Top Banner

of 28

nhsr055

Apr 03, 2018

Download

Documents

Jin Siclon
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
  • 7/28/2019 nhsr055

    1/28

    U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Centers for Disease Control and Prevention

    National Center for Health Statistics

    Number55 n July24,2012 This report was updated December 20, 2012.Valueswere corrected on pages 9 and 27; andTables2,3,6,andI,andFigureI,wereupdatedtoreflectcorrectedpercentagesandstandarderrors.

    IntendedandUnintendedBirthsintheUnitedStates:19822010

    byWilliamD.Mosher,Ph.D.;JoJones,Ph.D.;andJoyceC.Abma,Ph.D.,DivisionofVitalStatistics

    AbstractObjectivesThisreportshowstrendssince1982inwhetherawoman

    wantedtogetpregnantjustbefore thepregnancyoccurred.Thisis themostdirectmeasureavailableoftheextent towhichwomenareable(orunable)tochoose tohave thenumberofbirthstheywant,when theywantthem.Inthisreport, thisiscalledthestandardmeasureofunintendedpregnancy.

    MethodsThedatausedinthisreportareprimarilyfrom the20062010NationalSurveyofFamilyGrowth(NSFG),conductedbytheCentersforDiseaseControlandPreventionsNationalCenterforHealthStatistics.The20062010NSFGincluded in-personinterviewswith12,279womenaged1544.Somedatain thetrendanalysesare takenfromNSFGsurveysconductedin1982,1988,1995,and2002.

    ResultsAbout37%ofbirths intheUnitedStateswereunintendedat thetimeofconception.Theoverallproportionunintendedhasnotdeclinedsignificantlysince1982.Theproportionunintendeddiddeclinesignificantlybetween1982and20062010amongbirthstomarried,non-Hispanicwhitewomen.Largedifferencesexistbetweengroups inthepercentageofbirthsthatareunintended.Forexample,unmarriedwomen,blackwomen,andwomenwithlesseducationorincomearestillmuchmore likely toexperienceunintendedbirthscomparedwithmarried,white,college-educated,andhigh-incomewomen.Thisreportalsodescribessomealternativemeasuresofunintendedbirthsthatgiveresearchersanopportunitytostudy thistopic innewways.Keywords:unintendedpregnancyunwantedbirthscontraceptiveuseNationalSurveyofFamilyGrowth

    IntroductionThisreportprovidessomebasic

    statisticsontheextent towhichwomenintheUnitedStatesareable,orunable,tohavethenumberofbirths theywant,whentheywant them.Inthisreport, thismeasure iscalledthestandardmeasureofunintendedpregnancy.

    Thereportdescribes trendsandgroupdifferencessince1982inwhetherbirthswere intendedorunintendedandis limited topregnanciesthatendedinlivebirths.Pregnanciesending inmiscarriage,stillbirth,orabortionareexcluded.Research thatincludedallpregnancyoutcomes(13)hasshownthataboutone-halfofallpregnancies intheUnitedStatesareunintendedbythemotherat thetimeshebecomespregnant, includingmorethanone-thirdof livebirths(Table1).Otherstudies(1,46)haveshown thatahigherpercentageofbirthsamong teenagers,unmarriedadults, low-incomeandless-educatedwomen,andblackwomenareunintended,comparedwithmarried,high-income,college-educated,andwhite

    women.

    Manystudiesonunintended

    childbearing(713),includingacomprehensivereviewby theInstituteofMedicine(7)andarecentwhitepaperreviewingmore than60additional

  • 7/28/2019 nhsr055

    2/28

    Page2 NationalHealthStatisticsReports n Number55 n July24,2012studiesonthis topic(8),havealsoshown thatbirths thatwereunintendedbythemotherareatelevatedriskofadversesocial,economic,andhealthoutcomesfor themotherand thechild.Unintendedbirthsareassociatedwithdelayedprenatalcare,smokingduringpregnancy,notbreastfeeding thebaby,poorerhealthduringchildhood,andpooreroutcomesforthemotherandthemother-childrelationship(713).Longer-termnegativeconsequencesforchildrenhavebeenfoundbysomelongitudinalstudiesofunintendedpregnancies that trackthechildren intoadulthood(8,12,13).

    Reducing thepercentageofallpregnancies thatareunintendedhasbeenoneof theobjectivesof theHealthyPeoplenationalhealth initiativesince itsbeginningin1980(1416).TheHealthyPeopleobjectiveshaveplacedanemphasisonreducingdisparities inunintendedpregnancyamonggroupswithhigher levelsandrates(116),including teenagers,unmarriedadults,and low-incomeandminoritypopulations.In1999,familyplanning(definedastheability toachievedesiredbirthspacingandfamilysize)wasnotedasoneof10achievements inpublichealth inthe20thcenturybecause

    of

    its

    contribution

    to

    the

    health

    ofinfants,children,andwomen(17).

    Tworecentstudies(18,19)estimatedtheannualcostto taxpayersofunintendedpregnancyandbirthintheUnitedStates.Thecostsexaminedincludedonlycostsforprenatalcare,pregnancy, laboranddelivery,and infantcarefor1yearafterbirth.Thestudiesuseddifferentassumptionsandmethods:oneestimatedthecostsatabout$11.3billion,and theotheratabout$11.1billion,peryear.Theseestimatesexcludealllong-termcostsofunintendedpregnancyandallnonmedicalcostsbecausesuchcostsaremoredifficult toestimate.Evenwhenthecostsarelimitedtoshort-termmedicalcosts,preventingunintendedpregnancyhasbeenshowntobecost-effective.Oneof thestudies(18)estimated thatforeverydollarspentonvoluntaryfamilyplanningservicestopreventunintendedpregnancy,about$4

    aresavedinshort-termcoststo thegovernmentformedicalcareforthepregnancyandfor1yearofinfantcareafterthebirth.AsMoneaandThomas(19)andSonfieldetal.(20)havepointedout,manyof thesecostsformedicalcareare incurredbytheMedicaidprogram.Methods

    Thedatain thisreportarebasedprimarilyonthe20062010NationalSurveyofFamilyGrowth(NSFG),conductedby theCentersforDiseaseControlandPreventions(CDC)NationalCenterforHealthStatistics(NCHS).NSFGisdesigned tocollectdatafromanationalsampleofwomen(and,since2002,men)onfactorsaffectingbirthandpregnancyrates,includingcontraception;infertility;marriage,divorce,andcohabitation;pregnancyoutcomes;andcloselyrelatedhealthtopics(6,21).

    NSFG interviewednationalsamplesofwomenaged1544in1973,1976,1982,1988,and1995.In2002and20062010,nationalsamplesofmenwerealsointerviewed.NSFG interviewswereconductedinpersoninrespondentshomes.Since1973,theNSFGquestionnairehasbeenadministeredinbothEnglishandSpanish.

    Thisreport isbasedlargelyoninterviewswith12,279womenconductedfromJune2006 throughJune2010,andon the7,643 interviewswithwomen in2002.Interviewinganddatapreparationfor thesurveysin2002and20062010werecarriedoutby theUniversityofMichigansInstituteforSocialResearch(ISR),underacontractwithNCHS(21,22).

    The20062010NSFG isbasedonanationally

    representative,

    multistage,

    areaprobabilitysampledrawnfrom110primarysamplingareasacrossthecountry.Thesampleisdesignedtoproducenational(notstate)estimates.The interviewswithwomen lastedanaverageof80minutes,andtheresponseratewasabout78%.More informationabouthow thesurveywasplannedandconducted isavailablein twopreviousreports(21,22).

    Thepresentreport isbasedentirelyon theNSFGsamplesofwomen,forthreemainreasons:+ Dataforwomenofallmarital

    statuseshavebeenavailablesince1982,allowingthestudyoflonger-term

    trends.

    In

    contrast,

    data

    for

    men

    haveonlybeenavailablesince2002.

    + Interviewswithwomencontainmorequestionsaboutpregnancy, includingmultiplemeasuresof intendedandunintendedpregnancy,allowingmoredetailedstudy.

    + Samplesizesarelargerforwomen,especially in importantsubgroupsbyage,maritalstatus,andraceandethnicity.

    Limitedfindingsonintendedandunintendedbirthsusingdatafromthe2002NSFGsampleofmenhavebeenpublished(23).Although theoverallpatternsaresimilar to thoseforwomen,thedatafrommendeservemoredetailedstudy.StatisticalAnalysis

    Allestimatesofpercentagesandnumbersin thisreportusesamplingweights thataredesigned toproduceunbiasedestimatesfor theapproximately61millionwomenaged1544 in theUnitedStates.ThestatisticalpackageSAS,version9.2(SASInstitute,Cary,NorthCarolina;http://www.sas.com/)wasusedtoproduce theseestimates.Each tableincludesstandarderrorsasameasureof thesamplingvariabilityofeachestimatedpercentage.SUDAANsoftware(RTIInternational,ResearchTrianglePark,NorthCarolina;http://www.rti.org/sudaan/)wasused toestimate thesamplingerrorsbecause ittakes intoaccounttheuseofweighteddata

    and

    the

    complex

    design

    of

    the

    sample.

    Thesignificanceofdifferencesamongsubgroupswasdeterminedbystandardtwo-tailed t-tests.Noadjustmentsweremadeformultiplecomparisons.Termssuchasgreaterthanandless thanindicatethatastatisticallysignificantdifferencewasfound.Termssuchassimilarornodifferenceindicate that thestatistics

    http:///reader/full/http://www.sas.comhttp://www.rti.org/sudaanhttp:///reader/full/http://www.sas.comhttp://www.rti.org/sudaan
  • 7/28/2019 nhsr055

    3/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page3(usuallypercentages)beingcomparedwerenotsignificantlydifferent.Lackofcommentregarding thedifferencedoesnotmean thatsignificancewas testedandfoundtobenotsignificant.

    Readersshouldnote thesamplingerrorsforsmallgroups.Percentagesarenotshownin tables ifthedenominatorisfewer than75casesorthenumeratorisfewer than5cases.Whenapercentageorotherstatistic isnotshownforthisreason, it isreplacedbyanasterisksignifyingthat thefiguredoesnotmeetstandardsofreliabilityorprecision.Formostof thestatisticsreported,thenumeratorsanddenominatorsaremuchlarger.Asnotedabove,standarderrorsforallestimatesareshownin thetables.

    The95%confidence intervalsaroundeachpercentagecanbeconstructedbymultiplying thestandarderrorby1.96andaddingit to,andsubtracting itfrom, thepercentage.Forexample,Table1 indicates that thepercentageofbirths in thelast5yearsthatwereintendedwas62.9%,andthestandarderrorofthatpercentagewas1.51%.Thismeansthatthe95%confidenceintervalofthatpercentage is62.9plusorminus2.96(1.51times1.96),or59.965.9.

    Inthe

    description

    of

    results

    that

    follows,when thepercentagebeingcitedisbelow10%, thetextwillshowtheexactpercentage toonedecimalpoint.Tomakereadingeasierand toremindthereader that theresultsarebasedonsamplesandsubjecttosamplingerror,percentagesabove10%willgenerallybeshownroundedto thenearestwholepercentage.MeasuringUnintendedPregnancy inSurveys

    Thisreportmeasuresonlypregnanciesending inlivebirth, inpartbecause it ismoredifficulttocollectreliabledatain thesamedegreeofdetailonthe intendednessofotherpregnancies(24).Otherstudies(13)have includedmiscarriagesandabortions,butinlessdetail than themeasuresshownhereforbirths.

    Standardmeasureofunintendedpregnancy

    Theresultsshown inTables16arebasedonastandardmeasureofunintendedpregnancy thathasbeenusedinsurveys insomeformfordecades.

