Unintended pregnancy
[4][8] Rates tend to be higher in low-income regions in Latin America and Africa, estimated at 96 and 89 unintended pregnancies per 1000 women, respectively, and lower in higher-income regions such as North America and Europe, estimated at 47 and 41 unintended pregnancies per 1000 women, respectively.
[4] Unwanted pregnancies continues to be a major public health issue worldwide, especially in low- and middle-income countries.
[9] India, the number of unintended pregnancies has not changed much or been measured in a specific way in the last ten years.
][9] In each of the three rounds of the National Family Health Surveys (NFHS), about a quarter of the women in India had unintended pregnancies.
These facts highlight the necessity for additional investment to meet the contraceptive needs of women and couples and to ensure access to safe abortion services.
The state with the highest rate of unintended pregnancies was Mississippi, with 69 per 1,000 women, followed by California, Delaware, the District of Columbia, Hawaii and Nevada (66 to 67 per 1,000).
[24] One 2012 study found over one-third of living people in the US under 31 years of age (born since 1982) were the result of unintended pregnancies, a rate virtually unchanged from 2002.
Studies across the globe consistently find that younger age (adolescence or young adulthood) increases the likelihood of a pregnancy being unintended or unplanned.
[7] Poverty, lower income, and/or economic hardship increases a woman's risk of unintended pregnancy across the globe.
Women who deliver unintended pregnancies are less likely to breastfeed,[47][51] which in itself has been associated with a number of improved health outcomes for both mothers and infants.
[6][53] Children born of unintended pregnancies are less likely to succeed in school,[21] with significantly lower test scores,[50] more likely to live in poverty and need public assistance,[21] and more likely to have delinquent and criminal behavior.
[21] The U.S. states with the highest levels of abortions performed were Delaware, New York and New Jersey, with rates of 40, 38 and 31 per 1,000 women, respectively.
[6][62][63] In higher resource areas where abortion is legal, it has lower morbidity and mortality for the pregnant woman than childbirth.
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 unsanitary abortion.
[71] Most of the deaths occurred in low resource regions of the world, where family planning and reproductive health services were less available.
[71] In certain countries with extreme prohibitions on abortions like El Salvador, Honduras, Nicaragua, Haiti, the Dominican Republic, Jamaica, Suriname, Egypt, Madagascar, Mauritania, Senegal, Sierra Leone, the Republic of Congo, Laos, the Philippines, Iraq forced women which have unintended pregnancies to commit suicide and its also contributed to maternal deaths.
[21] Preventing unintended pregnancy would save the public over 5 billion dollars per year in short-term medical costs.
[73] The Brookings Institution conducted research and their results show that taxpayers spend more than $12 billion each year on unintended pregnancies.
They also find that, if all unintended pregnancies were prevented, the resulting savings on medical spending alone would equal more than three-quarters of the federal FY 2010 appropriation for the Head Start and Early Head Start programs and would be roughly equivalent to the amount that the federal government spends each year on the Child Care and Development Fund (CCDF).
[7] Accordingly, prevention includes comprehensive sexual education, availability of family planning services, and increased access to a range of effective birth control methods.
Available contraception methods include use of birth control pills, a condom, intrauterine device (IUD, IUC, IUS), contraceptive implant (Implanon or Nexplanon), hormonal patch, hormonal ring, cervical caps, diaphragms, spermicides, or sterilization.
[80] Providing contraceptives and family planning services at low or no cost to the user helps prevent unintended pregnancies.
Many of those at risk of unintended pregnancy have little income, so even though contraceptives are highly cost-effective,[81] up-front cost can be a barrier.
[82] The services provided at publicly funded clinics saved the federal and state governments an estimated $5.1 billion in 2008 in short term medical costs.
[82] Nationally, every $1.00 invested in helping women avoid unintended pregnancy saved $3.74 in Medicaid expenditures that otherwise would have been needed.
[48] Providing family planning and contraceptive services as part of prenatal, postpartum and post abortion care can help reduce recurrence of unintended pregnancy.
[84] Infanticide ('customary neonaticide') or abandonment (sometimes in the form of exposure) are other traditional ways of dealing with infants that were not wanted or that a family could not support.
In the 19th and 20th centuries, the desired number of pregnancies declined as reductions in infant and childhood mortality rates increased the probability that children would reach adulthood.
Other factors, such as the level of education and economic opportunities for women, have also led to reductions in the desired number of children.
[84] As the desired number of children decreases, couples spend more of their reproductive lives trying to avoid unintended pregnancies.
