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Between 2006 and  2010, more than one-third (37 percent) of all births in the United States were  unintended, according to mothers’ reports. Of these, nearly two-thirds of  unintended births were mistimed, rather than unwanted.

Importance

An unintended birth is any birth a mother identifies as either mistimed (the birth occurred earlier than desired), or unwanted (at the time of pregnancy, the woman did not want to have any more births).  A distinction is made between unwanted births and mistimed births, because they are typical of different stages in a woman’s life, and because unwanted births, in comparison with those that are mistimed, tend to be more strongly correlated with negative outcomes for both mothers and children.[1],[2]

Unintended births comprise a smaller number than unintended pregnancies. Unintended births include only unintended pregnancies that are carried to term, not those that end in abortion, stillbirth, or miscarriage. In 2006-08, 49 percent of pregnancies were unintended;[3] nearly half of unintended pregnancies end with a live birth.[4] So, unintended births represent about one-quarter of all pregnancies. In general, differences by woman’s age, race/Hispanic origin, and income-level in the proportion of pregnancies that are unintended mirror the differences reported here for unintended births.[5]

Although the evidence is mixed, some studies have linked unintended childbearing with a number of adverse prenatal and perinatal outcomes, including inadequate or delayed initiation of prenatal care, prematurity, and absence of breastfeeding.[6],[7]  Additionally, some studies find that children born as a result of unintended pregnancies, particularly when the birth is unwanted, have poorer physical and mental health, have mother-child relationships that are less close, and do less well in school, compared with children from pregnancies that were intended.[8],[9] From the perspective of first-time fathers, mistimed or unwanted pregnancies may also be associated with increased likelihood of depression among fathers, poorer coparenting, and higher parental conflict.[10]

Despite increases in contraceptive use, the United States continues to have comparatively high levels of unintended childbearing.[11] Moreover, the associated social costs are substantial. Medicaid subsidizes the costs of nearly two-thirds of unintended births, compared with just under half of all births.[12]

Trends

123_fig1Due to the design of the survey from which they are derived, the most recent national data for this indicator are for the combined years, 2006-2010. Since 1982, the percentage of births that are unintended has fluctuated between 35 and 39 percent (ignoring 1995, for which the data are unreliable).[13] This proportion decreased between 1988 and 2002, from 39 to 35 percent, with most of the change due to a decline in mistimed births (from 27 to 21 percent of all births). The proportion of unwanted births rose between 1982 and 1988, from 10 to 12 percent, though the rise was insufficient to result in a significant increase in the overall rate of unintended births. Indeed, no significant changes occurred in any of the three measures between 2002 and
2006-10. In 2006-10, mistimed births were 23 percent of all births, and unwanted births were 14 percent. (Figure 1) In all the years examined here,
between 60 and 75 percent of unintended births were mistimed.

Differences by Age

123_fig2Contrary
to some perceptions, most unintended births occur to women in their twenties,
not to teens. This is because, although most births to teenagers are
unintended, teens have many fewer births overall than do women in their
twenties.[14] Proportionately, in
2006-10, 77 percent of births to 15- to 19-year-old women were unintended, that
proportion was 50 percent were unintended among women ages 20 to 24, 28 percent
for those 25 to 29, and 23 percent for women between 30 and 34. Mistimed and
unwanted births show similar age-related patterns, though variability is
greater for births that are mistimed. (Figure 2)

Differences by Race and Hispanic Origin[15]

123_fig3In 2006-10, black mothers were most likely to have
unintended births (54 percent of all births), followed by Hispanic (43
percent), and white mothers (31 percent). There were more pronounced differences
by race and Hispanic origin for unwanted births than for births that were mistimed.
For example, in 2006-10, there was no significant difference between white and
Hispanic mothers in the proportion of births that were mistimed. (Figure 3)

Differences by Marital and Cohabiting Status

123_fig4In 2006-10, unintended births were 23 percent of
all births to married women, compared with 51 percent of births women who were
cohabiting with a partner, and 67 percent of births to women living outside a
union (that is, not cohabiting at the time of the birth).

Among women who were ever married, the
percent of births that were unintended was relatively stable between 1982 and
2006-10 (30 and 25 percent respectively), while among women who were never
married the percentage decreased (from 72 to 60 percent).

