The unintended pregnancy rate in the United States reached its lowest level in about 30 years, likely because women increasingly are using long-acting reversible contraceptives (LARCs), a Guttmacher Institute study finds, according to HealthDay/U.S. News & World Report (Thompson, HealthDay/U.S. News & World Report, 3/2).
Study details
For the study, researchers examined 2009 to 2013 data from CDC's National Survey of Family Growth and compared it with data collected between 2006 and 2010. Specifically, the researchers looked at information on about 2,000 pregnancies.
According to CNN, the researchers categorized a pregnancy as unintended if a woman indicated that she never wanted to become pregnant or said she did not yet want to become pregnant (Storrs, CNN, 3/2).
Key findings
The study found that unintended pregnancies decreased by 18 percent between 2008 and 2011, marking the most significant decline in decades.
Between the 1980s, when Guttmacher started tracking unintended pregnancies, and 2008, the unintended pregnancy rate remained between 49 and 59 per 1,000 women ages 18 to 44. By 2011, the rate fell to 45 unintended pregnancies per 1,000 women (Kliff, Vox, 3/2). Lawrence Finer -- lead author of the study and director of domestic research at the Guttmacher Institute -- said, "This is a very exciting thing to see because the rate has been somewhat stagnant for quite a while, and unintended pregnancy is a key measure of the extent to which American women are able to achieve their childbearing goals" (CNN, 3/2).
Overall, 2.8 million of 6.1 million pregnancies in 2011 were unintended, according to the study (Fox/Deo, NBC News, 3/2). The researchers noted that the percentage of unintended pregnancies that were terminated remained relatively stable between 2008 and 2011, from 40 percent to 42 percent (HealthDay/U.S. News & World Report, 3/2).
Despite improvement, disparities remain
Mia Zolna, a research associate at the Guttmacher Institute, said the unintended pregnancy rate declined across all age, income, race and ethnicity groups (NBC News, 3/2). Finer said, "This is really the first time we've seen such a broad-based decline. In the past, more advantaged groups have had declines and more disadvantaged groups have had increases" (CNN, 3/2).
Nonetheless, the study found that black and Hispanic women still were twice as likely as white women to have an unintended pregnancy, while women without a high school degree were three times more likely than women who graduated college to have an unintended pregnancy (HealthDay/U.S. News & World Report, 3/2). Moreover, women with incomes below the federal poverty level were about five times as likely as women with the highest incomes to have an unintended pregnancy (CNN, 3/2).
Increasing LARC use drives decline
Finer said the rate of unintended pregnancies is falling because women are using more effective birth control methods, particularly LARC (Vox, 3/2). The study found that the percentage of women in the United States who use intrauterine devices (IUDs) or other types of LARC increased from 4 percent in 2007 to 12 percent in 2012 (HealthDay/U.S. News & World Report, 3/2).
According to Vox, it is unclear what exactly drove the increase in LARC use. The Affordable Care Act (ACA) (PL 111-148) expanded access to such contraceptives, but LARC usage already started increasing before the law took effect, Vox reports (Vox, 3/2). Finer noted that the ACA could drive further declines in the unintended pregnancy rate, stating, "Given that we researched a period that was before the Affordable Care Act, we're interested to see what is going to happen going forward ... We may see a continued downward trend" (HealthDay/U.S. News & World Report, 3/2).
He added that the law also allows young adults, who are at risk for unintended pregnancies, to remain on their parents' health insurance plan until age 26. Such coverage could further curb the unintended pregnancy rate if it "translate[s] into improved access to and use of contraception," he said (NBC News, 3/2).
In addition, Finer said major medical groups, including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, have recently advised providers to offer IUDs to teenagers and nulliparous women. "Those groups of women have not traditionally been considered candidates for the IUD, but if you look at the evidence on safety and effectiveness, these methods can be used by a wide range of women," Finer said (HealthDay/U.S. News & World Report, 3/2).