    Questions

    on

    intended

    and

    unintendedpregnanciesendinginlivebirth(calledunintendedbirthsinthisreport)werefirst introduced ina largenationalsurveyof theU.S.populationbyWestoffandRyder inthe1965and1970NationalFertilityStudies(25,26),aftersomewhatsimilarconceptshadbeenusedinsurveysin1941,1955,and1960(27,28).Anearlyversionofquestionsonthis topicwasused inthe1972reportoftheCommissiononPopulationGrowthand theAmericanFuture,whichshowedthat44%ofbirthstomarriedcouples in19661970wereunintended(ref29,p164).Thereportalsoshowed that thepercentageofbirths thatwereunintendedwasmuchlowerformarriedwomenwithmoreeducationthanfor thosewithlesseducation.

    Sincethemid-1970s, informationfromNSFGhasbeenused tomeasuretheextentofunintendedfertilityintheUnitedStates(47).Thedatahavealsobeenthesubjectofmanystudies inscientificjournals(citedbelow)andamajorstudyfromtheInstituteofMedicinereferencedearlier(7).Questionssimilarto thoseasked inNSFGhavebeenusedinstudiessuchasCDCsPregnancyRiskAssessmentMonitoringSystem(PRAMS),astate-levelsurveyofsamplesofrecentmothers(http://www.cdc.gov/PRAMS).SimilarconceptsbasedonNSFGdatahavebeenusedbyotherresearchers(e.g.,refs13and30)andbyorganizationssuchas theNationalCampaigntoPreventTeenandUnplannedPregnancy(http://www.thenationalcampaign.org/).

    Thestandardmeasureofunintendedpregnancy[usedmoreor lessinthisformsince the1965NationalFertilityStudy(25)]isbasedonaseriesofquestionsthatclassifypregnancies intothreecategories:intended,mistimed,andunwantedmeaningthat thewoman

    wantedthepregnancywhenshehadit(intended),later thanshehad it(mistimed),ornever(unwanted)(17).

    Thepresentreportshows twopossibleways toimprovemeasuresofunintendedpregnancy.Oneapproach(usedinTables16)is toenhance thestandardmeasurebydividingthemistimedcategoryintotwosubcategories:birthsmistimedby lessthan2years,andthosemistimedby2yearsormore.Researchershaveexamined thesetwocategoriesofmistimedbirthsandhavefoundimportantdifferences.Pulleyetal.(31)calledbirthsmistimedby less than2yearsmoderatelymistimedand thosemistimedby2yearsormoreseriouslymistimed.Theyreported thatbirthsmistimedby2yearsormoreweremorecommonamong teenagers,unmarriedwomen,andblackwomenthanamongmarriedadultsandwhitewomen(31)(alsoseeref6).

    Using thisclassificationofmistimedbirths, thestandardmeasurenowhasfourcategories:1. Intendedmeans thepregnancy

    occurredatabout thetimethemotherwantedtobecomepregnant.

    2. Mistimedby less than2years(moderatelymistimed)means thepregnancyoccurredtoosoonspecifically, less than2yearsbeforethemotherwanted tobecomepregnant.

    3. Mistimedby2yearsormore(seriouslymistimed)meansthepregnancyoccurredtoosoonspecifically,2yearsormorebeforethemotherwanted tobecomepregnant.

    4. Unwantedmeans themotherneverwantedababy,orababyof thatbirthorder(second,third,fourth,etc.).Thebasicfindingsofthisreportare

    shown(Tables16)using thestandardfour-categorymeasureofunintendedpregnancy.Thespecificquestionsonwhich thestandardmeasureisbasedaregivenbelow.Thequestionsarefrom theNSFGFemaleQuestionnaire;questionnairewording isin italics.Notethatwomencouldbeusing,ornot

    http://www.cdc.gov/PRAMShttp:///reader/full/http://www.thenationalcampaign.orghttp://www.cdc.gov/PRAMShttp:///reader/full/http://www.thenationalcampaign.org
  • 7/28/2019 nhsr055

    4/28

    Page4 NationalHealthStatisticsReports n Number55 n July24,2012using,contraceptionat thetimeofthepregnancy.Forwomenwhohadusedcontraceptionsometimebefore thepregnancy, thefirstquestion isEG2.EG2Beforeyoubecamepregnant...hadyoustoppedusingallmethodsofbirthcontrol?Yes (gotoquestionEG3/EG5)No (gotoEG6)

    Forwomenwhohadneverusedcontraception,orhadstoppedusingcontraceptionbeforethepregnancy, thefirstquestion isEG3/EG5,andthewording isdidnotuse.EG3/EG5Was thereasonyou(didnotuse/stoppedusing)allmethodsofbirthcontrolbecauseyouyourselfwantedtobecomepregnant?Yes (gotoEG10)No (gotoINTR_EG2)

    INTR_EG2Thenextfewquestionsare important.Theyareabouthowyoufeltrightbeforeyoubecamepregnant.

    EG6Rightbeforeyoubecamepregnant...,didyouyourselfwanttohavea(nother)babyatanytime inthefuture?Yes (gotoEG10)No (skippedtonextseriesof

    questions)[Pregnancywasunwanted]

    Dontknow/notsure(gotoEG7,notshown, thatasks ifsheprobablywanted,orprobablydidntwant,ababyatsome timein thefuture.Ifprobablynot,pregnancywasunwanted; ifprobablyyes,gotoEG10.Ifsheresponded thatshedidntcare,pregnancywascodedas intended.

    EG10Sowouldyousay thatyoubecamepregnant toosoon,atabout therighttime,or laterthanyouwanted?Toosoon(gotoEG11)[Pregnancy

    wasmistimed]

    Right time[Pregnancywasintended]Later[Pregnancywas intended]Didntcare[Pregnancywas intended]

    EG11Howmuchsoonerthanyouwanteddidyoubecomepregnant?(Months/years)

    Fourexamplesaregiven toillustratehow thequestionswork:+ Ifthewomanstoppedusing

    contraception(EG2=yes)orhadnotusedcontraceptionbecauseshewanted tobecomepregnant(EG3/EG5=yes)andthepregnancyoccurredatabout theright time inherlife(EG10=righttime),thenthepregnancywas intended.

    + Ifthewomanstoppedusingcontraception

    (EG2

    =

    yes)

    or

    had

    notusedcontraceptionbutnotbecauseshewantedtobecomepregnant(EG3/EG5=no),andshebecamepregnant toosoon(EG10=toosoon)byabout1year(EG11=12months), then thepregnancywasmistimedby less than2years.

    + Ifthewomanwasstillusingcontraception(EG2=no)andwanted tohaveababyeventually(EG6=yes)butnotforanother5years(EG10= toosoonandEG11=5years),then thepregnancywasmistimedby2yearsormore.

    + Ifthewomanbecamepregnantwithherthirdbaby,wasstillusingcontraception(EG2=no),andonlywanted twochildren(EG6=no),then thethirdbirthwasunwanted.

    Theterminologyusedtodescribethestandardmeasureindifferentscientificjournals,andbydifferentresearchers,varies.Somecalltheconceptthewantednessofpregnancies;

    others

    call

    it

    intendedness.Somecall intendedpregnanciesplannedandunintendedpregnanciesunplanned.Somealsolabelintendedpregnanciesaspregnanciesoccurringat therighttimeorsimplyrighttime,withmistimedbeingwantedlater,andunwantedbeingneverwanted.

    Theseparaphrasesaregenerallyaccurate.Theyconvey that intendedness

    isameasureofwhen(ifever)thewomanwantedtobecomepregnant.Thisreportuses thelabelsintended,mistimed,andunwantedbecausetheyareusedmostoftenin theliteratureandhavebeenusedinpreviousNCHSpublications(46,910).Thefollowingsummarizeshowthe termscorrespondtoeachother:Termused in Equivalentthisreport term(s)

    Intended Planned;at therighttime;wanted then

    Unintended UnplannedMistimed Wanted laterUnwanted Neverwanted

    Alternativemeasuresofunintendedpregnancy

    Thesecondwayinwhichsomeresearchershavesought toimprove themeasurementofunintendedpregnancy istoconstructacompletelynewsetofmeasures(28,3036).In1999,BachrachandNewcomer(ref33,p252)suggestedanapproachsimilarto that takeninthepresentreport:

    Theresearchevidenceclearlydemonstratesthattheintendednessofapregnancy(asmeasuredbytheNSFG)isacontinuuminvolvingatleasttwodimensionsintentionalityorplanningplusanaffectivedimensionexpressinghappinessordismayatbeingpregnant...However,theresearchtodatereassuresusthattheintentionalityandaffectivedimensionsofthe...measurearerelatedinfact,stronglyrelated.Wethinkthisjustifiescontinueduseofthe(standard)measure.Atthesametime...researchersshouldcontinuetheireffortstoexpandapproaches totheseconceptsandtodevelopimprovedwaysofmeasuringthem.

    Inresponsetosuggestionssuchasthese,both thestandardmeasureofunintendedpregnancyandthealternativemeasureswere includedinthe2002and20062010NSFGsurveys.ThealternativemeasuresarepresentedinTable7 toencouragefurtherresearchusingthem.Thealternativequestions(askedforpregnanciesendinginthe3yearsbeforethesurvey)areasfollows:

  • 7/28/2019 nhsr055

    5/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page5EG21Lookat thescaleoncard40,wherea0meanstryinghardNOTtogetpregnant,and10meanstryinghardtogetpregnant.Ifyouhadtoratehowmuchyouwere trying togetpregnantoravoidpregnancy,howwouldyourateyourself?

    EG22Lookat thescaleoncard41wherea0meansyouwanted toavoidapregnancyanda10meansyouwantedtogetpregnant.Ifyouhad toratehowmuchyouwantedordidntwantapregnancyrightbeforeyougotpregnant that time,howwouldyourateyourself?

    EG13Please lookat thescaleoncard39.On thisscale,a1meansthatyouwereveryunhappy tobepregnant,anda10means thatyouwereveryhappy tobepregnant.Tellmewhichnumberon thecardbestdescribeshowyoufeltwhenyoufoundoutyouwerepregnant.

    Here,thesemeasuresarereferredtoas:+ Trying togetpregnantorthe

    tryingscale.+ Wanting togetpregnantorthe

    wantingscale.+ Happinessatbeingpregnantor

    thehappinessscale.Notethat thetryingandwanting

    scalesbothmeasurethewomansbehaviorandattitudejustbeforeshebecamepregnantasdoesthestandardmeasureofunintendedpregnancy.Incontrast, thethirdscalemeasuresherhappinessjustaftershebecameawarethatshewaspregnant.AsnotedabovefromBachrachandNewcomer(33),these threescalesarestronglycorrelatedwitheachother,butresearchersandclinicianshaveobserved thatsomecouplesexhibitambivalent, inconsistent,orindifferentbehaviorandattitudes.Havingmore thanonescale,andmakingthemeasurescontinuous,allowswomeninsurveystoreportsuchcomplexitywhileretainingthestandardmeasureforcomparisonsovertime.

    Questionsregardingmalepartners

    NSFGalso includedseveralquestionsaboutthefatherofthebirth.Thesemeasurescanbeusedwitheitherthestandardmeasureorthealternativemeasures.

    Following

    the

    questions

    about

    whethershewantedeachpregnancy,awomanwasasked:INTROWTH_1Sometimeshowpeoplefeelabouthavingababyingeneralcanbedifferentfromhow theyfeelabouthavingababywithacertainpartner.

    EG12aRightbeforethepregnancy,didyou(thinkyoumightever)want tohaveababywith thatpartner?Wouldyousay...Definitelyyes,Probablyyes,Probablyno,orDefinitelyno?

