Perspectives on Sexual and Reproductive Health
The ability to choose whether and when to bear children is
a fundamental aspect of reproductive health. Although some
unintended pregnancies come to be wanted, many do not
and may result in undesired consequences. About half of
unintended pregnancies end in abortion in the United
States,1and unintended pregnancies that are continued to
term are associated with an increased risk of detrimental
prenatal parental behaviors, such as smoking and drink-
ing,2as well as of negative health and social outcomes for
both mother and child.3
In 1994, the rate of unintended pregnancy (excluding
miscarriages) in the United States was 45 per 1,000 women
aged 15–44, and such pregnancies accounted for 49% of
all pregnancies.4However, the rate differed dramatically
among population subgroups. For example, the rate among
women whose income was below the federal poverty line
was three times that of women whose income was at least
double the poverty line.5These inequalities were manifested
in rates of both abortion and unintended births. Such gaps
have social justice implications, because they indicate that
some groups of women have more difficulty than others in
achieving their reproductive goals. Assessing these dispar-
ities may help policymakers and public health profession-
als identify these groups of women.
Moreover, there is reason to believe that the rate of un-
intended pregnancy may have increased since 1994, for
the U.S. population as a whole or for specific subgroups.
For example, between 1995 and 2002, the proportion of
women at risk of pregnancy who were currently using con-
traceptives decreased slightly,6and the proportion of births
that were unintended increased.7Furthermore, the rate of
abortion increased among poor and low-income women
between 1994 and 2000.8The purpose of the study de-
scribed here was to use newly available national data to ex-
amine trends in the rates of unintended pregnancy and re-
lated outcomes between 1994 and 2001, and to assess
whether disparities between subgroups of women have
grown or decreased.
DATA AND METHODS
Intendedness of Pregnancies
The primary source of information on intendedness of preg-
nancies in the United States is the National Survey of Fam-
ily Growth (NSFG), conducted by the National Center for
Health Statistics (NCHS). Since 1982, NCHS has periodi-
cally surveyed a nationally representative sample of women
aged 15–44 in their homes. The most recent surveys, con-
ducted in 1995 and 2002, collected responses from 10,847
Disparities in Rates of Unintended Pregnancy
In the United States, 1994 and 2001
Lawrence B. Finer is
director of domestic
Stanley K. Henshaw is
senior fellow, at the
CONTEXT:Many pregnancies are unintended, particularly in certain population groups. Determining whether unin-
tended pregnancy rates and disparities in rates between subgroups are changing may help policymakers target re-
productive health services to those women most in need.
METHODS: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.
RESULTS: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 un-
changed 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, col-
lege 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 contra-
ceptives were used, compared with 51% in 1994.
CONCLUSIONS: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 contracep-
tive use, particularly among high-risk groups.
Perspectives on Sexual and Reproductive Health, 2006, 38(2):90–96
By Lawrence B.
Finer and Stanley
Perspectives on Sexual and Reproductive Health
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The authors thank Rachel Jones and Susheela Singh for method-
ological assistance and for reviewing drafts of the paper; Joyce Abma,
Jo Jones and Barbara Vaughan for methodological assistance; and
Kathryn Kost and James Trussell for reviewing additional drafts.
The research on which this article is based was funded by the Na-
tional Institute of Child Health and Human Development under
grant HD40378. The conclusions and opinions expressed here are
those of the authors and not necessarily those of the funder.
Author contact: firstname.lastname@example.org
Disparities in Rates of Unintended Pregnancy