Management and Counseling for Patients with Unintended Pregnancy
Unintended pregnancies, which include pregnancies that are unplanned, mistimed, or unwanted, account for 42% of all pregnancies. 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%.
Demographics and Prevalence
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.
The Role of Family Physicians
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. In accordance with the American Academy of Family Physicians policy statement, counseling should remain nonjudgmental and unbiased.
Options for Patients
Options include continuing the pregnancy and parenting, continuing the pregnancy and pursuing adoption, or having a medication or procedural abortion. Below is the breakdown of these management paths:
- Parenting: If a patient chooses to parent the infant, physicians should be equipped to offer local resources.
- Adoption: Physicians are not authorized to broker adoptions.
- Abortion: Medication and procedural abortions are safe and effective for patients who choose abortion.