    Womenwerealsoasked thefollowingquestions,fromwhichameasuresimilarto thestandardmeasureforwomenwasformedforherperceptionofthefatherswantednessofthepregnancy:EG16Rightbeforeyoubecamepregnant,didthefatherwantyou tohaveababyatany time inthefuture?Yes(go toEG17)No (go tonextseriesofquestions)

    [Pregnancywasunwanted]Dontknow/notsure(go tonextseries

    ofquestions)[Dontknowfatherswantednessof thepregnancy]

    EG17Sowouldyousayyoubecamepregnantsooner thanhewanted,atabouttheright time,orlater thanhewanted?Sooner[Pregnancywasmistimed]Right time[Pregnancywasintended]Later[Pregnancywasintended]Didntcare[Pregnancywas intended]

    Onlytimeandfurtherresearchwilltellwhetherthesealternativequestionsarenecessary tounderstandandexplaintrendsandgroupdifferencesin theintendednessofbirths(27,32,33).Timeperiodsforanalysis

    Thequestionsusedin thestandardmeasureofunintendedpregnancywereaskedinNSFGforallbirths(andotherpregnancies) toallwomenin thesample.Inthisreport,however,statisticsonthisstandardmeasureareshownforbirthsinthe5yearsbefore the interviewbecause5yearsofbirthsyieldenoughcasestoobtainreliablestatistics(4,587birthsin20062010and2,818in2002),butchangesovertime, ifany,canbeseen;andeachwoman in thesamplehasthesamelengthoftime(5yearsor60months) tohaveabirth.Forwomeninterviewedin thefirstmonthofinterviewing inJune2006,birthsfromJune2001throughJune2006areincluded.Forwomeninterviewed inMay2010,birthsfromMay2005 toMay2010areincluded.Theaveragedateofinterviewforwomen interviewedin20062010wasinMay2008.Theaveragebirthinthelast5yearsoccurredinNovember2005,about2yearsbeforetheaveragedateofinterview.

    Thealternativemeasures,on theotherhand,requireseveraladditionalquestionsforeachpregnancy.If theywereaskedofeverypregnancyforeverywoman, the interviewwouldbecome toolong.Tominimize the timeburdenof thequestions, thealternativemeasureswere limited tobirthsinthe3yearsbeforethe interview.StrengthsandLimitationsofThisReport

    Becausethedata inthisreportcomefromNSFG, thereporthas thefollowingstrengths:+ Thedataaredrawnfrominterviews

    withlargenationalsamplesofwomen,selectedbyrigorousprobabilitysamplingmethods,so theestimatescanbegeneralizedto the

  • 7/28/2019 nhsr055

    6/28

    Page6 NationalHealthStatisticsReports n Number55 n July24,2012householdpopulationofwomenaged1544.In20062010,atotalof12,279womenwereinterviewed.

    + The interviewswereconducted inperson ineitherEnglishorSpanishbyfemale interviewerswhoreceivedthoroughtrainingonthesurvey,sothequalityofthedataisgenerallyverygood.

    + The20062010responserateforwomenwas78%,which isconsideredhighandsuggests that thedataformoststatisticscanbegeneralizedtothepopulationwithconfidence.

    + NSFGhasdatathatallow trendsanddifferences tobedescribedbysuchcharacteristicsas thewomansageandmaritalandcohabitingstatusatthetimeofthebirth,herrace,andhereducationandhouseholdincomeat thetimeoftheinterview.

    Thereporthas thefollowinglimitations:+ Thedatawerelimitedtopregnancies

    ending inlivebirth.Datawerecollectedthatallowsomeanalysesofotherpregnancies,butinterpretingthesedatawouldrequirefurtherdiscussion.Accordingtorecentresearch(1),aboutone-halfofallunintendedpregnanciesend inabortion,while theotherone-halfendin

    alive

    birth,

    miscarriage,

    or

    stillbirth.ThereportingofabortionsinNSFG(andothersurveys) isnotcomplete,sothepresentreportfocusesonlivebirths.However,groupsofwomenthathavehighratesofunintendedbirths[e.g.,unmarriedwomen,blackwomen,Hispanic(orLatina)women,andthoseaged1524]also tendtohavehigherabortionratesthanthecontrastinggroups(marriedwomen,whitewomen,andwomenaged2544)(37).

    + Thereportis intendedtopresentsomebasicstatisticalfactsontrendsanddifferences inintendedandunintendedbirthsintheUnitedStates.Itdoesnotperformcausalormultivariatestatisticalanalyses.Thefindingsshownhere,however,areconsistentwiththelargebodyofresearchonunintendedbirthscitedearlier,muchofwhichdidusemultivariatecontrols(713,30,31).

    + NSFGisdesigned toprovidestatisticallyreliablenationalestimates;thesamplewasnotdesigned toprovidestateorlocal-areaestimates.

    ResultsTrendsintheproportionof

    pregnanciesendingin livebirths(hereafter, theproportionofbirths)thatwereintended,mistimed,orunwantedareshown inTable1.Tables24showresultsfor2002and20062010bythemothersageandmaritalstatusat thetimeof thebirth,herraceandethnicity,hereducation,herfamilys income,andthebirthorderof thechild.Table5displaysdetailedcategoriesof thestandardmeasureofunintendedbirths.Table6containsdataonreasonsfornonuseofcontraceptionleadingtounintendedbirths.Table7showstherelationshipbetweenthestandardmeasureofunintendedpregnancyandthealternativemeasures.Table8displaysdataonsomeof theconsequencesofunintendedpregnancyforthemotherand theinfant.Finally,Table9presentsaprofileof intendedandunintendedbirths thatshows thecharacteristicsof thesecategoriesofbirths.Definitionsforsomeofthetechnical termsused in thisreportaregiven intheTechnicalNotes.

    Table1showsthepercentdistributionamongallwomenofpregnanciesendingin livebirths,bytheintendednessof thepregnancy,for thefivemostrecentNSFGsurveys(1982,1988,1995,2002,and20062010).Therewerefewchangesbetween1982and20062010overall inthedistributionofpregnanciesbyintendedness.Forexample,lookingatthe

    20062010

    row,

    63%

    of

    all

    births

    in

    the5yearsbeforethe interviewwereintendedby themotherthat is,shewanted thepregnancy tooccurwhenitdid.Another23%weremistimedthatis,shewantedtohaveapregnancyeventually,butnotthen.Finally,14%ofbirthswerefrompregnanciesthatwereunwantedthatis, themotherdidnotwanttohavethatpregnancy thenoratany time inthefuture.Thiscompareswith64%intended,27%mistimed,and

    10%unwantedbirthsin1982.(Thedatafor1995inTable1areshownin italicsbecauseresearchsuggests thatthe1995datamayshowabiastowardhigherpercentages intended,formethodologicalreasons.SeetheTechnicalNotesforfurtherdetails.)

    Unwantedandmistimedpregnanciesending inlivebirthareoftencombinedandreferredtoasunintendedbirths,asnotedaboveintheMeasuringUnintendedPregnanciesinSurveyssectionofthisreport.In20062010,37%ofbirthswerefromunintendedpregnancies(Table1),comparedwith37%in1982.Thus,therewasnostatisticallysignificantchangein thepercentageofbirthsintendedorunintendedin this28-yearperiod.However, thisapparent lackofchangefrom1982to20062010maskstwotrendsthatmoved inoppositedirectionsduringtheperiod:+ An increasein thepercentageof

    birthsthatwereintendedamongnon-Hispanicwhiteever-marriedwomen.

    + Adecreaseintheproportionofbirthsthatoccurred towhiteever-marriedwomenbecauseofanincreaseinbirthstonever-marriedwomen.Datafrom theNationalVitalStatisticsSystemshowthat theproportionofallbirthsoccurring tounmarriedwomen(mostofwhomwerenever-married) rosefrom18% in1980 to41% in2009(3840).Becausemostofthebirthstonever-marriedwomenareunintended,therisingproportionofbirthstounmarriedwomen tendedtoreducethepercentageofallbirthsthatwereintended.

    Thesetwochangesaredescribedin turn.First,Table1showsbirthsto

    womenwhohadeverbeenmarried in1982and20062010(alsoseeFigure1).Amongnon-Hispanicwhitewomen,thepercentageintendedincreasedsignificantly,from72% in1982to78%in20062010.Amongnon-Hispanicblackever-marriedwomen,thepercentageintendedwas59%in1982and66%in20062010,which isnotastatisticallysignificantchange.Changes

  • 7/28/2019 nhsr055

    7/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page7

    0

    10

    20

    30

    40

    50

    Mistimed

    Unwanted

    1982 2006

    2010

    Total

    8 9

    2216

    30

    25

    1982 2006

    2010

    Non-Hispanic

    white

    6 6

    2215

    29

    22

    1982 2006

    2010

    Non-Hispanic

    black

    16

    26

    23

    41

    12

    35

    NOTES: Refer to Table 1.Percentages may not sum to total unintended due to rounding.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 1982 and 20062010.

    Percent

    1982 2006

    2010

    Hispanic

    1116

    1818

    29

    34

    Figure1.Percentageofbirthstoever-marriedwomenthatwereunintended(unwantedormistimed)atconception,totalandbyraceofmother:UnitedStates,1982and20062010amongever-marriedHispanicwomenfrom1982to20062010werealsonotstatisticallysignificant.Statedanotherway, thepercentageofbirths thatwereunintendeddeclinedsignificantlyamongnon-Hispanicwhiteever-marriedwomen(Figure1).

    Second,noteinTable1thatnon-Hispanicwhiteever-marriedwomenhad12.175millionbirths inthe5yearsbefore the1982survey,whichwas66%ofall18.442millionbirths inthoseyears,comparedwith9.099millionbirthsin the5yearsbeforethe2006

    2010survey,whichwas43%ofall21.161millionbirths inthoseyears.Theproportionofbirthstoever-marriedwhitewomendecreasedoverthesedecadesbecausebirthstonever-marriedwomenwereincreasing,from16% in1982(2.955million tonever-marriedwomen in the5yearsbefore1982,outof18.442millionbirthsin thoseyears),to35%ofbirths inthe5yearsbeforethe20062010survey(7.311millionbirthsoutof21.161million).Thus,theproportionofbirths intendeddidincrease inonelargegroup

    NOTE: Refer to Table 2.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 20062010.

    Perc

    ent

    1519 2024 2544 Married Cohabiting Not marriedor cohabiting

    23

    50

    75 77

    49

    33

    0

    20

    40

    60

    80

    Age (years) Marital status

    Figure2.Percentageofbirthsthatwere intendedatconception,bymothersageandmaritalstatusatbirth:UnitedStates,20062010

    ever-marriednon-Hispanicwhitewomenbetween1982and20062010,but thatgroupaccountedforadecreasingproportionofallbirths.

    Dataonbirthsin the5yearsbeforethe interviewforthe2002and20062010surveysareshownby theageofthemotheratbirth,andhermaritalstatusatbirth, inTable2andFigure2.Only23%ofbirths to teenmotherswere intendedin20062010(Figure2),and77%(nearlyfourinfive)wereunintended.Amongbirthstoyoungadultwomenaged2024,50%wereintended(Figure2),andatages2544,75%wereintended.Thesepercentagesarevirtuallyunchangedfrom thepercentages intendedbyagein2002.Thefigureatage2024 isparticularlynoteworthybecauseitmeans that50%ofthe5.2millionbirths towomenaged2024 inthatperiod(about2.6millionbirthsin5years)wereunintended.Notealsothat51%ofbirthsto teenagers in20062010weremistimedby2ormoreyearsthat is, theteenmotherwantedthebirthtooccuratleast2yearslaterthan itdidcomparedwith22%ofbirthstowomenaged2024and4.8%towomenaged2544.

    Table2alsoshowsbirthsbywhether themotherwasmarried,cohabiting,

    or

    neither

    at

    the

    time

    of

    the

    birth in2002and in20062010.Notethatthenumberofbirthstocohabitingwomenaged1544 increasedfrom2.998millionin2002 to4.950millionfrom2002to20062010,whichisanincreasefrom14%ofbirthsin2002to23% in20062010.About77%ofbirthstowomenwhoweremarriedatthe timeofthebirthwereintended in20062010,comparedwith49%ofbirths towomenwhowerecohabitingatthebirthand33%towomenwhowereunmarriedandnotcohabiting(Figure2).Birthstowomenaged2544weremorelikely tobe intendedthanbirthstowomenunderage25,formarried,cohabiting,andunmarriedwomen(Table2).Births tomarriedwomenaremorelikely tobe intendedthanbirthstounmarriedwomen,andbirthstowomenaged2544aremore likely tobeintendedthanbirthstoyoungerwomen.

