An unintended pregnancy is a pregnancy that is either unwanted, such as the pregnancy occurred when no children or no more children were desired. Or the pregnancy is mistimed, such as the pregnancy occurred earlier than desired. The concept of unintended pregnancy helps in understanding the fertility of populations and the unmet need for contraception, also known as birth control, and family planning. Most unintended pregnancies result from not using contraception or from not using it consistently or correctly.
To help women, men, and couples prevent or achieve pregnancy, it is essential to understand their pregnancy intentions or reproductive life plan. A reproductive life plan may include personal goals about becoming pregnant, such as whether they want to have any or more children, and the desired timing and spacing of those children. A reproductive life plan may help identify reproductive health care needs that include contraceptive services, pregnancy testing, and counseling to help become pregnant, or manage a pregnancy with prenatal and delivery care.
Women who choose to delay or prevent pregnancy should be offered contraceptive services that include:
- A full range of FDA-approved contraceptive methods.
- A brief assessment to identify the contraceptive methods that are safe for the client.
- Contraceptive counseling to help a client choose a method of contraception and learn how to use it correctly and consistently.
- Provision of one or more selected contraceptive methods, preferably on site, but by referral if necessary.
Preconception Health Promotion
Preconception health and health care services [PDF – 284 KB] aim to promote the health of women (and men) of reproductive age before conceiving a child, and thereby help to reduce pregnancy-related adverse outcomes, such as low birthweight, premature birth, and infant mortality. Moreover, preconception health services may improve a woman’s health and wellbeing, regardless of her childbearing intentions.
Women of reproductive age can make choices about their health and health care that help to keep themselves healthy, and if they choose to be pregnant, have a healthy baby. Adopting healthy behaviors is the first step women can take to get ready for the healthiest pregnancy possible.
Unintended pregnancy is associated with an increased risk of problems for the mom and baby. If the mom was not planning to get pregnant, she may have unhealthy behaviors or delay getting health care during the pregnancy, which could affect the health of the baby. Therefore, it is important for all women of reproductive age to adopt healthy behaviors such as:
- Take folic acid.
- Maintain a healthy diet and weight.
- Be physically active regularly.
- Quit tobacco use.
- Refrain from excessive alcohol drinking.
- Abstain from alcohol if pregnant or planning to become pregnant.
- Take only medicines prescribed by your doctor.
- Talk to your health care provider about screening and proper management of chronic diseases.
- Visit your health care provider to receive recommended health care for your age, learn about possible health risks, and discuss if or when you are considering becoming pregnant.
- Use effective contraception correctly and consistently if you are sexually active but choose to delay or avoid pregnancy.
Snapshot of Progress
In 2008, women reported that more than half of all pregnancies (51%) were unintended. By 2011, the percentage of unintended pregnancies declined to 45%. That is an improvement, but some groups still tend to have higher rates of unintended pregnancy. For example, 75% of pregnancies were unintended among teens aged 15 to 19 years. Unintended pregnancy rates per 1,000 women were highest among women who:
- Were aged 18 to 24 years.
- Had low income (<100% of federal poverty level).
- Had not completed high school.
- Were non-Hispanic black or African American.
- Were cohabiting but had never married.
Note: Information was obtained from the journal article “Declines in Unintended Pregnancy in the United States, 2008–2011”published in N Engl J Med. 2016;374(9):843–852.
The United States set family planning goals in Healthy People 2020 to improve pregnancy planning and spacing, and to reduce the number of unintended pregnancies. Two ways to reach these goals are to increase:
- Access to contraception that includes the full range of methods, such as long-acting, and reversible forms like intrauterine devices and hormonal implants.
- Correct and consistent use of contraception for sexually active women who choose to delay or avoid pregnancy.
What CDC Is Doing
CDC is working on many things to help prevent unintended pregnancy such as:
- Examine the need for contraceptive services among women of reproductive age.
- Increase access, use, and dissemination of data to identify groups most at risk for unintended pregnancy; show the health impacts of teen and unintended pregnancy; and close gaps in access to quality, patient-centered family planning services.
- Develop and identify evidence-based strategies to reduce unmet needs for quality family planning services among the most affected groups.
- Provide guidance for health care providers who counsel men, women, and couples about contraception.
- Build capacity for health care providers, states, communities, and partners to improve quality patient-centered family planning services and support states and communities to increase access to contraception services.
- Association of State and Territorial Health Officials: Increasing Access to Contraception Learning Community
- Zika Contraception Access Network (Z-CAN): Increasing Access to Contraception: A Toolkit for Program Development, Implementation, and Evaluation
- CDC Contraceptive Guidance for Health Care Providers: US Medical Eligibility Criteria (US MEC) for Contraceptive Use, 2016
- US Selected Practice Recommendations for Contraceptive Use, 2016.
- Update: Providing Quality Family Planning Services—Recommendations from CDC and the US Office of Population Affairs, 2017.