Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001

Guttmacher Institute, New York, NY, USA.
Perspectives on Sexual and Reproductive Health (Impact Factor: 2). 07/2006; 38(2):90-6. DOI: 10.1363/psrh.38.090.06
Source: PubMed


Many pregnancies are unintended, particularly in certain population groups. Determining whether unintended pregnancy rates and disparities in rates between subgroups are changing may help policymakers target reproductive health services to those women most in need.
To calculate rates of unintended pregnancy and related outcomes, data on pregnancy intendedness from the 2002 National Survey of Family Growth were combined with birth, abortion and population data from federal, state and nongovernmental sources.
In 2001, 49% of pregnancies in the United States were unintended. The unintended pregnancy rate was 51 per 1,000 women aged 15-44, meaning that 5% of this group had an unintended pregnancy. This level was unchanged from 1994. The rate of unintended pregnancy in 2001 was substantially above average among women aged 18-24, unmarried (particularly cohabiting) women, low-income women, women who had not completed high school and minority women. Between 1994 and 2001, the rate of unintended pregnancy declined among adolescents, college graduates and the wealthiest women, but increased among poor and less educated women. The abortion rate and the proportion of unintended pregnancies ending in abortion among all women declined, while the unintended birth rate increased. Forty-eight percent of unintended conceptions in 2001 occurred during a month when contraceptives were used, compared with 51% in 1994.
More research is needed to determine the factors underlying the disparities in unintended pregnancy rates by income and other characteristics. The findings may reflect a need for increased and more effective contraceptive use, particularly among high-risk groups.

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    • "We had the opportunity to fill these gaps with an analysis of the 2006–2010 National Survey of Family Growth (NSFG), a nationally representative study of US women and men between the ages of 15 and 44. For this paper, we included only 15 to 24 year-olds, which allowed us to focus on a group among whom withdrawal [6] and unintended pregnancies [14] are widespread. Our objectives were twofold: first, to explore prevalence of any and only use of withdrawal for both young women and men, and second, to document sociodemographic and select psychological and sexual correlations with withdrawal use. "
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    ABSTRACT: Use of withdrawal (coitus interruptus) has consequences for reproductive health, but few nationally representative studies exist. We 1) examined patterns of withdrawal among 15-24 year-old women and men, and 2) explored withdrawal’s associations with socio-demographic, psychological, and sexual factors.
    Contraception 12/2014; 91(4). DOI:10.1016/j.contraception.2014.12.005 · 2.34 Impact Factor
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    • "Family planning efforts that can help reduce unintended pregnancy include increasing access to contraception, particularly to the more effective and longer acting reversible forms of contraception including IUDs [12]. Despite the availability of IUDs, unintended pregnancy continues to be a major public healthcare issue in the Unites States [12]. The percent of unintended pregnancies in this country has increased from 48% in 2001 to 51% in 2008 [13]. "
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    ABSTRACT: Objective: The purpose of this study was to determine the barriers to intrauterine device (IUD) use at a University-Based Women’s Clinic. Methods: This study is a cross-sectional survey of a con- venience sample of subjects receiving obstetrical care at a University-Based Women’s Clinic. Eligi- ble women who consented to participate self-administered a 16-question survey during a routine prenatal visit. Descriptive statistics were used to report participants’ demographics and history of contraception use. Additionally, subjects were asked if they would consider IUD use in the future. Results: A total of 160 women participated in this study. The average age of this sample was 24.9 (SD = 6.3). The majority were in low income and low education categories. Only 5% of women re- ported previous IUD use. 27% of women surveyed desired more information regarding IUD con- traception. 19% of participants would consider using an IUD in the future and 25% would consider IUD in the future if they knew more about them. Insurance and financial constraints were cited as barriers to IUD use. 4% of the sample reported that they had used an IUD previously and were unhappy with it due to pain and discomfort. 18% would not consider an IUD because they had heard about side effects. 68% of the surveyed sample reported unintended pregnancies. Conclu- sion: The two most common barriers to IUD use in this patient population was lack of knowledge and concern about side effects. Increasing patients’ knowledge of IUDs has the potential to increase IUD utilization in this clinic population which reported a 68% rate of unintended pregnancy.
    Open Journal of Obstetrics and Gynecology 12/2014; 4:1058-1064. DOI:10.4236/ojog.2014.416145
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    • "Inconsistent use and discontinuation of contraceptives are major causes of unintended pregnancy [1]. The failure rate of the pill, patch or ring is 20 times higher than that of longacting reversible contraceptives (LARCs) [2]. "
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    ABSTRACT: To evaluate if ibuprofen 800mg reduces pain with intrauterine device (IUD) insertion among U.S. women. We conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2-6weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800mg or placebo 30-45min prior to IUD insertion. A 100-mm visual analog scale (VAS) was administered to measure pain after speculum insertion (baseline) and immediately following IUD insertion. A total of 202 women were enrolled, with 101 randomized to each group (ibuprofen or placebo). Sociodemographic characteristics and baseline VAS scores were similar between groups. The median pain score with IUD insertion was 41.5mm in the placebo group and 38.0mm in the ibuprofen group (p=.50). Mean and median pain scores did not differ between placebo and ibuprofen when nulliparous and parous women were analyzed independently. Overall, median pain scores were 17.5mm higher in nulliparous women than parous women (p=.004). Median pain scores did not differ by age, IUD-type, history of dysmenorrhea or time since aspiration. Administration of ibuprofen 800mg prior to IUD insertion does not reduce pain associated with the procedure for U.S. women. Overall, nulliparous women report more pain with IUD insertion than multiparous women. Copyright © 2014 Elsevier Inc. All rights reserved.
    Contraception 11/2014; 91(3). DOI:10.1016/j.contraception.2014.11.012 · 2.34 Impact Factor
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