Unwanted pregnancy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Unintended pregnancies are pregnancies that were unwanted at the time of conception, these are sometimes divided into unwanted pregnancies and those that are mistimed. Worldwide, 38% of pregnancies were unintended in 1999 (some 80 million unintended pregnancies in 1999). Unintended pregnancies are the primary cause of induced abortion, resulting in about 42 million induced abortions. Unintended pregnancy is linked to numerous maternal and child health problems.

The use of modern contraceptive methods has greatly reduced the incidence of unintended pregnancy, particularly in more developed countries. However the United States has an unusually high rate of unintended pregnancy, especially among the poor.

Causes

  • Not using contraception.
  • Using contraception inconsistently or incorrectly.
  • Contraceptive failure (the method was used correctly, but did not work.) Contraceptive failure accounts for a relatively small fraction of unintended pregnancies when modern highly effective contraceptives are used.[1]

Reasons contraceptives might not have been used or been used incorrectly include:

  • Coercion. Rape or involuntary sex which sometimes happens in the context of domestic violence. Unintended pregnancies are more likely to be associated with abuse than intended pregnancies.[2] This may also include birth control sabotage - manipulation of someone's use of birth control to undermine efforts to prevent pregnancy.
  • Lack of knowledge about sex and reproduction. Including erroneous beliefs.
  • Lack of knowledge or experience with the contraceptive, or lack of motivation to use it correctly.
  • Lack of planning or ambivalence about whether to have a child.
  • Religious or other cultural beliefs that discourage or even prohibit contraceptive use, or contribute to ignorance about them or how to use them correctly.

References

  1. Hatcher, Robert D. (2011). Contraceptive Technology (20th ed.). Ardent Media, Inc. ISBN 978-1-59708-004-0.
  2. J.E. Hathaway, L.A. Mucci and J.G. Silverman et al., Health status and health care use of Massachusetts women reporting partner abuse, Am J Prev Med 19 (2000), pp. 302–307.

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