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Unintended Pregnancy -- New York, 1988 - 1989

Unintended pregnancies may be associated with an increased occurrence of low birth weight infants and other problems (1). To assist in the prevention of unintended pregnancies, in 1988-1989 the New York State Family Planning Program (NYSFPP) surveyed reproductive-aged women (15-44 years of age) in New York to estimate family planning needs (2). This report presents the results from that survey regarding unintended pregnancy.

From October 1988 through February 1989, the NYSFPP conducted a computer-assisted telephone survey (using both a list of telephone numbers and random-digit dialing) to obtain data on reproductive health topics from 1910 reproductive-aged women who lived in New York (women who lived in New York City were excluded from the survey). Respondents were asked, "At the time you last became pregnant, did you, yourself, actually want to have a baby at some time?" Respondents who answered "yes" were asked, "Did you become pregnant sooner than you wanted, later than you wanted, or at about the right time?" A pregnancy was classified as intended if it occurred "at about the right time" or "later than desired." An un intended pregnancy was classified as mistimed if it occurred sooner than desired or unwanted if it had not been wanted at any time. Analysis for this report was restricted to the 1301 (68.1%) women who had ever been pregnant.

Overall, 36.2% (95% confidence interval (CI)=32.9%-39.4%) of the women surveyed reported that their last pregnancy had been unintended: 23.5% (95% CI=20.7%-26.4%) reported that their last pregnancy was mistimed, and 12.6% (95% CI=10.3%-15.0%), that the pregnancy had been unwanted. Women aged 15-24 years were substantially more likely (67.2%) to report an unintended pregnancy than were women aged 25-34 years (37.0%) or 35-44 years (27.3%) (Table 1). The risk for unintended pregnancy varied inversely by educational level and income (Table 1). Women who had never had a live-born infant were substantially more likely to report an unintended last pregnancy than were women who had had one or more live-born infants (Table 1).

The overall rate of unintended pregnancy was 35.1% for white women, compared with 43.4% for women of other races (Table 1).* Although rates of mistimed pregnancy were similar by race, white women reported a lower proportion of unwanted pregnancies (11.1% (95% CI=9.0%-13.3%)) than did women of other races (20.7% (95% CI=11.3%-30.0%)). In both racial groups, the proportion of unintended pregnancies was higher among younger women.

Married women were substantially less likely (29.9%) than previously married (49.7%) and never married (92.8%) women to report their last pregnancy as unintended (Table 1). Among married women, unintended pregnancies were reported by 49.9% (95% CI=36.8%-63.0%) of those aged 15-24 years, 31.1% (95% CI=25.8%-36.4%) of those aged 25-34 years, and 25.5% (95% CI=21.0%-30.0%) of those aged 35-44 years. Rates of unintended pregnancies for married women did not vary by race, but married women with incomes less than or equal to 200% of the federal poverty level were more likely (47.1% (95% CI=38.7%-55.6%)) to report unintended pregnancies than were married women with higher incomes (27.3% (95% CI=23.6%-30.9%)). Reported by: ML Woelfel, MA, R Walsh, MPA, DL Morse, MD, State Epidemiologist, New York State Dept of Health. Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: One goal of the national health objectives for the year 2000 is that no more than 30% of all pregnancies be unintended (3). In New York, the occurrence of unintended pregnancy was substantially higher than this among women who were young, in the lowest income group, or never married. These differences suggest the need to address variations by subgroup.

During the 1980s, national rates of unintended and unwanted childbearing increased substantially for several groups (4). However, the findings in this report underscore the importance of state-specific data in characterizing factors associated with unintended pregnancy. Without state-specific data, estimates of unintended pregnancy must be based on national or regional estimates that may be less accurate for teenaged women, unmarried women, and women of certain racial and ethnic groups (5). For example, in the 1988 National Survey of Family Growth, the overall estimate of unintended pregnancy for women who had never been married was 18 percentage points lower than the rate for never-married women in New York (6).

State-specific surveys can provide useful information to program planners and administrators for planning and allocating resources to target populations in local areas. As a result of the findings in this report, the New York State Department of Health has increased efforts to promote local programs to prevent unintended pregnancy.

References

  1. Pamuk ER, Mosher WD, NCHS. Health aspects of pregnancy and childbirth: United States, 1982. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1988; DHHS publication no. (PHS)88-1992. (Vital and health statistics; series 23, no. 16).

  2. CDC/New York State Department of Health. New York Reproductive Health Survey, 1989: final report. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1991.

  3. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

  4. Williams DB, Pratt WF, NCHS. Wanted and unwanted childbearing in the United States: 1973-1988. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1990; DHHS publication no. (PHS)90-1250. (Vital and health statistics; series 23, no. 189).

  5. Morris L. Estimating the need for family planning services: a case study on the suitability of national data for making local estimates in the United States. Ann Arbor, Michigan: University of Michigan, 1978.

  6. NCHS. National Survey of Family Growth (machine-readable public-use data tape). Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1988.

*Numbers from other racial groups were too small to provide estimates for each group independently.

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