    Thedifferencesbyageandmaritalstatusareoftenlarge(Table2):

  • 7/28/2019 nhsr055

    8/28

    Page8 NationalHealthStatisticsReports n Number55 n July24,2012

    NOTES: Refer to Table 3. Education is measured at time of interview.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 2002 and 20062010.

    Percent

    5864

    67

    86

    59 6063

    83

    0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    Less than high

    school diploma

    High school

    diploma

    Some college College degree

    2002 20062010

    Figure3.Percentageofbirthsthatwere intendedatconception,byeducationofmother:UnitedStates,2002and20062010+ Amongbirthstowomenaged1524,

    60%ofbirthstomarriedwomenwere intended,comparedwith42%ofbirthstocohabitingwomenand21%tounmarriednoncohabitingwomen.

    + Amongbirthstowomenaged25andover,81%ofbirths tomarriedwomenwereintended,comparedwith59%ofbirthstocohabitingwomenand52%tounmarriednoncohabitingwomen.

    Informationonthe intendednessofbirthsbytheeducationof themother,forwomenaged2244at thedateofinterview,isdisplayed inTable3.(Womenaged1521areoftenstill inschool,sotheyareexcludedfrom thesestatistics.Also,becauseeducation ismeasuredatthedateofinterview,somewomenmayhavehadlesseducationatthedateofthebirththanat thedateofinterview.)Births towomenwithacollegedegreearesignificantlymorelikelytobe intended thanbirths toless-educatedwomen.In20062010,59%63%ofbirthswereintendedforwomenwhohadnotcompletedhighschool,hadahighschooldiploma,orattendedsomecollege,comparedwith83%ofbirthstomotherswithacollegedegreeorhigher(Figure3).

    In20062010,about17%ofbirthstowomenwithahighschooldiplomawereunwanted,comparedwith4.0%ofbirths towomenwithacollegedegree.Anadditional13%ofbirths towomenwithahighschooldiplomaweremistimedby2yearsormore,comparedwithjust2.9%ofbirthstocollegegraduates.Clearly,inboth2002and20062010womenwithacollegedegreeweremoreoftensuccessful inhavingchildrenonlywhen theyintendedtohave them,comparedwithwomenwithlesseducation.

    DataarealsoshowninTable3bybirthorder,thatis,whetherthebirthwas thewomansfirst,second,orthirdorhigherbirth.Amongfirstbirths,61%wereintended in20062010,while22%weremistimedby2yearsormoreand8.8%wereunwantedindicating that31%offirstbirthsoccurred2yearsormorebefore themotherwanted them,ortheywerenotwantedever.Thepercentageofbirths thatwereunwantedatconceptionwas9%forfirstbirths,11%forsecondbirths,and23%amongthirdor laterbirths.

    Changeswithincategoriesofbirthorderweregenerallynotstatisticallysignificantbetween2002and20062010.Changesbetweenthetwodates

    withincategoriesofeducationwerealsogenerallynotstatisticallysignificant.

    The intendednessofbirthsvariesconsiderablyby theraceandethnicityofthemother(Table4).Forexample,in20062010 thepercentageofbirths thatwere intendedvariedfrom69%ofbirthstonon-Hispanicwhitewomen, to57%forHispanicwomenand47%forblackwomen.Thedifferencesin2002showasimilarpattern.

    Birthstowhitewomenare lesslikelytobereportedasunwanted,orasmistimedbymorethan2years[whatPulleyetal.(31)callseriouslymistimed].Thepercentageofbirthsthatwereunwantedwas9.3%amongnon-Hispanicwhitewomen,comparedwith18%amongHispanicand23%amongblackwomen.In20062010,birthsmistimedby2yearsormoreaccountedfor11%ofbirthsamongwhitewomen,17%amongHispanicwomen,and22%amongblackwomen.AsshowninFigure4,addingthese twocategories together, thepercentageofbirthsin20062010thatwereeitherunwantedormistimedby2yearsormorewas:+ 20%amongnon-Hispanicwhite

    women.+ 35%amongHispanicwomen.+ 45%amongblackwomen.Thesedifferencesmayberelated to thelowerlevelsofeducationandincomeamongHispanicandblackwomencomparedwithwhitewomen,aswellasthehigherproportionsofbirthstounmarriedblackwomen.

    Table4containsdatafor2002and20062010bycurrentfamilyincome,expressedasapercentageofthepovertylevel.Thoseat0%99%ofthepovertylevelarebelowpoverty,whereasthoseat400%ofpovertyorhigherhaveincomesat leastfour times thepovertylevel.In2008(themidpointofinterviewingfor the20062010NSFG),thepoverty levelwas$14,489forafamilyof twoand$22,025forafamilyoffour.(Thisanalysis islimited towomenaged2044becausewomenaged1519oftendonotknow theirfamilys income.Incomeismeasuredatthedateofinterviewbecause itis

  • 7/28/2019 nhsr055

    9/28

    50

    45

    40

    35

    17

    Mistimed by 2

    years or more30

    22

    2020

    11Unwanted23

    10 18

    9

    0Non-Hispanic Hispanic Non-Hispanic

    white black

    NOTES: Refer to Table 4. Percentages may not sum to total unwanted and mistimed by 2 years or more, due to rounding.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 20062010.

    Figure4.Percentageofbirthsthatwereunwantedormistimedby2yearsormoreatconception,byHispanicoriginandraceofmother:UnitedStates,20062010

    Percent

    NationalHealthStatisticsReports n Number55 n July24,2012 Page9

    unknownatthetimeofthebirth,but itisunlikelytobedifferentformostwomenbecausethecategoriesofincomearebroadroughlyequalto$20,000.)

    In20062010,53%ofbirthsin theprevious5years towomencurrentlylivingbelow thepovertylevelwereintended,

    compared

    with

    82%

    of

    births

    towomenwithcurrentfamilyincomesat400%ofpovertyorhigher.Differencesbyincomeintheproportionofbirthsthatwereunwantedormistimedby2yearsormorewerelarge:38%ofbirthstowomen livinginhouseholdswith incomesbelowpoverty(0%99% inTable4)wereeitherunwanted(20%)ormistimedby2yearsormore(18%),comparedwith9.4%ofbirths towomenlivingat400%ofthepovertylevelorhigher(4.3%unwantedand5.1%mistimedby2yearsormore).

    NSFGprovidesadditionaldetailinthe intendedcategory(Table5) to furtherdistinguishthetimingofbirthsformarriedandunmarriedmothersbybirthorder.Overall,63%ofallbirthswere intended,with53%occurring,according tothewoman,attherighttime(i.e.,aboutwhenshewanted ittohappen);9.5%werewantedearlier(i.e.,it tookherlonger togetpregnantthan

    shewanted);andjust0.9%didntcarewhethertheygotpregnantatthattime.Furtherstudyof thewantedearliercategory iswarranted,butfor thisreportitisnoteworthythatonly1%ofwomensaid theydidntcarewhether theirpregnancyoccurredwhenitdidoratsomeothertime.

    Amongfirst

    births

    to

    married

    women,84%were intendedand16%wereunintended(Figure5).Amongfirstbirths tounmarriedwomen,38%wereintendedand62%wereunintended(Figure6).Althoughonly7.1%offirstbirths tomarriedwomenweremistimedby2yearsormore(theyoccurred2yearsormore toosoon),39%offirstbirths tounmarriedwomenweremistimedby2yearsormore(Figures5and6).

    Ifawomanhadtwochildrenandwantednomore,buthada thirdchild,that thirdbirthisclassifiedasunwanted.Similarly, ifshehadthreechildrenandwantednomore,buthadafourthbirth,thatfourthbirthisclassifiedasunwanted.Theproportionofunwantedbirths tomarriedwomenwas1.7%forfirstbirths,4.1%forsecondbirths,and17%forthirdandhigherbirths.Thismay indicatethatmarriedwomen,priorto their thirdor laterpregnancy,intendtohaveonlytwochildren.Thepattern

    bybirthorderwassimilarforunmarriedwomen,buttheproportionsunwantedweremuchhigher:16%offirstbirths,25%ofsecondbirths,and35%ofthirdandlaterbirthstounmarriedwomenwereunwanted(Figures5and6andTable5).NonuseofContraceptionandUnintendedBirths

    AmongwomenwhohadunintendedbirthsintheUnitedStatesin19982002,about40%wereusingcontraception,whichmeansthat60%werenot(ref1,p92).It isuseful toexaminethereasonsfornonuseofcontraceptionamongwomenwhodidnotuseamethodbefore theirmostrecentunintendedbirth(Table6).[Otherresearchers(41)haveusedNSFGtostudy therateofunintendedpregnancywhenwomenareusingspecificcontraceptivemethods,termedcontraceptivefailurerates.]

    Ifawomangavebirthwithin3yearsof theinterview,becamepregnantinamonthwhenshewasnotusingcontraception,andindicatedthat thepregnancywasmistimedorunwanted,shewasshownacardlistingreasonsoftengivenfornonuseofcontraceptionandasked

    Whichof thefollowingstatementsappliestoyourightbeforeyoubecamepregnant that time?Thecardlistedthefollowingreasons,andshecouldchoosemore thanonereason:Youdidnotexpect tohavesex.Youdidnot thinkyoucouldgetpregnant.Youdidntreallymind ifyougotpregnant.Youwereworriedabout thesideeffectsofbirthcontrol.Yourmalepartnerdidnotwantyou touseabirthcontrolmethod.Yourmalepartnerhimselfdidnotwanttouseabirthcontrolmethod.

    Fromthis list, thewomanwasasked tochoosethereasonsshewasnotusingcontraception.ArelativelysmallgroupofwomenisrepresentedinTable6(about2.442millionover3years,orabout814,000peryear,which isabout

  • 7/28/2019 nhsr055

    10/28

    0

    10

    20

    40

    70

    60

    50

    35

    7

    17Perce

    nt

    3023 Unwanted

    20

    6

    7 16 4 Mistimed by2 years or more4

    72

    Mistimed by12 1110 less than 2 years8

    All birth orders 1st birth 2nd birth 3rd or higher birth

    NOTES: Refer to Table 5.Percentages may not sum to total unintended due to rounding and the inclusion of cases where

    amount mistimed cannot be calculated.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 20062010.

    Figure5.Timingofunintendedbirthsbybirthorder,formarriedwomen:UnitedStates,20062010

    0

    10

    20

    30

    40

    50

    Unwanted

    Percent

    70

    62

    60 57

    16

    57

    24

    26

    39

    Mistimed by less

    15

    8 7 9 8 than 2 years

    35

    50

    16

    25

    Mistimed by 2years or more

    All birth orders 1st birth 2nd birth 3rd or higher birth

    NOTES: Refer to Table 5. Percentages may not sum to total unintended due to rounding and the inclusion of cases where

    amount mistimed cannot be calculated.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 20062010.

    Figure6.Timingofunintendedbirthsbybirthorder,forunmarriedwomen:UnitedStates,20062010

    Page10 NationalHealthStatisticsReports n Number55 n July24,2012+ Themostcommonreasonawoman

    gavefornotusingcontraceptionwasthatshedidnotthink(she)couldgetpregnant.Therewasnosignificantvariationin thepercentageofwomenwhogavethisreasonby

    unintendedpregnancybecausetheydidntreallymindgettingpregnantappear tobegivingan inconsistentanswer.Butthereasonsfornonuseof

    age,maritalstatus,orincome.

    (49%,comparedwith35%ofwhite

    However,Hispanicwomenweremore likely thanotherstosaytheydidnotthink theycouldgetpregnant

    + Thedataalsosuggestthatwomenwithsomecollegeeducationwerewomenand25%ofblackwomen).

    lesslikelytosaytheydidnot think(they)couldgetpregnant(26%)thanwomenwithahighschooleducationorless(42%).

