User:Terrapinaz/Unintended Pregnancy
Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception[existing CDC source], also known as unplanned pregnancies.[1][2]
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Factors associated with unintended pregnancy
[edit]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 use contraception inconsistently or not at all accounted for 41% and 54% of all unintended pregnancies, respectively.[3]
There are many factors that 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 higher likelihood of having an unintended pregnancy, as follows.
Younger age
[edit]Studies across the globe consistently find that younger age (adolescent or young adult) to increase the likelihood of a pregnancy being unintended or unplanned.[4][5][6][7][8][9]
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.[10]
Of the estimated 574,000 teen pregnancies (to young women aged 15–19) in the US in 2011, 75% were unintended.[11] In 2011, the unintended pregnancy rate was 41 per 1,000 women aged 15–19.[11] 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.[12] About one-third of unintended teen pregnancies end in abortion.[11]
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.[13] This decline is attributed to improved contraceptive use among sexually active teens, rather than changes in sexual activity.[14]
Relationship status
[edit]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,[7][15][16] some find that not living with a partner increases the likelihood,[9][15] and others find cohabitation with a partner to increase the risk of unintended pregnancy.[17]
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).[18]
Lower income
[edit]Poverty, lower income, and/or economic hardship increases a woman's risk of unintended pregnancy across the globe.[5][7][8][9][19]
In the U.S., unintended pregnancy rates among women with incomes less than 100% of the poverty line was 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).[18]
Minority racial background/ethnicity
[edit]Women living in countries where they are a racial or ethnic minority frequently have higher unintended pregnancy rates compared to women of the regional majority.[4][5][9]
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).[18]
Lower education level
[edit]Studies across the globe consistently find that women with relatively lower educational attainment are far more likely to experience an unplanned pregnancy than women who are more educated; the level of education that makes the difference is relative, varying by region and country, as demonstrated by multiple studies.[5][6][7][8][9][15][17][20]
In the U.S., women without a high school degree had the highest unintended pregnancy rate among any educational level in 2011, at 73 per 1,000, accounting for 45% of all pregnancies in this group. Unintended pregnancy rates decreased with each level of educational attainment.[18][21]
Lifetime abuse, Current domestic abuse, and Non-consensual intercourse
[edit]Sexual coercion, rape, or even forced pregnancy may be associated with unintended pregnancy, all of which sometimes happens in the context of domestic violence. Studies have linked intimate partner violence or current abuse,[9][15][16] as well as prior abuse[9] (incl. during childhood),[22] to a higher risk of experiencing unintended pregnancy.
Unintended pregnancies are more likely to be associated with abuse than intended pregnancies.[23] This may also include birth control sabotage, which is the manipulation of someone's use of birth control to undermine efforts to prevent pregnancy. A longitudinal study in 1996 of over 4000 women in the United States followed for three years found that the rape-related pregnancy rate was 5.0% among survivors aged 12–45 years. Applying that rate to rapes committed in the United States would indicate that there are over 32,000 pregnancies in the United States as a result of rape each year.[24]
Multiparity / Already having children
[edit]Women who already have children are more likely to report a pregnancy as unintended; the number of children that makes the difference is relative, varying by region and country, as demonstrated by different studies.[5][7][8][15]
- ^ Australia, Healthdirect (2023-10-17). "Making decisions about unplanned pregnancies". www.healthdirect.gov.au. Retrieved 2024-04-29.
- ^ "Health matters: reproductive health and pregnancy planning". GOV.UK. Retrieved 2024-04-29.
- ^ "Contraceptive Use in the United States". Guttmacher Institute. July 2018. Retrieved 27 August 2019.
- ^ a b Hohmann‐Marriott, Bryndl E. (2018). "Unplanned pregnancies in New Zealand". Australian and New Zealand Journal of Obstetrics and Gynaecology. 58 (2): 247–250. doi:10.1111/ajo.12732. ISSN 0004-8666.
- ^ a b c d e Enthoven, Clair A.; El Marroun, Hanan; Koopman-Verhoeff, M. Elisabeth; Jansen, Wilma; Lambregtse-van den Berg, Mijke P.; Sondeijker, Frouke; Hillegers, Manon H. J.; Bijma, Hilmar H.; Jansen, Pauline W. (2022-10-24). "Clustering of characteristics associated with unplanned pregnancies: the generation R study". BMC Public Health. 22 (1). doi:10.1186/s12889-022-14342-y. ISSN 1471-2458. PMC 9590126. PMID 36274127.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ a b Wellings, Kaye; Jones, Kyle G; Mercer, Catherine H; Tanton, Clare; Clifton, Soazig; Datta, Jessica; Copas, Andrew J; Erens, Bob; Gibson, Lorna J; Macdowall, Wendy; Sonnenberg, Pam; Phelps, Andrew; Johnson, Anne M (2013). "The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)". The Lancet. 382 (9907): 1807–1816. doi:10.1016/S0140-6736(13)62071-1. PMC 3898922. PMID 24286786.
{{cite journal}}: CS1 maint: PMC format (link) - ^ a b c d e Bain, Luchuo Engelbert; Zweekhorst, Marjolein B.M.; de Cock Buning, Tjard (2020). "Prevalence and determinants of unintended pregnancy in sub–saharan Africa: a systematic review". African Journal of Reproductive Health. 24 (2): 187–205.
