- In 2013, the U.S. teenage pregnancy rate reached its lowest level (43 per 1,000 females, ages 15–19) since 1990 (118 per 1,000).
- Rates of teenage pregnancy have declined across all racial/ethnic groups since the 1990s, although the rates for black and Hispanic teens are still more than twice the rate for non-Hispanic white teens.
- Older teens (ages 18–19) have much higher rates of pregnancy than younger teens.
While rates of unplanned pregnancy have declined in recent years, nearly half of all pregnancies in the U.S. States are unplanned, as described by the women themselves. In addition, despite recent progress, significant disparities in unplanned pregnancy rates remain.
Rates are highest among older teens and young women in their 20s, women living in poverty, and women of color. For example, women ages 20-to-24 experience a higher rate of unplanned pregnancy than any other age group, accounting for one-third of all unintended pregnancies. According to a 2016 report, the rate of unplanned births among women with incomes below federal poverty guidelines was nearly seven times greater than the rate among women with incomes of 200 percent of the federal poverty level or higher. The unplanned pregnancy rate among African-American women was more than double the rate among white women.
Both individuals and states pay for the high costs associated with unplanned pregnancies. An unplanned pregnancy can disrupt educational goals, severely affecting future earning potential and family financial wellbeing.
Significant intergenerational effects also exist. Women with an unplanned pregnancy, for example, are less likely to receive prenatal care. And children born as a result of an unplanned pregnancy are more likely, on average, to have poorer health and score worse on behavioral and developmental measures, compared to children born as a result of a planned pregnancy.
These costs extend to state coffers. A 2011 Brookings Institution report found that taxpayers spend an estimated $12 billion each year on publicly financed medical care for women and infants related to unplanned pregnancy. A 2015 report examined these and additional public medical care costs (e.g., the cost of medical care for children up to age five) associated with unplanned pregnancy. It found that in 2010, U.S. state and federal government expenditures for unplanned pregnancy-related care totaled $21 billion, with public insurance programs, such as Medicaid, financing 68 percent of unplanned births, compared to 38 percent of planned births. This number does not capture additional costs stemming from an unplanned pregnancy’s impact on educational attainment, family economics, and child health and wellbeing.
Numerous evidence-informed strategies can help prevent unplanned pregnancy and its associated costs. The Centers for Disease Control and Prevention include preventing unintended pregnancy in its 6 |18 Initiative, which targets six common and costly health conditions, such as high blood pressure and asthma, with 18 proven prevention activities.
The initiative proposes reimbursing providers for the full range of contraceptive services and removing administrative and logistical barriers to accessing long-acting reversible contraception (or LARC, such as intrauterine devices and implants) to help prevent unplanned pregnancy, among other recommendations.
In addition, in response to the high costs for women, families and states, some state leaders have also explored a range of strategies to help women plan, space or prevent future pregnancies.
- Insurance coverage for contraception.
- Medicaid reimbursement for post-partum long-acting reversible contraception (LARC).
- Pharmacy access to contraception.
- Expanding access to information for college students.