Patterns by
marital and cohabiting status for unwanted and mistimed births are generally
similar. However, among married women, unwanted births represent a smaller proportion
of unintended births than they do for women who were cohabiting or living outside
a union (31 percent versus 40 and 41 percent, respectively). (Figure 4)

Finally, married women account for over 40
percent of all unintended births, highlighting that unintended childbearing is
a concern for married as well as unmarried women.[16]

Differences by Parity (Birth Order)

Second births are the least likely to be described
as unintended. First births are the most likely to be mistimed, while later
births are more likely to be unwanted. In 2006-10, 39 percent of first births,
31 percent of second births, and 43 percent of third or higher order births were
unintended. Thirty percent of first births were mistimed, compared with 19 and
20 percent, respectively, of second and third-or-higher-order births. Of first
and second births, respectively, nine and 11 percent were unwanted, compared with
23 percent of third-or-higher-order births. (Appendix 1)

Differences by Mother’s Education[17]

123_fig5The majority of unintended births occur to
women with limited socioeconomic resources–those with lower levels of education
and income.[18],
[19]

In 2006-10, 41 percent of births to women with
less than a high school diploma were unintended, compared with 37 percent for
those with some college, and 17 percent for women with a bachelor’s degree or
higher. Among women without a bachelor’s degree, the more education they had
received, the less likely they were to have had a birth that was unwanted and
the more likely they were to have had a mistimed birth (although between women
with a high school diploma and those with some college there was no significant
difference in the proportion of births that were mistimed). Women with a bachelor’s
degree or higher levels of education were less likely than those with less
education to have had either mistimed or unwanted births. (Figure 5) Note
that an unintended birth may influence a woman’s decision to end or delay her
education, so that cause and effect are not readily interpretable.

Differences by Poverty Level[20]

In 2006-10, 46 percent of births to women whose
family income was less than 150 percent of the federal poverty level (at the
time of the interview) were unintended, compared with 35 percent to women whose
income was between 150 and 299 percent of the federal poverty level, and 18
percent to women whose income was 300 percent or more. There were similar patterns
by poverty level in the percentages of births that were mistimed and unwanted.
(Appendix 1)

State and Local Estimates

State-level estimates of unintended pregnancy rates for 2002, 2004, 2006, and 2008 are available from the Guttmacher Institute.

International Estimates

Percentages of mistimed and unwanted births for
selected countries are available from the Population Reference Bureau’s DataFinder.

National Goals

Several goals related to family planning are
included in Healthy People 2020, a federal initiative to
improve health in the United States. One is to increase the proportion of
pregnancies that are intended from 51 percent in 2002 to 56 percent in 2020. Related
objectives aim to increase access to and use of contraceptives among sexually
active youth and adults.

More information is available here.

What Works to Make Progress on This Indicator

See Child Trends’ LINKS database (“Lifecourse
Interventions to Nurture Kids Successfully”), for reviews of many rigorously
evaluated programs, including the following which have been shown to be
effective at preventing or delaying pregnancy:

Also, see Policy Solutions for Preventing Unplanned Pregnancy, by Adam Thomas, 2012. Center on Children and Families
at Brookings.

Related Indicators

Definition

Births that are “unintended” are any births to the
mother in the five years before the interview that she indicated were either
“unwanted” or “mistimed.” An “unwanted” birth is one where the mother states
that she never wanted a child, or did not want a child of that birth order
(second, third, etc.). A “mistimed” birth is one where the mother states that
the pregnancy occurred too soon. In 2006-10, these determinations were made on
the basis of the following questions (there were slight differences in wording in
earlier years):

  1. [if
    the mother had ever used contraceptives] Before you became pregnant, had you
    stopped using all methods of birth control?
  2. Was
    the reason you (did not use/ stopped using) all methods of birth control
    because you yourself wanted to become pregnant?
  3. Right
    before you became pregnant, did you yourself want to have a(nother) baby at any
    time in the future?
  4. So
    would you say that you became pregnant too soon, at about the right time, or
    later than you wanted?

If, to either question
three or four, the mother answered that she “didn’t care,” the birth was
considered intended.

More information is
available here.

Data Sources

Data by age and poverty level, 1982-1988: Forrest, J. D., and
Singh, S. (1990). The sexual and reproductive behavior of American women. Family
Planning Perspectives, 22
(5), 206-219. Available at: http://www.jstor.org/stable/10.2307/2135494.

Data for 1995, except for total unintended, mistimed, and
unwanted: Abma J. C., Chandra A., Mosher W. D., Peterson L., Piccinino L.
(1997). Fertility, family planning, and women’s health: New data from the 1995
National Survey of Family Growth. Vital Health Stat 23(19). National
Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/series/sr_23/sr23_019.pdf.

Data for ages 25-29, in 2002: Chandra A., Martinez G.M., Mosher W.
D., Abma J. C., Jones J. (2005). Fertility, family planning, and reproductive
health of U.S. women: Data from the 2002 National Survey of Family Growth. Vital
Health Stat 23
(25). National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf.

All other data: Mosher W.D., Jones J., Abma J.C. (2012). Intended
and unintended births in the United States: 1982-2010. National health
statistics reports; no 55
. Hyattsville, MD: National Center for Health
Statistics. Available at: http://www.cdc.gov/nchs/data/nhsr/nhsr055.pdf.