    + Womenwhowereneithermarriednorcohabitingwere themostlikelytosay that theydidnotexpect tohavesex(32%,comparedwith11%ofmarriedwomenorcohabitingwomen).

    + Atfirst, thosewhosaidtheydidnot

    related things.Among thesmallgroupwhowerenotusingcontra-

    usecontraceptionbeforean

    contraception,andtheintentionsaboutpregnancy,areelicitedbyquestions

    that

    ask

    about

    different

    but

    ceptionbeforeapregnancythatwas

    19.2%ofthe4.25millionbirthseachyear; in2008,therewere4,247,694,or4.25millionbirths).Ofthis19.2%ofbirths,womengave thefollowingreasonsfor theirnonuseofcontraception:+ About36%said theydidnot think

    theycouldgetpregnant(19.2%36%isabout6.9%ofallbirths,orabout290,000births inayear).

    + 23%saidtheydidntreallymindifIgotpregnant(19.2%23% isabout4.4%ofallbirths).

    + 17%didnotexpect tohavesex(about3.3%ofbirths).

    + 14%(2.7%ofbirths)wereworriedabout thesideeffectsofbirthcontrol.

    + 8.0%saidhermalepartnerdidntwanttousebirthcontrolhimself.

    + 5.3%saidhermalepartnerdidntwanther tousebirthcontrol.

    Lookingatvariations inthesereasonsby thecharacteristicsofthewomenreveals thefollowing:

    mistimedby lessthan2years,55%saidtheydidntreallymindgettingpregnant,whereasamongwomenwhosaidthepregnancywasmistimedby2yearsormore,just12%gavethisreason;andamongthosewhowerenotusingcontraceptionbeforeanunwantedpregnancy,only7.6%saidtheydidntreallymind.

    + Thevariations inthepercentageswhodidntreallymindhavinganunintendedpregnancyshowthatwomenwhogave thisreasonweremore likely tohaveapartnerorspouse,higher income,andmoreeducation,andweretryingtopostponethepregnancybyayearortwo,comparedwithwomenwhodidnotgive thisreasonfornonuse.

  • 7/28/2019 nhsr055

    11/28

    Happiness when found out pregnant (110 scale)

    How hard trying to get or avoid pregnancy right before (010 scale)

    How much wanted to get or avoid pregnancy right before (010 scale)

    Meanscalevalue

    0

    2

    4

    6

    8

    9.4

    7.2

    5.8

    4.8

    10

    8.2

    7.5

    4.6

    4.0 2.7

    2.3

    2.6

    1.9

    Intended Mistimed by less Mistimed by 2 Unwantedthan 2 years years or more

    NOTE: Refer toTable 7.

    SOURCE: CDC/NCHS, National Survey of Family Growth, 20062010.

    Figure7.Meanscalevalueofalternativemeasuresofunintendedpregnancyforeachcategoryofthestandardmeasureofunintendedpregnancy:UnitedStates,20062010

    NationalHealthStatisticsReports n Number55 n July24,2012 Page11Thequestions inTable6allowed

    womentoreporttwoormorereasonsfor theirnonuseofcontraception.If theanswersare limited toonereasonperwoman, theproportionwhoseprimaryreasonwas thattheydidntreallymindgettingpregnantdropsfrom23%(whenmorethanonereasoniscollected) to17%,or3.2%ofallbirths.Lookingonlyatmothersofbirths thatweremistimedby less than2years,39%ofthesewomengaveIdidntreallymindgettingpregnantastheironlyreasonfornonuseofcontraception(comparedwith55%whenmorethanonereasonwascollected).

    Thisapparent inconsistencyfor3.2%4.4%ofbirths isnotsurprisingforafewreasons.Themultidimensionalnatureofintendedness(33) isbeingrepresented:intentionalitymaybebettermeasuredby thequestionsin thestandardmeasureofunintendedpregnancy,whereastheaffective(emotional)dimensionmaybesurfacingwhenwomenconsider thequestionposingvariousreasonsfortheirnonuseofcontraception.Finally,whenunintendedissubdivided into thecategoriesofmistimed less than2yearsandmistimed2yearsormore, thosewhoweremostlikelytogivethisreasonwere

    those

    whose

    pregnancy

    was

    moderatelymistimed(itoccurredlessthan2yearstoosoon).Thisshowsthevalueofhavingmultipletypesofmeasuresanddevelopingmeaningfulsubcategories.Researchusingthealternativemeasuresdiscussed inthisreportmayshedfurtherlightonfindingssuchasthis.

    ThefindingsinTable6aresimilartothose inastudyofdatacollectedfrom26states in20002002(42),whichstrengthens thefindingsofbothstudies.Bothstudieswerebasedon largesamplesofwomenandusedsimilarlistsofreasonsfornonuseofcontraception.Thepresentstudy,however,advancesresearch inthisareabyincludingmeasurestoclassifymistimedbirthsasmistimedby lessthan2yearsorby2yearsormore,anditalso includesIdidnotexpect tohavesexasareasonfornonusethe thirdmost-citedreasoninthisreport.

    AlternativeMeasuresofUnintendedPregnancy

    Thissectioncomparestheresultsforintendednessofpregnancies,usingthestandardmeasureofunintendedpregnancy(Tables16)andthealternativemeasuresbasedon theattitudinalscalequestionsdescribed intheMethodssection.Asdiscussedearlier, thealternativemeasureswereadded toNSFGtoprovideadifferentapproachformeasuring intendedness.Thisapproachhasatleastthreedistinctivefeatures:+ Numericalscalesareusedto indicate

    thestrengthoffeelings.+ Separatequestionsareaskedabout

    threeof thespecificelementsthatarethought tocontributetoapregnancybeing intendedorunintended(30,3336).

    + Questionsareaddedabout thewomanspartnersattitudesabout thepregnancy.

    BasedontheobservationsofBachrachandNewcomer(33)andothers(6,3436),positivefeelingstoward thepregnancyon thestandardmeasure(an intendedpregnancy)shouldbeassociatedwithpositivefeelingsoneachof thealternativemeasures:

    wanting,trying,andhappiness(withvaluesof,forexample,710).Conversely,negativefeelingsonthestandardmeasure(unwanted,ormistimedby2yearsormore)shouldbeassociatedwithnegativefeelingsoneachofthealternativemeasures(withvaluesof,forexample,03).

    Table7

    displays

    the

    average

    (mean)

    valueof thethreeattitudinalscalesdescribedearlier thatmeasuretheseimportantelementsofintendedness.Table7andFigure7showthatthesethreescalesand thestandardmeasureofintendednessarestronglycorrelated:theymeasurewomenspositiveandnegativefeelingstowardpregnancies,buteachscalemeasuresaslightlydifferentaspectof thosefeelings(30,32,36).

    Thefirstscale,wanted togetpregnant,measureshowmuch thewomanwanted(i.e.,desired) toget(ortoavoidgetting)pregnantjustbeforeshegotpregnant.Note thatwantedasused inthisscale isdifferentfromwantedasoneofthecategoriesof thestandardmeasure(seetheMeasuringUnintendedPregnancies inSurveyssectionof thisreport).Thecategoryintendedistheresultoftheseriesofquestions involvingcontraceptiveuse,pregnancytiming,andfuture

  • 7/28/2019 nhsr055

    12/28

    Page12 NationalHealthStatisticsReports n Number55 n July24,2012childbearingplans.Despite thesedifferences,note thatwomenwhoreported that theirpregnancywasintended(on thestandardfour-categorymeasure)rated theirpregnancyat8.2onthis010scale.Thishighratingreflectsagreementthatapregnancy thatwasintendedonthestandardmeasurealsorateshighon the010wanting(desireforpregnancy)scale.Incontrast,thosewhoreported that thepregnancywasunwantedon thestandardmeasureratedthepregnancyat1.9,onaverage,onthewantingscale, indicatingtheydidnotdesiretobecomepregnant.

    Lookingat thesecondscale,trying tobecomepregnant(howhardthewomanwastrying togetpregnantortoavoidpregnancy),intendedpregnancies(onthestandardmeasure)hadameanratingof7.5,comparedwith2.6forunwantedpregnancies.Thisshowsagreementbetween thestandardmeasureandthealternativemeasure,butthedifferencebetween7.5and2.6(4.9)isnotaslargeasforthewantingscalemeasuresof8.2and1.9,adifferenceof6.3.Theseresultssuggestthatthewantingandtryingscales(measuresofthewomansdesireandbehavior)arestronglybutnotperfectlycorrelated,assuggestedbyBachrachandNewcomer

    (33)

    and

    by

    Miller

    and

    Jones(36).Furtherresearchwiththesequestionswilllikelyfocusonthecircumstancesunderwhichwomengivedivergentanswerson thestandardmeasureandthealternativemeasuresofunintendedpregnancy.

    Lookingat theaveragevaluesforthe thirdscale,happy tobepregnant(howhappyshewaswhenshefoundoutshewaspregnant), thesamepatternemerges:pregnancies thatwere intendedonthestandardmeasurewererated9.4outof10,whereasunwantedpregnancieswererated4.8onaverage.(Theaveragevaluesof thehappinessscaleareslightlyhigher than thoseofthewantedortryingscalesinpartbecausethehappinessscalehasvaluesof110,whereastheothertwoscaleshavevaluesof010.)

    Theassociationbetweenthemothersdesire tohaveachildwith thebabysfatherandherperceptionofhisintendednessofthepregnancyarealso

    showninTable7.Womenwhosaidthattheydefinitelywantedtohaveababywiththatpartnerratedtheirdesireforthepregnancyat7.3onaverage,apositiverating.Thosewhosaid theydefinitelydidnotwantababywiththatpartnerratedtheirwantingofthepregnancyat1.8onaverage,astronglynegativeratingequivalenttosayingthatshedidnotwant thebaby.

    Theseresultsreflectthecloserelationshipbetweenwantingababywithaspecificpartnerand intendingtobecomepregnantusing thestandardmeasure.Thefindingsaresimilarforboththetrying togetpregnantandthehappytobepregnantscales:womenwhowanted togetpregnantwithaparticularpartnerweretryingharder tobecomepregnantandwerehappierwhen theyfoundouttheywerepregnant,that is, theyratedthepregnancymorepositively than thosewhodidnotwanttohaveababywiththatpartner.

    Finally, theratingsmothersgavetotheirpregnanciesareshown inTable7bywhetherthewomanthought thebabysfatherwantedthepregnancy.Ifshethoughtherpartner intendedthepregnancy,theaveragewanting togetpregnantratingwas7.9,stronglypositive;

    if

    she

    thought

    he

    did

    not

    want

    thepregnancy,heraverageratingwas2.7,astronglynegativerating.

    It istoosoon tosaydefinitelywhetherthealternativemeasureswillproveusefulornecessaryforresearchin thelongrun,but theresultsinTables17suggest that:+ Mostintendedbirthsareintended

    because themotherintended(usingthestandardmeasure) tohaveababywhenshedid(Tables15);shetriedtohave thepregnancy then,shewanted tohaveababywiththatpartnerasthefather,andhealsowanted thebabyat that time(Table7).

    + Formanyunintendedbirths,oneormoreoftheseconditionsdoesnothold.Forexample,anunintendedbirthisoneinwhichthe timingofthebirthwasnotrightforthewoman(Tables15),orshedidnottrytobecomepregnant(Table7),orshedid

    notwanttohavethebabywiththatpartner,orsheknewthefatherdidnotwantthebirth(Table7).

