Expert Commentary

With no budge in more than 20 years, are US unintended pregnancy rates finally on the decline?

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Yes.

In 2008, the rate of unintended pregnancy was 54 per 1,000 among women and girls aged 15 to 44 years. In 2011, this rate dropped by 18%, to 45 per 1,000. Reducing the number of unintended pregnancies in the United States has been a challenge for decades, but increased use of long-acting reversible contraceptive methods could account for this recent decline in the unintended pregnancy rate in the United States, according to an analysis of trends.

Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008−2011. N Engl J Med. 2016;374(9):843–852.


 

References

Expert Commentary The unintended pregnancy rate has hovered around 50% for at least 20 years despite vigorous efforts to educate both the public and health care providers on the importance of using effective contraceptive methods. During that time, new contraceptives were developed and older methods were improved to reduce risk and adverse effects. Despite these efforts, however, an estimated 48% of all unintended pregnancies in the United States occurred among contraceptive users.1 Results of the study by Finer and Zolna on the recent decline in unintended pregnancies suggest there may be some light at the end of the tunnel.

Details of the studyThe study authors used data from the National Survey of Family Growth (NSFG) and other sources to calculate rates of pregnancy in the United States for 2008 and 2011, including rates based on pregnancy intentions and outcome. About 45% of pregnancies in 2011 were unintended, compared with 51% in 2008. The rate in 2011 represents the lowest rate of unintended pregnancy in more than 3 decades.

Rates reduced in many population subgroupsThe percentage of unintended pregnancies ending in abortion remained stable at 40% in 2008 and 42% in 2011. The largest changes in rate of unintended pregnancy from 2008 to 2011 occurred in women aged 15 to 17 years (−44%), women cohabiting (−29%), those with incomes at 100% to 199% of the federal poverty level (−32%), women who were not high school graduates (−28%), and Hispanic women (−26%). Other population subgroups also showed improvement but to a lesser extent than those described here.

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