Management and Options for Patients with Unintended Pregnancy
Unintended pregnancies, which include pregnancies that are unplanned, mistimed, or unwanted, account for 42% of all pregnancies. In addition to obtaining a thorough history and performing a physical examination, family physicians are integral in providing counseling and resources to patients with unintended pregnancies. Because most of the cited studies and guidelines use the term women, this article uses the same term or female to include cisgender women and patients with similar reproductive potential.
Epidemiology and Statistics
Between 2010 and 2019, the overall pregnancy rate (estimated number of pregnancies in women 15–44 years of age) declined by 12%; however, the rate of unintended pregnancies only declined from 43% to 42%. Groups with the highest unintended pregnancy rates include females who are 20 to 24 years of age, patients who are non-Hispanic Black, and those who are unmarried. Furthermore, there are limited data on rates of unintended pregnancies in transgender men; one small survey of 41 transgender men found a rate of 24% and showed that this population has unique needs.
Unintended Pregnancy Data Summary
| Category | Statistics and Groups |
|---|---|
| Overall Prevalence | 42% of all pregnancies |
| Historical Trend (2010-2019) | Rate declined from 43% to 42% |
| Highest Rate Demographics | Females 20-24 years of age, non-Hispanic Black patients, and unmarried individuals |
| Transgender Men | 24% unintended pregnancy rate |
Clinical Counseling and Available Options
In accordance with the American Academy of Family Physicians policy statement, counseling should remain nonjudgmental and unbiased. Options include continuing the pregnancy and parenting, continuing the pregnancy and pursuing adoption, or having a medication or procedural abortion.
Implementing Patient Choices
If a patient chooses to parent the infant, physicians should be equipped to offer local resources. Regarding alternative paths, it is important to note that physicians are not authorized to broker adoptions. For those seeking other medical interventions, medication and procedural abortions are safe and effective for patients who choose abortion.