Unplanned Pregnancies At 35-Year Low, Thanks To IUDs; How Women And Children’s Health May Benefit
A new report published in the New England Journal of Medicine finds that unplanned pregnancies have reached an all-time low in 35 years, mainly due to an increase in women using intrauterine devices (IUD) or other long-acting reversible contraceptives (LARCs). After the rates of unplanned pregnancies increased slightly in 2008, the report finds that between 2008 and 2011, they dropped by 18 percent. The numbers declined from 54 unintended pregnancies per 1,000 women of childbearing age (18-44 years old) in 2008, to 45 unintended pregnancies per 1,000 women in 2011.
In the past few years, CDC reports have noticed a decline in both general pregnancies and abortions, so it’s perhaps not too surprising that unplanned pregnancies are also dropping. And a recent study found that women are giving birth much later, with the average age of first-time childbirth now at 26.
But it’s likely that an increase of IUD and LARC usage — which has tripled since 2007 — is what’s contributing to the big drop in unplanned pregnancies. A 2015 study out of the University of California-San Francisco found that education about contraceptives led to a dramatic reduction in unintended pregnancies. These long-term implants allow women to have more freedom in their daily life without having to remember to take a pill every day or rely on condoms. As a result, women have more control over when to start a family.
“You empower women to choose when they start their family,” Dr. Adam Jacobs, director of family planning for Mount Sinai Hospital in New York City, told HealthDay. “By doing that, you let them stay in education, which leads to a better income. They’re better able to plan their families and plan their lives.”
Unplanned Pregnancies: The Public Health Impact
In addition to these financial and educational benefits, what are the health benefits of fewer unplanned pregnancies? “[U]nintended pregnancy has a public health impact,” the Guttmacher Institute states. “Births resulting from unintended or closely spaced pregnancies are associated with adverse maternal and child health outcomes, such as delayed prenatal care, premature birth, and negative physical and mental health effects for children. For these reasons, reducing the unintended pregnancy rate is a national public health goal.”
Firstly, in many parts of the world, improving access to contraception and family planning would result in fewer maternal deaths, as teens and young mothers are at a higher risk of death and complications than other women, according to the WHO. Due to a lack of education about sexual health and contraception, young women may be at a greater risk of unplanned pregnancies than older women.
While abortion rates are decreasing due to an increase in the use of contraception, 42 percent of unplanned pregnancies still end in abortion, according to the Guttmacher Institute. Though most women don’t regret having an abortion in the long-run, the stress of an unplanned pregnancy and resulting abortion can still have an impact on a woman’s mental health, at least temporarily.
Finally, unplanned pregnancies can have an impact on a mother’s mental health as well as the health of her child. If a mother isn’t ready to care for a child, she’s more likely to disregard proper nutrition or lifestyle changes necessary for a health pregnancy and birth. “If a pregnancy is not planned before conception,” the CDC states, “a woman may not be in the optimal health for childbearing.”
Research has found that emotional distress or stress during pregnancy can increase the risk of preterm birth and other birth complications. And not maintaining a healthy weight, diet, or exercise routine — as well as continuing to use tobacco or alcohol — during pregnancy could result in a slew of health problems for both mother and baby. In addition, a 2013 study found that children born from unplanned pregnancies have lower developmental scores and cognitive delay.
And it’s often the women from lower socioeconomic backgrounds who fare the worst when it comes to unplanned pregnancies. Before Obamacare, women didn't have easy access to affordable contraceptives. Now, the increase in the availability of birth control and IUDs will continue working to improve the public health situation for both mothers and children.
Source: Finer L, Zolna M. Declines in Unintended Pregnancy in the United States, 2008-2011. The New England Journal of Medicine, 2016.