Management and Clinical Options for 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 Data
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. Additionally, 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. 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.
Key Statistics on Unintended Pregnancy
| Category | Statistical Data |
|---|---|
| Prevalence | 42% of all pregnancies |
| Trend (2010–2019) | Declined from 43% to 42% |
| High-Rate Demographics | Females 20-24, non-Hispanic Black, and unmarried patients |
| Transgender Men Rate | 24% (based on survey of 41 individuals) |
Clinical Approach and Patient Counseling
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.
Review of Patient Options
Options include continuing the pregnancy and parenting, continuing the pregnancy and pursuing adoption, or having a medication or procedural abortion.
- 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.