014). Womens values in contraceptive choice: a systematic review of relevant attributes included in decision aids. BMC Womens Health 14 (1): 28.
doi:10.1186/1472-6874-14-28. PMID 3932035.
[4] Hanson, S.J.; Burke, Anne E. (21 December 2010).
Fertility control: contraception, sterilization, and abortion. In Hurt, K. Joseph; Guile, Matthew W.; Bienstock, Jessica L.; Fox, Harold E.; Wallach, Edward E. The
Johns Hopkins manual of gynecology and obstetrics (4th
ed.). Philadelphia: Wolters Kluwer Health/Lippincott
Williams & Wilkins. pp. 382395. ISBN 978-1-60547433-5.
[5] Eisenberg, Leon; Brown, Sarah Hart (1995). The best intentions: unintended pregnancy and the well-being of children and families. Washington, D.C: National Academy
Press. ISBN 0-309-05230-0. Retrieved 2011-09-03.
[6] J. Joseph Speidel, Cynthia C. Harper, and Wayne
C. Shields (September 2008).
The Potential of
Long-acting Reversible Contraception to Decrease Unintended Pregnancy. Contraception 78 (3): 197
200. doi:10.1016/j.contraception.2008.06.001. PMID
18692608.
[7] Sharing Responsibility:Women, Society and Abortion
Worldwide (PDF) (Report). 1999.
[8] Abortion in Context: United States and Worldwide.
Alan Guttmacher Institute. May 1999. Retrieved 201108-28.
[9] Healthy Timing and Spacing of Pregnancy: HTSP Messages. USAID. Retrieved 2008-05-13.
[10] Hatcher, Robert D. (2011). Contraceptive Technology
(20th ed.). Ardent Media, Inc. ISBN 978-1-59708-0040.
[11] Hathaway J.E., Mucci L.A., Silverman J.G. et al. (2000).
", Health status and health care use of Massachusetts
women reporting partner abuse. Am J Prev Med 19 (4):
302307. doi:10.1016/s0749-3797(00)00236-1.
[12] <name=Oopsie babies>Oopsie babies? A third of U.S.
births unintended, study nds. July 2012.
[13] Family Planning - Healthy People 2020. Retrieved
2011-08-18. Which cites: * Logan C, Holcombe E,
Manlove J et al. (2007 May [cited 2009 Mar 3]). The
consequences of unintended childbearing: A white paper (PDF). Washington: Child Trends, Inc. Check
date values in: |date= (help) * Cheng D, Schwarz E,
Douglas E et al. (March 2009). Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception 79 (3):
1948. doi:10.1016/j.contraception.2008.09.009. PMID
19185672. * Kost K, Landry D, Darroch J. (MarApr
1998). Predicting maternal behaviors during pregnancy:
Does intention status matter?". Fam Plann Perspectives
30 (2): 7988. doi:10.2307/2991664. PMID 9561873.
* DAngelo, D, Colley Gilbert B, Rochat R et al. (Sep
Oct 2004). Dierences between mistimed and unwanted
pregnancies among women who have live births. Perspect
Sex Reprod Health 36 (5): 1927. doi:10.1363/3619204.
PMID 15519961.
[14] Providers miss opportunities to prevent depression in and
discuss birth control with women with unplanned pregnancies. Research Activities (Agency for Healthcare Research and Quality) (372): 15. August 2011.
[15] Unplanned Pregnancy (PDF). The National Campaign.
Retrieved 2013-11-21.
[16] "Religious Views on Contraception". Religious Coalition
for Reproductive Choice. 2006. Retrieved 2007-05-16.
[17] Logan C, Holcombe E, Manlove J et al. (2007 May
[cited 2009 Mar 3]). The consequences of unintended
childbearing: A white paper (PDF). Washington: Child
Trends, Inc. Check date values in: |date= (help)
[18] Lesa Bethea (1999). Primary Prevention of Child
Abuse. American Family Physician.
[19] Monea J, Thomas A (June 2011). Unintended pregnancy
and taxpayer spending. Perspectives on Sexual and Reproductive Health 43 (2): 8893. doi:10.1363/4308811.
PMID 21651707.
[20] Bankole et al. (1998). Reasons Why Women Have Induced Abortions: Evidence from 27 Countries. International Family Planning Perspectives.
[21] Lawrence B. Finer, Lori F. Frohwirth, Lindsay A.
Dauphinee, Susheela Singh, and Ann M. Moore (September 2005). Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives (PDF). Perspec-
10
REFERENCES
[48] Maureen Paul. Management of unintended and abnormal pregnancy: comprehensive abortion care. WileyBlackwell. p. 34. ISBN 978-1-4051-7696-5.
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