    Furtherresearchwillbeneededtoconfirmorrefinethesehypotheses.Themainpurposeof includingthesemeasures

    in

    the

    present

    report

    is

    to

    encouragetheresearchcommunitytouse theminfurtherresearchwithNSFGdata.Futureresearchmayfocuson thecircumstancesunderwhich themeasuresdiverge,conflict,orreflectambivalencetowardhavingababy.Buthavingthesenewmeasuresavailableshouldmake itpossible tomeasurethesecircumstancesandtofindouthowcommontheyareandwhatfactorsarecorrelatedwiththem(3436).CorrelatesofUnintendedPregnancy

    The introduction tothisreportsummarizedsomeof thefindingsoftheextensivebodyof literatureon theconsequencesofunintendedpregnancyfor thebabyandthemother.Thisresearchsuggeststhatifawomanhasanunintendedpregnancy,shemaybeunpreparedfor itand thusmaybeslower toobtainneededprenatalcareandlessawareofotherchangessheshouldmake(suchasimprovingnutritionorquittingsmoking),comparedwithwomenwith intendedpregnancies.Thesefactorsmayresultin lessfavorableoutcomes,suchasthoseshown inTable8.

    Theresultsshown inTable8arecross-tabulationswithoutstatisticalcontrols(anddeservecarefulreplicationwithcontrols),butmanypreviousstudieshaveshown thatwhetherapregnancywas intendedorunintended isrelated to thesecharacteristicsofthepregnancy,aftercontrollingappropriatelyforthemothersage,race,maritalstatus,andothervariables(713).InTable8,thesemeasuresareshownwiththefollowingnewdatafromthe20062010NSFG:+ Whenprenatalcarebegan.+ Whether themothersmoked

    cigarettesduringthepregnancy.+ How thedeliverywaspaidfor.

  • 7/28/2019 nhsr055

    13/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page13+ Whether themotherbreastfed the

    baby.+ Thebabysbirthweight.

    ThefirstmeasureshowninTable8is thetimingofprenatalcare.Themeasureusedis thepercentageofwomen

    who

    did

    not

    get

    any

    prenatal

    carein thefirsttrimesterorwhodidnotgetanyprenatalcareatall.Receivinglateornoprenatalcarehasbeenassociatedwithadversechildoutcomes,including lowbirthweight,neonatalmortality,and increasedhealthcarecostsfortheinfant,atbirthandlater(6,9,10,4345).Amongintendedpregnancies,8.2%of themothersfirstreceivedprenatalcareafterthefirsttrimesterorreceivednoprenatalcareatall.Forunintendedpregnancies, thisproportionwas19%more thandouble.Sowomenwhowerenotintending togetpregnantandwerethereforenotpreparedforpregnancy(i.e.,theyhadunwantedormistimedpregnancies)weremorethantwiceas likely toobtainprenatalcare lateornotatall,thusdelayingmedicaltreatmentandadviceaswell.

    ThesecondmeasureshowninTable8issmokingduringpregnancy.Numerousstudies(10,4548)show thatsmokingduringpregnancyputsthemotherandbabyatriskformanyhealthproblems, includinglowbirthweight,pretermbirth,miscarriage,infantdeath,and illnessduringchildhood.About10%ofmotherswith intendedpregnanciessmokedduringpregnancy,comparedwith16%if thepregnancywasunintended, including18%ofunwantedpregnancies.This isconsistentwith thefindingsonprenatalcare:ifprenatalcare isdelayed,medicaladvicetostopsmokingwouldalsobedelayed.

    ThethirdmeasureinTable8 iswhether thedeliverywaspaidforbyMedicaidaloneorincombinationwithotherfunds.It isnotfeasibleforNSFGtocollectahistoryofhowmuchincomethewomanhadatvariouspointsin thepast,sothere isnodirectmeasureof themothershousehold incomeatthe timeofthebirth.Buthaving thebirthpaidforbyMedicaid indicates thatthemothershouseholdhadalowincomeatthe timeof thebirth,andthusindicates

    that thehouseholdhadfewerresourcestocarefor thechild.UseofMedicaid isalsoan indicatorofpubliccostsforthepregnancy(1820).About35%ofthedeliveriesof intendedpregnancieswerepaidforbyMedicaid,comparedwith65%of thedeliveriesofunintendedpregnancies.Thus,unintendedpregnancies tend tooccurtomotherswithfewerresourcestosupport thechild,andthereforeresultindirectpublichealthcarecosts throughMedicaidmoreoftenthanintendedpregnancies.

    Thefourthmeasure inTable8iswhetherthemotherbreastfedthebabyatall.Breastfeedinghasbeenshowntoreduceaninfantsriskofearinfections,vomiting,diarrhea,pneumonia,andsudden infantdeathsyndrome(49).Breastfeedingalsobenefits thewomanbyreducingherriskof type2diabetesandbreastandovariancancers(49).Becauseoftheshort- andlong-termbenefitstoboththechildand themother,theAmericanAcademyofPediatricsin2005recommended thatallinfantsbebreastfed(50).In20062010,26%ofbabiesfrom intendedbirthswerenotbreastfedatall,comparedwith39%ofbabiesfromunintendedbirths(Table8).

    Finally,Table

    8

    shows

    that

    7.2%

    of

    intendedbirthswere lowbirthweight(lessthan2,500gramsor5.5pounds),comparedwith12%ofunwantedpregnancies.Theotherdifferencesaresmallandarenotsignificantin thissample.

    Thus,delayedornoprenatalcare,smokingduringpregnancy,Medicaidpaymentfordelivery,andnotbreastfeedingareallmorecommonamongpregnanciesthatwereunwantedormistimedby2yearsormorethanamongintendedpregnancies.Basedastheyareonthemostrecentdata, thefindingsinTable8areconsistentwithearlierstudies thatusedolderdataandmultivariatestatisticalmodelsandfoundhigherrisksofthesecharacteristicsforunintendedpregnancies thanforintendedpregnancies.ResearchusingNSFGandemployingmultivariatecontrolswouldbea logicalnextsteptoconfirmthesefindings.

    AProfileofUnintendedPregnancies in20062010

    Tables18showed thepercentagesofbirthstowomen incertaincategoriesthatwere intendedorunintended.Table9shows thereverse:profilesofthepercentagesofmothersofintendedandunintendedbirthswhowere incertainage,maritalstatus,andothercategories.

    ThedatabyageinTable9showthatin20062010,22%ofunintendedbirthswere toteenagemothers(aged1519atthebirth),68%towomenaged2034,and9%towomenaged35andoveratthetimeofthebirth.Amongintendedbirths,4%weretoteenagers,79% towomenaged2034,and17%towomenaged3544.

    Basedon thedatabymaritalstatus,unmarriedwomenhad62%ofunintendedbirthsandonly27%ofintendedbirths.Conversely,marriedwomenhad38%ofunintendedbirthsand73%ofintendedbirths.

    Byraceandethnicity,non-Hispanicwhitewomenhad45%ofunintendedbirths,whereasHispanicwomenhad25%andblackwomenhad22%.Incontrast,non-Hispanicwhitewomenhad60%ofintendedbirthsandblackwomenhadjust11%.

    Womenwithincomesbelow150%ofthepoverty levelhad56%ofunintendedbirths,buttheyhadjust35%ofintendedbirths.Fourteenpercentofunintendedbirthsweretowomenwithincomes threetimesthepoverty levelorhigher,butabout35%of intendedbirthswere tothisgroup.Discussion

    Thepurposeof thisreportis toprovidereliablenationalestimatesoftrendsandgroupdifferencesin intendedandunintendedbirthsintheUnitedStates in19822010.Datafromnationalsamplesofwomeninterviewedinperson in theirhomesareanalyzed.Thereportprovidesaverygeneraloverviewofthese importanttopics,andit isexpectedthatresearcherswilluseNSFGdatatoexplorethese topicsfurther.Thissectionsummarizes thethreemostimportantfindingsofthereportandthen

  • 7/28/2019 nhsr055

    14/28

    Page14 NationalHealthStatisticsReports n Number55 n July24,2012discusseshow thefindingsarerelatedtoteenagebirthrates,theuseofsterilizationforcontraception,andoverallbirthrates.1. TrendsTheproportionofbirths that

    wereunintendeddeclinedamongever-married

    non-Hispanic

    white

    womenbetween1982and20062010.However, thisgroupaccountedfor66%ofallbirths in1982andonly43%ofallbirths in20062010.Theothergroups(includingnever-marriedwomenandHispanicwomen)hadagrowingnumberandpercentageofbirths,andtheirbirthsweremorelikelytobeunintended(6,31).Asaresult, thepercentageofallbirthsthatwereunintendeddidnotdeclinesignificantlybetween1982and2010(Table1).

    2. DifferencesUnintendedbirthsoccurdisproportionatelyamongnon-Hispanicblackwomen,unmarriedwomen,andwomenwith lessincomeandeducation.Forexample,theproportionofallbirths thatwereunwantedormistimedby2yearsormorewas7%forcollegegraduatescomparedwith35%forwomenwhodidnotcompletehighschool(Table3).Thissamepercentagewas9%

    for

    women

    with

    incomes

    of

    400%ofpovertylevelorhighercomparedwith38%forwomenwithincomesbelowpoverty(0%99%)(Table4).Thus,theexperienceofunintendedfertilityforwomenatdifferenteducationand incomelevelsremainsverydivergent,as itwasin2002(Tables3and4)and inthe1970sand1980s(47,25,26).

    3. FirstbirthsOnly8.8%offirstbirthstomarriedwomenareunwantedoroccuratleast2yearsbefore theywerewanted,comparedwith55%offirstbirths tounmarriedwomen(Table5).Thisworksouttonearlyone-thirdofallfirstbirthsintheUnitedStates;that is,31%,ormorethan500,000firstbirthsperyear(40),areeitherunwantedormistimedby2yearsormore(Table3).

    EffectsofUnintendedBirthsontheTeenageBirthRate

    Ausefulway to illustratetheeffectsofunintendedfertility istolookat theeffectofunintendedbirthsonteenbirthrates.Note thatonly22.8%ofbirthstoteenagemothersarefromintendedpregnancies(Table2).Theteenbirthrate intheUnitedStatesin2008was40.2birthsper1,000womenaged1519.IfU.S.teenagershadonlybirthsthat they intendedtohave(andunintendedbirthsto teenswerepostponeduntilafterage20), then theU.S.teenbirthratewouldbejust22.8%of40.2,or9.2per1,000(51).Ifthishappened,teenbirthswoulddropfrom11%ofallbirthsin theUnitedStates to

    just4%ofallbirths(Table9).EffectsofUnintendedBirthsonContraceptiveChoice

    ArecentreportfromNSFG(52)showed thatfemalesterilizationwasthemostusedmethodofbirthcontrolamongblack,Hispanic, low-income,and less-educatedwomenin theUnitedStates.Usingmultivariatestatisticaltechniques,arecentanalysis(53)foundthat themorefrequentexperienceofunintendedbirthsamongblackandHispanicwomenaccountsfor theirmorefrequentuseoffemalesterilizationasamethodofbirthcontrol.Thisfinding isconsistentwithearlierresearch(54).Unintendedbirthsaremorecommonamongwomenwithlow levelsofeducationandincome.Previousresearchhasshownthat thosegroupsuse thepillandotherbirthcontrolmethodslesseffectively thanwomenwithhigherlevelsofeducationand income(41).EffectsofUnwantedBirthsonBirthRates

    In2008(themidpointofinterviewingforthe20062010survey),therewere4,247,694birthsin theUnitedStates(40).Anestimated13.8%wereunwantedby theirmothers(Table1),that is, themotherdidnotwanttohaveabirthatthattimeoratany time inthefuture.Ifwomen

    intheUnitedStateswereable toavoidpregnanciesending inunwantedbirthsasubsetofunintendedbirthsthenumberofbirthswoulddropbyabout586,000peryear,from4,247,694toabout3,661,694(orfrom68.1birthsper1,000womenaged1544,to58.7).Two-thirds(68%)ofthesebirthsavertedwouldbetounmarriedwomen.Conclusions

    HighlightsoffindingsonintendedandunintendedbirthsintheUnitedStatessince1982havebeendescribedwith thegoalofencouragingresearcherstouseNSFGdatatofurtherexaminethese importantissues.Despiteadecrease inunintendedbirths toever-marriednon-Hispanicwhitewomen, thegrowingproportionofbirthstounmarriedwomen,mostofwhichwereunintended,haskepttheoverallproportionofunintendedbirthsapproximatelyconstant.Largeandpersistentdifferencesareseen inunintendedbirthsby incomeandeducation.Mostbirths toteenagersandtounmarriedadultwomenareunintended.Underestimating theriskofpregnancyis themostcommonreasonfornotusingcontraception thatleads tounintendedpregnancy(42,55).References1. FinerLB,HenshawSK.Disparities

    inratesofunintendedpregnancyintheUnitedStates,1994and2001.PerspectSexReprodHealth38(2):906.2006.

