Unintended Pregnancy in North Carolina

North Carolina

An unintended pregnancy is either unwanted (occurring when no children are desired) or mistimed (occurring at a different time than desired). Delayed or lack of prenatal care for women with unintended pregnancies can pose health risks to both them and their babies. Births resulting from unintended pregnancies are associated with adverse health outcomes for mother and baby, including:

• Low birth weight.
• Shorter duration of breastfeeding.
• Increased risk of postpartum depression.
• Physical or psychological aggression and parental maltreatment.

The percentage of unintended pregnancies is higher among:

• Women ages 18-29 compared with older women.
• Non-Hispanic Black women, who have a prevalence more than twice that of non-Hispanic white women.
• Women with incomes below the federal poverty level compared with those who have higher incomes. 
• Women without a high school education compared with those who have higher educational attainment.
• Unmarried but cohabiting women compared with currently married women.

Strategies to reduce unintended pregnancy among sexually active women include: 

• Increasing access to high-quality reproductive health care that includes contraceptive methods. The Centers for Disease Control and Prevention (CDC) recommends that health care providers receive reimbursements for providing their patients with both contraceptive services and education on their contraceptive options — including the benefits of long-acting and reversible contraceptive (LARC) methods such as intrauterine devices (IUDs) and implants.
• Improving correct and consistent use of contraception: Once inserted, LARCs don't require the user to do anything, making them more consistent and easy to use than short-acting contraceptive methods. Increasing LARC usage could also generate significant health care cost savings.

Educating male partners about pregnancy planning can also strengthen efforts toward preventing unintended pregnancies. The CDC provides more resources on proper contraceptive use.

Healthy People 2030 family planning objectives include reducing the proportion of unintended pregnancies and increasing the proportion of women at risk for unintended pregnancy who use effective birth control.

Finer, Lawrence B., and Mia R. Zolna. “Declines in Unintended Pregnancy in the United States, 2008–2011.” New England Journal of Medicine 374, no. 9 (March 3, 2016): 843–52. https://doi.org/10.1056/NEJMsa1506575.

Frost, Jennifer J., Lori F. Frohwirth, and Mia R. Zolna. “Contraceptive Needs and Services, 2014 Update.” Report. New York: Guttmacher Institute, September 27, 2016. https://www.guttmacher.org/report/contraceptive-needs-and-services-2014-update.

Guterman, Kai. “Unintended Pregnancy as a Predictor of Child Maltreatment.” Child Abuse & Neglect 48 (October 2015): 160–69. https://doi.org/10.1016/j.chiabu.2015.05.014.

Kost, Kathryn, and Laura Lindberg. “Pregnancy Intentions, Maternal Behaviors, and Infant Health: Investigating Relationships With New Measures and Propensity Score Analysis.” Demography 52, no. 1 (February 2015): 83–111. https://doi.org/10.1007/s13524-014-0359-9.

Qiu, Xing, Senmao Zhang, Xin Sun, Haiou Li, and Donghua Wang. “Unintended Pregnancy and Postpartum Depression: A Meta-Analysis of Cohort and Case-Control Studies.” Journal of Psychosomatic Research 138 (November 2020): 110259. https://doi.org/10.1016/j.jpsychores.2020.110259.

Sonfield, Adam, Kinsey Hasstedt, and Rachel Benson Gold. “Moving Forward: Family Planning in the Era of Health Reform.” Report. New York: Guttmacher Institute, March 1, 2014. https://www.guttmacher.org/report/moving-forward-family-planning-era-health-reform.

Trussell, James, Nathaniel Henry, Fareen Hassan, Alexander Prezioso, Amy Law, and Anna Filonenko. “Burden of Unintended Pregnancy in the United States: Potential Savings with Increased Use of Long-Acting Reversible Contraception.” Contraception 87, no. 2 (February 2013): 154–61. https://doi.org/10.1016/j.contraception.2012.07.016.