- ^ a b c d Aziz Ali, Sumera; Aziz Ali, Savera; Khuwaja, Nadir Suhail (2016). "Determinants of Unintended Pregnancy among Women of Reproductive Age in Developing Countries: A Narrative Review". Journal of Midwifery and Reproductive Health. 4 (1). doi:10.22038/jmrh.2016.6206.
- ^ a b c d e f g On behalf of the Bidens study group; Lukasse, Mirjam; Laanpere, Made; Karro, Helle; Kristjansdottir, Hildur; Schroll, Anne-Mette; Van Parys, An-Sofie; Wangel, Anne-Marie; Schei, Berit (2015). "Pregnancy intendedness and the association with physical, sexual and emotional abuse – a European multi-country cross-sectional study". BMC Pregnancy and Childbirth. 15 (1). doi:10.1186/s12884-015-0558-4. ISSN 1471-2393. PMC 4494794. PMID 26008119.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ Jones J, Mosher W, Daniels K (October 2012). "Current contraceptive use in the United States, 2006-2010, and changes in patterns of use since 1995" (PDF). National Health Statistics Reports (60): 1–25. PMID 24988814.
- ^ a b c Finer LB, Zolna MR (March 2016). "Declines in Unintended Pregnancy in the United States, 2008-2011". The New England Journal of Medicine. 374 (9): 843–852. doi:10.1056/NEJMsa1506575. PMC 4861155. PMID 26962904.
- ^ Finer LB (September 2010). "Unintended pregnancy among U.S. adolescents: accounting for sexual activity". The Journal of Adolescent Health. 47 (3): 312–314. doi:10.1016/j.jadohealth.2010.02.002. PMID 20708573.
- ^ Finer LB, Zolna MR (March 2016). "Declines in Unintended Pregnancy in the United States, 2008-2011". The New England Journal of Medicine. 374 (9): 843–852. doi:10.1056/NEJMsa1506575. PMC 4861155. PMID 26962904.
- ^ Lindberg L, Santelli J, Desai S (November 2016). "Understanding the Decline in Adolescent Fertility in the United States, 2007-2012". The Journal of Adolescent Health. 59 (5): 577–583. doi:10.1016/j.jadohealth.2016.06.024. PMC 5498007. PMID 27595471.
- ^ a b c d e Goossens, J.; Van Den Branden, Y.; Van der Sluys, L.; Delbaere, I.; Van Hecke, A.; Verhaeghe, S.; Beeckman, D. (2016). "The prevalence of unplanned pregnancy ending in birth, associated factors, and health outcomes". Human Reproduction. 31 (12): 2821–2833. doi:10.1093/humrep/dew266. ISSN 0268-1161.
- ^ a b Martin-de-las-Heras, Stella; Velasco, Casilda; Luna, Juan de Dios; Martin, Aurelia (2015). "Unintended pregnancy and intimate partner violence around pregnancy in a population-based study". Women and Birth. 28 (2): 101–105. doi:10.1016/j.wombi.2015.01.003.
- ^ a b Woodward, Vivien M (1995-12-01). "Psychosocial factors influencing teenage sexual activity, use of contraception and unplanned pregnancy". Midwifery. 11 (4): 210–216. doi:10.1016/0266-6138(95)90006-3. ISSN 0266-6138.
- ^ a b c d "Unintended Pregnancy in the United States". Guttmacher Institute. January 2019. Retrieved 20 August 2019.
- ^ Bearak, Jonathan; Popinchalk, Anna; Ganatra, Bela; Moller, Ann-Beth; Tunçalp, Özge; Beavin, Cynthia; Kwok, Lorraine; Alkema, Leontine (2020). "Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019". The Lancet Global Health. 8 (9): e1152–e1161. doi:10.1016/s2214-109x(20)30315-6. ISSN 2214-109X.
- ^ Font-Ribera, Laia; Pérez, Glòria; Salvador, Joaquín; Borrell, Carme (2008). "Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision". Journal of Urban Health. 85 (1): 125–135. doi:10.1007/s11524-007-9233-z. ISSN 1099-3460. PMC 2430141. PMID 18038210.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Finer LB, Zolna MR (March 2016). "Declines in Unintended Pregnancy in the United States, 2008-2011". The New England Journal of Medicine. 374 (9): 843–52. doi:10.1056/NEJMsa1506575. PMC 4861155. PMID 26962904.
- ^ Dietz, Patricia M. (1999-10-13). "Unintended Pregnancy Among Adult Women Exposed to Abuse or Household Dysfunction During Their Childhood". JAMA. 282 (14): 1359. doi:10.1001/jama.282.14.1359. ISSN 0098-7484.
- ^ Hathaway JE, Mucci LA, Silverman JG, Brooks DR, Mathews R, Pavlos CA (November 2000). "Health status and health care use of Massachusetts women reporting partner abuse". American Journal of Preventive Medicine. 19 (4): 302–7. doi:10.1016/s0749-3797(00)00236-1. PMID 11064235.
- ^ Holmes MM, Resnick HS, Kilpatrick DG, Best CL (August 1996). "Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women". American Journal of Obstetrics and Gynecology. 175 (2): 320–4, discussion 324–5. doi:10.1016/S0002-9378(96)70141-2. PMID 8765248.