    2. FinerLB,ZolnaMR.UnintendedpregnancyintheUnitedStates:Incidenceanddisparities,2006.Contraception84(5):47885.2011.

    3.

    HenshawSK.

    Unintended

    pregnancy

    intheUnitedStates.FamPlannPerspect30(1):249.1998.

    4. Munson,ML.Wantedandunwantedbirthsreportedbymothers1544yearsofage:UnitedStates,1973.Advancedatafromvitalandhealthstatistics;no9.Hyattsville,MD:NationalCenterforHealthStatistics.1977.Availablefrom:http://www.cdc.gov/nchs/data/ad/ad009acc.pdf.

    http://www.cdc.gov/nchs/data/ad/ad009acc.pdfhttp://www.cdc.gov/nchs/data/ad/ad009acc.pdfhttp://www.cdc.gov/nchs/data/ad/ad009acc.pdfhttp://www.cdc.gov/nchs/data/ad/ad009acc.pdfhttp://www.cdc.gov/nchs/data/ad/ad009acc.pdfhttp://www.cdc.gov/nchs/data/ad/ad009acc.pdf
  • 7/28/2019 nhsr055

    15/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page155. WilliamsLB,PrattWF.Wantedand

    unwantedchildbearingintheUnitedStates:197388.Advancedatafromvitalandhealthstatistics;no189.Hyattsville,MD:NationalCenterforHealthStatistics.1990.Availablefrom:http://www.cdc.gov/nchs/data/ad/ad189.pdf.

    6. ChandraA,MartinezGM,MosherWD,etal.Fertility,familyplanning,andreproductivehealthofU.S.women:Datafromthe2002NationalSurveyofFamilyGrowth.NationalCenterforHealthStatistics.VitalHealthStat23(25).2005;tables 2029.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf.

    7. BrownSS,EisenbergL.Thebestintentions:Unintendedpregnancyandthewell-beingofchildrenandfamilies.

    Washington,

    DC:

    National

    AcademyPress.1995.

    8. LoganC,HolcombeE,ManloveJ,RyanS.Theconsequencesofunintendedchildbearing:Awhitepaper.Washington,DC:TheNationalCampaigntoPreventTeenandUnplannedPregnancy.2007.Availablefrom:http://www.thenationalcampaign.org/resources/pdf/consequences.pdf.

    9. PamukER,MosherWD.Healthaspectsofpregnancyandchildbirth:UnitedStates,1982.NationalCenterfor

    Health

    Statistics.

    Vital

    Health

    Stat

    23(16).1988.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdf.

    10.ChandraA.Healthaspectsofpregnancyandchildbirth:UnitedStates,198288.NationalCenterforHealthStatistics.VitalHealthStat23(18).1995.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdf.

    11.TaylorJS,CabralHJ.Arewomenwithanunintendedpregnancylesslikelytobreastfeed?JFamPract51(5):4316.2002.12.DavidHP.Bornunwanted,35yearslater:ThePragueStudy.ReprodHealthMatters14(27):18190.2006.

    13.BarberJS,AxinnWG,ThorntonA.Unwantedchildbearing,health,andmother-childrelationships.JHealthSocBehav40(3):23157.1999.

    14.U.S.DepartmentofHealthandHumanServices,PublicHealthService.Promotinghealth/preventingdisease:Objectivesforthenation.Washington,DC:U.S.GovernmentPrintingOffice.1980.

    15.U.S.DepartmentofHealthandHumanServices.HealthyPeople2000:Nationalhealthpromotionanddiseasepreventionobjectives.Washington,DC:U.S.GovernmentPrintingOffice.1990.

    16.U.S.DepartmentofHealthandHumanServices.HealthyPeople2020.Familyplanningtopicarea.Availablefrom:http://www.healthypeople.gov/2020/topicsobjectives2020/overview .aspx?topicid=13[AccessedFebruary2012].

    17.CDC.Achievementsinpublichealth,19001999:Familyplanning.MMWR48(47):107380.1999.Available

    from:

    http://www.cdc.gov/

    mmwr/preview/mmwrhtml/mm4847a1.htm.

    18.FrostJJ,FinerLB,TapalesA.Theimpactofpubliclyfundedfamilyplanningclinicservicesonunintendedpregnanciesandgovernmentcostsavings.JHealthCarePoorUnderserved19(3):77896.2008.

    19.MoneaE,ThomasA.Unintendedpregnancyandtaxpayerspending.PerspectSexReprodHealth43(2):8893.2011.

    20.Sonfield

    A,

    Kost

    K,

    Gold

    RB,

    Finer

    LB.Thepubliccostsofbirthsresultingfromunintendedpregnancies:Nationalandstate-levelestimates.PerspectSexReprodHealth43(2):94102.2011.

    21.GrovesRM,MosherWD,LepkowskiJM,KirgisNG.PlanninganddevelopmentofthecontinuousNationalSurveyofFamilyGrowth.NationalCenterforHealthStatistics.VitalHealthStat1(48).2009.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdf.

    22.LepkowskiJM,MosherWD,DavisKE,etal.The20062010NationalSurveyofFamilyGrowth:Sampledesignandanalysisofacontinuoussurvey.NationalCenterforHealthStatistics.VitalHealthStat2(150).2010.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdf.

    23.MartinezGM,ChandraA,AbmaJC,etal.Fertility,contraception,andfatherhood:DataonmenandwomenfromCycle6(2002)oftheNationalSurveyofFamilyGrowth.NationalCenterforHealthStatistics.VitalHealthStat23(26).2006.Availablefrom:http://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdf.

    24.JonesRK,KostK.UnderreportingofinducedandspontaneousabortionintheUnitedStates:Ananalysisofthe2002NationalSurveyofFamilyGrowth.StudFamPlann38(3):18797.2007.

    25.RyderNB,WestoffCF.ReproductionintheUnitedStates,1965.Princeton,NJ:PrincetonUniversityPress.1971.

    26.WestoffCF.Theyieldoftheimperfect:The1970NationalFertilityStudy.Demography12(4):57380.

    1975.

    27.CampbellAA,MosherWD.A

    historyofthemeasurementofunintendedpregnanciesandbirths.MaternChildHealthJ4(3):1639.2000.

    28.PetersonLS,MosherWD.Optionsformeasuringunintendedpregnancyincycle6oftheNationalSurveyofFamilyGrowth.FamPlannPerspect31(5):2523.1999.

    29.CommissiononPopulationGrowthandtheAmericanFuture.PopulationandtheAmericanfuture.Washington,

    DC:

    U.S.

    Government

    PrintingOffice.1972.

    30.SantelliJS,LindbergLD,OrrMG,FinerLB,SpeizerI.Towardamultidimensionalmeasureofpregnancyintentions:EvidencefromtheUnitedStates.StudFamPlann40(2):87100.2009.

    31.PulleyL,KlermanLV,TangH,BakerBA.Theextentofpregnancymistiminganditsassociationwithmaternalcharacteristicsandbehaviorsandpregnancyoutcomes.PerspectSexReprodHealth34(4):20611.2002.32.LondonK,PetersonL,PiccininoL.TheNationalSurveyofFamilyGrowth:Principalsourceofstatisticsonunintendedpregnancy.In:BrownSS,EisenbergL,eds.Thebestintentions:Unintendedpregnancyandthewell-beingofchildrenandfamilies.Washington,DC:NationalAcademyPressAcademyPress;26895.1995.

    http://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/series/sr_02/sr02_150.pdfhttp://www.cdc.gov/nchs/data/series/sr_01/sr01_048.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_018.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_016.pdfhttp://www.thenationalcampaign.org/resources/pdf/consequences.pdfhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htmhttp://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdfhttp://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdfhttp://www.cdc.gov/nchs/data/ad/ad189.pdf
  • 7/28/2019 nhsr055

    16/28

    Page16 NationalHealthStatisticsReports n Number55 n July24,201233.BachrachCA,NewcomerS.Intended

    pregnanciesandunintendedpregnancies:Distinctcategoriesoroppositeendsofacontinuum?FamPlannPerspect31(5):2512.1999.

    34.SpeizerIS,SantelliJS,Afable-MunsuzA,KendallC.Measuringfactorsunderlyingintendednessofwomensfirstandlaterpregnancies.PerspectSexReprodHealth36(5):198205.2004.

    35.MillerWB,SeveryLJ,PastaDJ.Aframeworkformodellingfertilitymotivationincouples.PopulStud(Camb)58(2):193205.2004.

    36.MillerWB,JonesJ.Theeffectsofpreconceptiondesiresandintentionsonpregnancywantedness.JPopulRes26(4):32757.2009.

    37.JonesRK,KavanaughML.Changesinabortionratesbetween2000and2008

    and

    lifetime

    incidence

    of

    abortion.ObstetGynecol117(6):135866.2011.

    38.VenturaSJ,BachrachCA.NonmaritalchildbearingintheUnitedStates,194099.Nationalvitalstatisticsreports;vol48no16.Hyattsville,MD:NationalCenterforHealthStatistics.2000.Availablefrom:http://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdf.

    39.VenturaSJ.ChangingpatternsofnonmaritalchildbearingintheUnitedStates.NCHSdatabrief,no18.Hyattsville,

    MD:

    National

    Center

    for

    HealthStatistics.2009.Availablefrom:http://www.cdc.gov/nchs/data/databriefs/db18.pdf.

    40.MartinJA,HamiltonBE,VenturaSJ,etal.Births:Finaldatafor2009.Nationalvitalstatisticsreports;vol60no1.Hyattsville,MD:NationalCenterforHealthStatistics.2011.Availablefrom:http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf.

    41.KostK,SinghS,VaughanB,TrussellJ,BankoleA.Estimatesofcontraceptivefailurefromthe2002NationalSurveyofFamilyGrowth.Contraception77(1):1021.2008.

    42.NettlemanMD,ChungH,BrewerJ,AyoolaA,ReedPL.Reasonsforunprotectedintercourse:AnalysisofthePRAMSsurvey.Contraception75(5):3616.2007.

    43.LockwoodCJ,LemonsJA,eds.Guidelinesforperinatalcare,6thed.ElkGrove,IL:AmericanAcademyofPediatrics;andWashington,DC:AmericanCollegeofObstetriciansandGynecologists.2007.

    44.KirkhamC,HarrisS,GrzybowskiS.Evidence-basedprenatalcare:PtI.Generalprenatalcareandcounselingissues.AmFamPhysician71(7):130716.2005.

    45.MathewsTJ,MacDormanMF.Infantmortalitystatisticsfrom the2007periodlinkedbirth/infantdeathdataset.Nationalvitalstatisticsreports;vol59no6.Hyattsville,MD:NationalCenterforHealthStatistics;tableII,p27.2011.Availablefrom:http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdf.

    46.U.S.DepartmentofHealthandHumanServices(HHS).Howtobaccosmokecausesdisease:Thebiologyandbehavioralbasisforsmoking-attributabledisease:AReportoftheSurgeonGeneral.Atlanta,GA:HHS,CentersforDisease

    Control

    and

    Prevention,

    NationalCenterforChronicDiseasePreventionandHealthPromotion,OfficeonSmokingandHealth.2010.

    47.Mathews,TJ.Smokingduringpregnancyinthe1990s.Nationalvitalstatisticsreports;vol49no7.Hyattsville,MD:NationalCenterforHealthStatistics.2001.Availablefrom:http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdf.

