How much do you know about the problem of unintended pregnancies? Or about the relationship between these pregnancies and birth control? If the answer is "Not a lot", read on. You might be surprised by what you learn.

Worldwide, according to the Center for Reproductive Law and Policy , nearly 230 million women--1 in 6 women of childbearing age--lack information on, and access to, the full range of birth control methods. More than one-third of all pregnancies--80 million each year--are unwanted or mistimed.

In the U.S., there are approximately 5.38 million pregnancies each year. About  half, or 2.65 million, are unintended pregnancies.
Of these unintended pregnancies, the majority or 1.4 million end in abortion. The rest, or 1.2 million, result in births.

Teenagers (ages 15 - 18) have the highest rate of unintended pregnancies.

Surprisingly, the second highest rate is found in women aged 40 - 44 years.

What is even more surprising, and disconcerting, is that the majority of unintended pregnancies occur in women using birth control. This means approximately 1.4 million unintended pregnancies happen in women using birth control at the time that they become pregnant. Only 40% of accidental pregnancies occur in women who don't use birth control.
For example, it's estimated that about 1 million unintended pregnancies happen because of improper use of birth control pills.

The U.S. has one of the highest rates of unintended pregnancies in the developed world. Overall, this rate has declined little over the past several decades.
Clearly unintended pregnancies represent an important public health concern in the U.S.

There are many health risks associated with an unintended pregnancy. Unfortunately, in the U.S., the abortion aspect and the negative socioeconomic issues are usually the predominant focus. The actual health problems and the mortality associated with an unintended pregnancy are usually completely overlooked.
For example, consider just a few of the health benefits of planning a pregnancy:

treatment of any preexisting medical conditions--the blood sugar level can be optimized, for the diabetic woman, the anemic woman can receive iron supplements, etc.
if the woman has a potentially deadly infection for the baby, the infection can be treated before there is a risk of transmitting the infection to the fetus
the mother-to-be can bring her immunizations up-to-date
couples with genetic problems can benefit from genetic counseling

Also, childbirth is the most common reason for hospitalization in the U.S. Hospitalizations for pregnancy complications occurring before delivery account for more than 2 million hospital days per year, at a cost of greater than $1 billion annually.

For the overwhelming majority of women, effective birth control is much safer than childbirth.

In addition to the health benefits of a planned pregnancy, by using birth control you can derive a host of other health benefits, unrelated to pregnancy.
For example, if you use birth control, you can:

reduce your risk of ovarian, uterine, and possibly colorectal cancers
treat painful periods and premenstrual syndrome (PMS)
improve anemia, or acne
control whether and when you have a period (menstrual management)  
lower your risk of acquiring a Sexually Transmitted Infections (STI), like HIV, the virus that causes AIDS

In the U.S., each year about 17.6 million women visit their health care provider to receive services for a birth control method. Despite this, studies have found that women report using some form of birth control during the month of conception for more than half of all unintended pregnancies.
Of course, there are many factors that can contribute to the failure of a birth control method. By far, the most common reasons reported by women are incomplete or improper use of a birth control method due either to:

intolerance of its side-effects
displeasure with its side-effects
misperceptions about the potential risks of using a particular method

For example, women using birth control pills point to several reasons for not taking the pill regularly, or taking it improperly:

difficulty remembering to take a pill every day
problems tolerating the pill's side effects, especially spotting between periods
fears about the potential risks of using the pill

So why don't women just chose another method of birth control, which is better suited to them? Sadly, because they lack information about, and access to, all the available birth control methods.
Consider the fact that the U.S. is the only developed country in the world where sterilization is still the most frequently used method of birth control. Women all over the world, from India to Uruguay have more birth control options than women in the U.S.

A very high number of unintended pregnancies occur in the U.S. each year.

An unintended pregnancy can have long-lasting, negative health consequences for both the mother and the baby.

By contrast, a planned pregnancy can facilitate a healthy outcome for both mother and child. The benefits of planning a pregnancy extend not only to the psychosocial and economical aspects but, most importantly, to the health aspects.

In addition to protecting against an unintended pregnancy, using birth control allows women to improve their health and lead healthier lives.

Millions of women become pregnant despite using birth control at the time of conception.

Women in the U.S. experience problems with their birth control method because they lack adequate information about, and access to, all the available birth control options.

In the U.S., preventing unintended pregnancies and allowing women to lead healthier lives through the use of birth control represent a pressing challenge for both the public and the medical professionals.

Some suggestions that might help with this challenge are:

better educating the public about the problem of unintended pregnancies and its health implications
better informing women, as well as men, about the correct use of birth control, the health benefits it can offer, and dispelling the misconceptions about its side effects
making available to the U.S. public the entire array of available birth control options
continuing research efforts into developing new and improved methods of birth control


1. Clinical Courier  Vol.19, No.5  April 2001
2. Dialogues in Contraception  Vol.6,  No7  Spring 2001

Copyright 2001-2004 GHO.  All rights reserved.