Raw Data Source

National Survey of Family Growth 1982, 1988,
1995, 2002, and 2006-2010

http://www.cdc.gov/nchs/nsfg.htm

 

Appendix 1 – Percentage of births that were unintended, by type of unintended birth, and by mother’s characteristics, selected years 1982-2010

1982 1988 1995 1 2002 2006-10
Total Unintended 36.5 39.1 30.6 34.9 37.1
Age
15-19 67.4 72.6 65.7 78.4 77.2
20-24 37.7 46.1 38.9 44.0 50.1
25-29 26.3 31.9 22.2 27.0 28.3
30-34 31.4 27.1 22.5
35-39 27.3 34.3
40+ 23.7 53.2
Race/Hispanic origin
White, non-Hispanic 30.1 26.9 28.8 30.7
Black, non-Hispanic 51.4 51.3 50.9 53.5
Hispanic2 28.7 30.3 43.3 42.9
Marital Status (at birth)
Ever married 29.7 22.2 25.3
Never married 71.6 58.3 59.6
Married 21.5 23.1 23.4
Unmarried 53.1 55.9 56.4
Not cohabiting 59.5 66.9
Cohabiting 51.3 50.7
Birth order
First birth 31.3 36.1 38.6
Second birth 23.8 28.4 30.6
Third or higher order birth 39.9 41.4 42.9
1982 1988 1995 1 2002 2006-10
Education at time of interview3
Less than high school 37.4 41.8 41.1
High school or GED only 29.8 35.8 40.1
Some college 24.0 33.2 36.7
Bachelor’s degree or more 17.4 14.5 16.7
Household income at time of interview4
0-149% FPL 38.0 44.2 46.3
0-99% FPL 51.1 58.6 40.6 47.2 47.5
150-299% FPL 28.1 34.7 35.0
300%+ FPL 16.1 18.6 17.7
Mistimed Births 26.7 26.7 20.5 20.8 23.3
Age
15-19 53.7 57.0 54.5 56.9 57.9
20-24 31.2 34.6 30.9 26.9 33.6
25-29 18.7 22.9 13.3 16.3 15.8
30-34 14.8 14.2 11.9
35-39 8.3 13.4
40+ 11.6 9.0
Race/Hispanic origin
White, non-Hispanic 23.5 20.0 18.1 21.4
Black, non-Hispanic 31.5 31.3 24.6 30.6
Hispanic2 18.2 19.9 26.5 24.8
1982 1988 1995 1 2002 2006-10
Marital Status (at birth)
Ever married 22.2 12.8 16.4
Never married 50.2 42.9 36.5
Married 14.8 14.1 16.2
Unmarried 36.1 32.8 33.5
Not cohabiting 32.6 39.2
Cohabiting 33.2 30.3
Birth order
First birth 27.0 27.6 29.9
Second birth 17.5 17.2 19.2
Third or higher order birth 18.5 14.8 19.9
Education at time of interview3
Less than high school 19.8 22.7 17.9
High school or GED only 18.4 19.7 22.8
Some college 17.1 19.3 24.1
Bachelor’s degree or more 12.4 8.5 12.6
Household income at time of interview4
0-149% FPL 22.3 24.4 25.6
0-99% FPL 34.7 33.8 22.7 24.1 27.2
150-299% FPL 20.6 20.5 23.3
300%+ FPL 11.7 11.7 13.2
1982 1988 1995 1 2002 2006-10
Unwanted Births 9.8 12.4 10.1 14.1 13.8
Age
15-19 13.7 15.6 10.6 21.4 19.3
20-24 6.5 11.5 7.7 17.2 16.5
25-29 7.6 9.0 8.9 10.4 12.4
30-34 16.6 12.9 10.5
35-39 19.0 20.9
40+ 12.1 44.2
Race/Hispanic origin
White, non-Hispanic 6.5 6.7 10.7 9.3
Black, non-Hispanic 19.9 19.1 26.2 22.9
Hispanic2 10.5 10.4 16.8 18.1
Marital Status (at birth)
Ever married 7.6 6.8 8.9
Never married 21.4 14.9 23.1
Married 6.5 9.0 7.2
Unmarried 15.4 22.5 22.9
Not cohabiting 26.9 27.7
Cohabiting 18.1 20.4
Birth order
First birth 4.0 8.5 8.8
Second birth 6.2 11.3 11.3
Third or higher order birth 21.0 26.6 23.0
1982 1988 1995 1 2002 2006-10
Education at time of interview3
Less than high school 17.5 19.1 23.2
High school or GED only 16.1 17.3
Some college 6.9 13.9 12.6
Bachelor’s degree or more 5.0 6.0 4.0
Household income at time of interview4
0-149% FPL 15.5 19.8 20.7
0-99% FPL 16.4 24.8 17.6 23.2 20.3
150-299% FPL 7.3 14.2 11.7
300%+ FPL 4.3 7.0 4.5
1Due to a programming error
on the survey, data for 1995 inflated the percentage of births that were
intended, treat data with caution.2Hispanics may be any race.3Refers only to births to women
who were older than 20 at the time of the interview. In 1995, only refers to
women who were older than 22 at the time of the interview.