    48.JaddoeVW,TroeEJ,HofmanA,MackenbachJP,MollHA,SteegersEA,WittemanJC.Activeandpassivematernal

    smoking

    during

    pregnancy

    andtherisksoflowbirthweightandpretermbirth:TheGenerationRStudy.PaediatrPerinatEpidemiol22(2):16271.2008.

    49.IpS,ChungM,RamanG,TrikalinosTA,LauJ.AsummaryoftheAgencyforHealthcareResearchandQualitysevidencereportonbreastfeedingindevelopedcountries.BreastfeedMed4(Suppl1):S17S30.2009.

    50.GartnerLM,MortonJ,LawrenceRA,NaylorAJ,OHareD,SchanlerRJ,etal.Breastfeedingandtheuseofhumanmilk.Pediatrics115(2):496506.2005.

    51.HamiltonBE,MartinJA,VenturaSJ.Births:Preliminarydatafor2010.Nationalvitalstatisticsreports;vol60no2.Hyattsville,MD:NationalCenterforHealthStatistics;tablesS1,S2,andS3.2011.Availablefrom:http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdf.

    52.MosherW,JonesJ.UseofcontraceptionintheUnitedStates:19822008.NationalCenterforHealthStatistics.VitalHealthStat23(29).2010.Availablefrom:http://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdf.

    53.BorreroS,MooreCG,QinL,SchwarzEB,AkersA,CreininMD,IbrahimSA.Unintendedpregnancyinfluencesracialdisparityintubalsterilizationrates.JGenInternMed25(2):1228.2010.

    54.BumpassLL,ThomsonE,GodeckerAL.Women,men,andcontraceptivesterilization.FertilSteril73(5):93746.2000.

    55.KayeK,SuellentropK,SloupC.TheFogZone:Howmisperceptions,magicalthinking,andambivalenceputyoungadultsatriskforunplanned

    pregnancy.

    Washington,

    DC:NationalCampaigntoPreventTeenandUnplannedPregnancy.2009.Availablefrom:http://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdf.

    http://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdfhttp://www.cdc.gov/nchs/data/databriefs/db18.pdfhttp://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_07.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr48/nvs48_16.pdfhttp://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdfhttp://www.cdc.gov/NCHS/data/series/sr_23/sr23_029.pdf
  • 7/28/2019 nhsr055

    17/28

    NationalHealthStatisticsReports n Number55 n July24,2012 Page17Table1.Trendsinthe intendednessofbirthsatconception,bymaritalstatusatbirthandHispanicoriginandraceofmother:UnitedStates,selectedyears

    Unintended Mistimed

    Numberof Lessthan 2yearsbirths in Total Total 2years ormore

    Characteristic1 thousands Total Intended2 unintended Unwanted mistimed3 toosoon toosoonPercentdistribution(standarderror)

    Total19824 . . . . . . . . . . . . . . . . . 18,442 100.0 63.5 (1.25) 36.5 (1.25) 9.8 (0.80) 26.7 (1.23) - -Total1 98 8. . . . . . . . . . . . . . . . . . 19,020 100.0 60.9 (1.25) 39.1 (1.25) 12.4 (0.65) 26.7 (1.04) - -Total19955 . . . . . . . . . . . . . . . . . 19,462 100.0 69.4 (0.89) 30.6 (0.89) 10.1 (0.55) 20.5 (0.74) 7.3 (0.47) 12.8 (0.60)Total2 00 2. . . . . . . . . . . . . . . . . . 21,018 100.0 65.1 (1.28) 34.9 (1.28) 14.1 (0.90) 20.8 (0.92) 8.0 (0.64) 12.1 (0.68)Total200620104 . . . . . . . . . . . . . 21,161 100.0 62.9 (1.51) 37.1 (1.51) 13.8 (0.78) 23.3 (1.14) 9.2 (0.75) 14.0 (0.93)

    Evermarried1982 . . . . . . . . . . . . . . . . . . . . . 15,433 100.0 70.3 (1.22) 29.7 (1.22) 7.6 (0.74) 22.2 (1.26) - -

    HispanicorLatina . . . . . . . . . . . 1,568 100.0 71.3 (4.83) 28.7 (4.83) 10.5 (4.10) 18.2 (2.74) - -NonHispanicwhite. . . . . . . . . . . 12,175 100.0 71.5 (1.48) 28.5 (1.48) 6.2 (0.75) 22.3 (1.61) - -NonHispanicblack. . . . . . . . . . . 1,315 100.0 58.9 (2.55) 41.1 (2.55) 15.5 (1.68) 25.7 (1.84) - -

    20062010 . . . . . . . . . . . . . . . . . 13,850 100.0 74.7 (1.46) 25.3 (1.46) 8.9 (0.80) 16.4 (1.14) 9.8 (0.91) 6.4 (0.75)HispanicorLatina . . . . . . . . . . . 2,630 100.0 66.1 (2.55) 33.9 (2.55) 15.9 (2.31) 17.9 (2.11) 8.2 (1.31) 9.6 (1.59)NonHispanicwhite. . . . . . . . . . . 9,099 100.0 78.4 (1.71) 21.6 (1.71) 6.4 (0.86) 15.2 (1.35) 10.3 (1.25) 4.7 (0.81)NonHispanicblack. . . . . . . . . . . 1,111 100.0 65.5 (3.82) 34.5 (3.82) 11.7 (2.64) 22.8 (3.60) 12.9 (3.17) 9.3 (2.29)

    Nevermarried1982 . . . . . . . . . . . . . . . . . . . . . 2,955 100.0 28.4 (3.28) 71.6 (3.28) 21.4 (2.34) 50.2 (3.22) - -

    HispanicorLatina . . . . . . . . . . . * 100.0 * * * * - -NonHispanicwhite. . . . . . . . . . . 1,062 100.0 20.0 (5.36) 80.0 (5.36) 18.3 (6.21) 61.7 (6.83) - -NonHispanicblack. . . . . . . . . . . 1,297 100.0 31.0 (2.16) 69.0 (2.16) 28.1 (2.02) 40.9 (2.99) - -

    20062010 . . . . . . . . . . . . . . . . . 7,311 100.0 40.4 (2.03) 59.6 (2.03) 23.1 (1.32) 36.5 (1.70) 7.9 (1.01) 28.4 (1.56)HispanicorLatina . . . . . . . . . . . 1,917 100.0 44.6 (2.40) 55.4 (2.40) 21.4 (2.68) 34.0 (2.25) 7.6 (1.39) 26.3 (1.89)NonHispanicwhite. . . . . . . . . . . 2,745 100.0 39.1 (3.94) 60.9 (3.94) 19.3 (2.66) 41.6 (3.49) 9.7 (2.36) 31.4 (3.15)NonHispanicblack. . . . . . . . . . . 2,308 100.0 38.3 (2.66) 61.7 (2.66) 27.5 (1.94) 34.2 (2.21) 6.2 (0.87) 27.9 (2.33)

    Datanotavailable;cannotbecalculated.*Figuredoesnotmeetstandardsofreliabilityorprecision.1

    The1977OfficeofManagementandBudgetdefinitions forraceareused.See DefinitionsofTermssection.2Includesbirthswithintendednessreportedas dontknow.3Thetwocategoriesofamountmistimedmaynotsum to totalmistimeddue tocaseswhereamountmistimedcannotbecalculated.4Includeswomenofotherorunknownraceandorigingroupsnotshownseparately.5Showninitalicsbecauseresearchsuggeststhat, formethodologicalreasons,thesedatashowabias towardhigherpercentages intended.SeeTechnicalNotes.NOTES:Dataare limited tobirthsoccurring in the5yearsbeforetheinterview.Percentagesmaynotadd to100due torounding.SOURCE:CDC/NCHS,NationalSurveyofFamilyGrowth.

  • 7/28/2019 nhsr055

    18/28

    Page18 NationalHealthStatisticsReports n Number55 n July24,2012Table2. Intendednessofbirthsatconception,bymothersageandmaritalorcohabitationstatusatthebirth:UnitedStates,2002and20062010

    IntendednessstatusUnintended

    Mistimed

    CharacteristicNumber

    of

    births in

    thousands Total Intended1 Totalunintended Unwanted Totalmistimed2Less

    than

    2years

    toosoon2

    years

    ormore

    toosoonPercentdistribution(standarderror)

    Ageatbirth1519years:

    20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    2024years:20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    2544years:20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    2,2152,2835,5535,243

    13,25013,635

    100.0100.0100.0100.0100.0100.0

    21.6 (2.14)22.8 (2.63)56.0 (2.12)49.9 (2.35)76.2 (1.40)74.6 (1.39)

    78.4 (2.14)77.2 (2.63)44.0 (2.12)50.1 (2.35)23.8 (1.40)25.4 (1.39)

    21.4 (2.66)19.3 (2.59)17.2 (1.72)16.5 (1.37)11.6 (1.02)11.8 (0.88)

    56.9 (2.71)57.9 (2.90)26.9 (1.78)33.6 (2.03)12.2 (0.97)13.7 (1.09)

    9.0 (2.14)6.5 (1.50)9.4 (1.34)

    11.6 (1.61)7.2 (0.76)8.6 (0.87)

    46.3 (2.82)51.3 (2.87)16.3 (1.35)21.6 (1.90)

    4.6 (0.65)4.8 (0.58)

    MaritalorcohabitingstatusatbirthMarried:

    20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    Unmarried,cohabiting:20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    Unmarried,notcohabiting:20 02 . . . . . . . . . . . . . . . . . . . . 20062010. . . . . . . . . . . . . . . .

    13,53412,635

    2,9984,9504,4863,576

    100.0100.0100.0100.0100.0100.0

    76.9 (1.18)76.6 (1.47)48.8 (3.12)49.3 (2.34)40.5 (2.28)33.1 (2.41)

    23.1 (1.18)23.4 (1.47)51.3 (3.12)50.7 (2.34)59.5 (2.28)66.9 (2.41)

    9.0 (0.88)7.2 (0.75)

    18.1 (2.50)20.4 (1.68)26.9 (2.25)27.7 (1.91)

    14.1 (0.91)16.2 (1.20)33.2 (2.45)30.3 (1.99)32.6 (1.97)39.2 (2.21)

    8.4 (0.72)10.1 (0.97)

    8.2 (1.52)8.8 (1.41)6.5 (1.32)6.4 (1.20)

    5.3 (0.66)6.0 (0.73)

    24.2 (2.32)21.5 (1.67)24.5 (1.79)32.1 (1.93)

    Maritalorcohabitingstatusandageatbirth

    Married:1524years:

    2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    2544years:2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    Unmarried,cohabiting:1524years:

    2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    2544years:2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    Unmarried,notcohabiting:1524years:

    2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    2544years:2002 . . . . . . . . . . . . . . . . . . 20062010 . . . . . . . . . . . . . .

    3,1032,475

    10,43110,160

    1,8532,8471,1452,103

    2,8122,2041,6731,372

    100.0100.0100.0100.0

    100.0100.0100.0100.0

    100.0100.0100.0100.0

    67.0 (2.33)59.5 (3.14)79.9 (1.41)80.8 (1.47)

    40.1 (4.02)42.1 (3.43)62.7 (4.67)59.1 (3.68)

    27.3 (2.65)21.1 (2.20)62.7 (4.10)52.4 (4.26)

    33.1 (2.33)40.5 (3.14)20.2 (1.41)19.2 (1.47)

    59.9 (4.02)57.9 (3.43)37.3 (4.67)40.9 (3.68)

    72.7 (2.65)78.9 (2.20)37.3 (4.10)47.6 (4.26)

    8.4 (1.29)7.1 (1.36)9.2 (1.07)7.3 (0.84)

    18.6 (2.85)19.4 (2.21)17.3 (3.53)21.8 (2.84)

    29.2 (2.93)26.3 (2.48)23.0 (2.81)30.0 (2.87)

    24.6 (2.18)33.