Unintended Pregnancies

An unintended pregnancy (UI pregnancy) is defined as a pregnancy that occurs when the pregnant person either did not want children at all, or did not want them at that point in time.

How Common Are Unintended Pregnancies?

Are All Unintended Pregnancies Unwanted?

“Unintended” is not synonymous with unwanted. For example, someone may want a child at some point but have too many uncertainties or unmet needs in their life at that moment. There are a range of reactions to a pregnancy that wasn’t planned that are as broad as the range of outcomes.

How Do Unintended Pregnancies Occur?

UI pregnancies typically come with the assumption that the pregnant person is an unwed teenager, when in fact any person who is able to have children can have a UI pregnancy. Older people can experience UI pregnancies due to misconceptions about their fertility and extremely young people can experience an UI pregnancy due to force. Stigma comes with a pregnancy occurring out of wedlock in many cultures, whereas within a marriage it is assumed that a wife is open to having a child at any time. The reality is that contraception isn’t nearly as widely understood and used as it should be, no contraceptive method is 100% reliable, consent isn’t always obtained, and it unfortunately isn’t uncommon for contraception to be undermined through violence and/or coercion.

Many factors are at the root of UI pregnancy, including shame, fear, stigma, poverty, lack of education, and gender inequality. Any factors that erode human agency contribute to UI pregnancies. Poverty is a factor, not only due to living in an underserved area and the potential inability to afford or obtain contraception, but poor women often see pregnancy as an inevitability and/or they live in economic circumstances where large families are viewed as beneficial. Additionally, a power imbalance between genders in certain countries gives men more say in the number of children they have with their partners. 23% of women in all countries with available data actually reported that they are unable to say no to sex.

Consequences of Unintended Pregnancy

UI pregnancies aren’t without cost, not only to the individual’s health, education and future but to entire health systems, workforces and societies. A growing body of evidence has correlated UI pregnancies not only with massive healthcare costs but with lower human development scores and high rates of unsafe abortion and maternal death.

Loss of education for teenagers, loss of income for adults, and increased risk of poverty are all common consequences of UI pregnancy. Consequences are typically most severe for adolescents, as pregnancy is the leading cause of death for girls aged 15 to 19. Older women face higher rates of pregnancy complications in addition to opportunity costs.

UI pregnancies are strongly associated with poorer maternal mental health when the pregnancy is carried to term. Increased maternal depression was observed both during the pregnancy as well as within the first 7 years of the child’s life. Additionally, mothers of unintended children aged 5 to 18 were found to have significantly higher rates of depression and unhappiness. Evidence also suggests that unintended births lead to poorer parent-child relationships.

While 29% of all pregnancies end in abortion, the rate for UI pregnancies is 61%. And since an estimated 45% of abortions are unsafe, UI pregnancies cause 7 million people in developing countries to be hospitalized each year.

Reducing Unintended Pregnancy

Contraception

Contraception access and education is obviously necessary for reducing UI pregnancies. Surprisingly, lack of access isn’t the primary reason that contraception isn’t used by people who want to avoid pregnancy but either aren’t using contraception or are using outdated or unsafe methods. Stigma, myths, opposition from others, and potential side effects are among their top concerns.

Human Rights

Gender equality and human rights are inextricably tied to UI pregnancies; empowered women are better equipped to avoid UI pregnancies and also to address ones that occur. While UI pregnancy rates have fallen in recent years, they still have a long way to go, and are still very much an issue on an absolute basis.

Education

More education for women equals greater agency over their own lives. Not only are they better equipped to make decisions, but they also have greater levels of support. There’s a proven reduction in UI pregnancy rates in relationships where either or both partners have higher levels of education.

Connection with Abortion

There’s no evidence that abortion rates are lower in countries where it is restricted. On the contrary, one study found that in countries that restricted abortion, the percentage of UI pregnancies ending in abortion increased every 5 years over the time period studied. By contrast, there was a 13% decrease in abortion in countries where it is legal, with the exception of China and India. The fact that women were found to seek abortions at the same rate regardless of restrictions points to a need for the inclusion of abortion care in national health care systems.

Sources

Nearly half of all pregnancies are unintended—a global crisis, says new UNFPA report. (2022, March 30). United Nations Population Fund. https://www.unfpa.org/press/nearly-half-all-pregnancies-are-unintended-global-crisis-says-new-unfpa-report
Bearak, J., Popinchalk, A., Ganatra, B., Moller, A.-B., Tunçalp, Ö., Beavin, C., Kwok, L., & Alkema, L. (2020). Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. The Lancet Global Health, 8(9). https://doi.org/10.1016/S2214-109X(20)30315-6
Herd, P., Higgins, J., Sicinski, K., & Merkurieva, I. (2016). The Implications of Unintended Pregnancies for Mental Health in Later Life. American journal of public health, 106(3), 421–429. https://doi.org/10.2105/AJPH.2015.302973