4Refers only to births to women
who were between 20 and 44 at the time of the interview.

Sources: Data by age and poverty level, 1982-1988:
Forrest, J. D., and Singh, S. (1990). The sexual and reproductive behavior of
American women. Family Planning Perspectives, 22(5), 206-219.
Available at: http://www.jstor.org/stable/10.2307/2135494. Data for 1995,
except for total unintended, mistimed, and unwanted: Abma J. C., Chandra A.,
Mosher W. D., Peterson L., Piccinino L. (1997). Fertility, family planning,
and women’s health: New data from the 1995 National Survey of Family Growth. Vital
Health Stat 23
(19). National Center for Health Statistics. Available at:
http://www.cdc.gov/nchs/data/series/sr_23/sr23_019.pdf. Data for ages 25-29,
in 2002: Chandra A., Martinez G.M., Mosher W. D., Abma J. C., Jones J.
(2005). Fertility, family planning, and reproductive health of U.S. women:
Data from the 2002 National Survey of Family Growth. Vital Health Stat 23(25).
National Center for Health Statistics. Available at:
http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf. All other data:
Mosher W.D., Jones J., Abma J.C. (2012). Intended and unintended births in
the United States: 1982-2010. National health statistics reports; no 55.
Hyattsville, MD: National Center for Health Statistics. Available at:
http://www.cdc.gov/nchs/data/nhsr/nhsr055.pdf.

 

Endnotes


[1]Barber, J. S., & Emens, A. (2006). The
intersection among unintended, premarital, and teenage childbearing in the U.S.
:
Population Studies Center, Report No. 06-608. University of Michigan Institute
for Social Research.

[2]Mosher, W. D., Jones, J., & Abma, J. C. (2012). Intended and
unintended births in the United States: 1982-2010
. Hyattsville, MD:
National Center for Health Statistics.

[3]Finer, L. B., Zolna, M. R. (2011) Unintended
pregnancy in the United States: incidence and disparities, 2006. Contraception,84(5), 478-485. Available at:http://www.guttmacher.org/pubs/journals/j.contraception.2011.07.13.pdf.

[4]Ibid.

[5]Mosher, W. D., Jones, J., & Abma, J. C.
(2012). Op. cit.

[6]Gipson, J., Koenig, M., & Hindin, M. (2008). The
effects of unintended pregnancy on infant, child, and parental health: A review
of the literature. Studies in Family Planning, 39(1), 18-38.

[7]Logan, C., Holcombe, E., Manlove, J., & Ryan, S. (2007). The
consequences of unintended childbearing: A white paper
. Washington, DC:
Child Trends, and the National Campaign to Prevent Teen and Unplanned
Pregnancy.

[8]Gipson, J., Koenig, M., & Hindin, M. (2008). Op.
cit.

[9]Logan, C., Holcombe, E., Manlove, J., & Ryan,
S. (2007). Op. cit

[10]Bronte-Tinkew, J., Scott,
M. E., Horowitz, A., & Lilja, E (2009).
Pregnancy intentions during the transition to parenting and links to
coparenting for first-time fathers of infants.
Parenting, 9(1/2), 1-35.

[11]Mosher, W. D., Jones, J., & Abma, J. C. (2012).
Op. cit.

[12]Sonfield, A., Kost, K., Gold, R. B., & Finer, L.
B. (2011). The public costs of births resulting from unintended pregnancies:
National and state-level estimates. Perspectives on Sexual and Reproductive
Health, 43
(2), 94-102.

[13]Mosher, W. D., Jones, J., & Abma, J. C.
(2012). Op. cit.

[14]Barber, J. S., & Emens, A. (2006). Op. cit.

[15]Hispanics may be any race. However, blacks and whites in this report do not include Hispanics.

[16]Barber, J. S., & Emens, A. (2006). Op. cit.

[17]Education at time of interview, for women 22 years or
older.

[18]Barber, J. S., & Emens, A. (2006). Op. cit.

[19]Musick, K., England, P., Edgington, S., & Kangas,
N. (2009). Education differences in intended and unintended fertility.
Unpublished manuscript, Los Angeles: California Center for Population Research.

[20]Income data was calculated only for women between the
ages of 20 and 44 at the time of the interview.

 

 

Suggested Citation:

Child Trends. (2013). Unintended births. Available at: https://www.childtrends.org/?indicators=unintended-births

 

Last updated: September 2013