Published on Friday, May 5, 2006 by the San Francisco Chronicle
Unplanned Pregnancy Increases among Poor
by Marc Kaufman
WASHINGTON - Poor women are getting pregnant unintentionally at considerably higher rates now than in the mid-1990s, and they are giving birth to many more unplanned children and having more abortions.
In contrast, the rate of unplanned pregnancies and resulting abortions for more affluent women declined substantially during the same eight-year period, according to a new study by researchers at the Guttmacher Institute who analyzed federal data.
As a result, the study found, women living in poverty are almost four times more likely to become pregnant unintentionally than women of greater means.
"Clearly, something is changing, and it doesn't bode well in terms of unplanned pregnancies and abortions for poor women in particular," said Heather Boonstra, one of the authors of the Guttmacher report.
Guttmacher is a nonprofit group based in New York and Washington that engages in research, policy analysis and public education on sexual and reproductive health issues.
Based on nationwide data collected by the National Center for Health Statistics and other sources, the researchers found that from 1994 through 2001, the rate of unplanned pregnancy increased by almost 30 percent for women below the federal poverty line. For women in families comfortably above poverty (now $16,000 annually for a family of three), the rate of unplanned pregnancies fell by 20 percent during the same time.
Asked what was driving the trends, the authors noted that some state and federal reproductive health programs have been cut back and made more restrictive in recent years, and the decline in contraceptive use could be a result of those changes. Both types of programs have increasingly focused on abstinence rather than contraception, and some have argued that the switch also is leading to reduced contraceptive use and more unintended pregnancies. Many social conservatives argue, however, that all contraceptives have limitations and that the only way a woman can ensure she will not have an unintended pregnancy is to refrain from sexual intercourse until she is ready to have a child.
The finding that poor and wealthier women are having such increasingly different experiences with unintended pregnancy is part of a larger study of pregnancy and abortion. That study found that the overall abortion rate has declined steadily for years and that a higher percentage of women with unintended pregnancies are carrying them to birth. It also concluded that women who do get abortions are doing so considerably earlier in their pregnancies, when it is safer for the woman, than in the past.
But as with unintended pregnancies generally, the differences between the experiences of poor and more affluent women in these categories were diverging, too. Among poor women, the proportion of unintended pregnancies that resulted in live births increased by almost 50 percent between 1994 and 2001, while it declined for women in families whose income was at least twice the official poverty level. Poor women who had abortions did so on average six days later in their pregnancy than women of greater means.
"We're seeing greater disparities when it comes to education and race as well," said Lawrence Finer, Guttmacher's director of domestic research and lead author of the study on abortion trends in the June edition of the peer-reviewed Perspectives on Sexual and Reproductive Health.
The study found there were 6.4 million pregnancies in the United States in 2001, resulting in about 4 million births. There were 1.3 million abortions and 1.1 million miscarriages. The pregnancies were almost evenly divided between intended and unintended, and the unintended ones led to almost even numbers of births and abortions.
The authors said the growing disparities between richer and poor women appeared to be the result of considerably higher levels of contraceptive use by the more affluent. The health statistics center, which is part of the Centers for Disease Control and Prevention, reported in 2004 that after decades of increasing contraceptive-use rates, the trend stalled in the late 1990s and began to decline after that. The decline was almost entirely in poorer women.
The overall pregnancy rate for women of child-bearing age declined slightly from 1994 to 2001, as did the overall abortion rate. Black and Hispanic women were considerably more likely to become pregnant than white women, and black women had by far the highest percentage of unintended pregnancies and abortions.
In 1994, the study found, 87 women out of 1,000 living below the poverty line had unintended pregnancies. In 2001, that number had risen to 112 out of 1,000 women.
For women earning between $16,000 and $32,000 a year, the number of unintended pregnancies increased from 65 per 1,000 in 1994 to 81 per 1,000 in 2001. But for women in families earning more than $32,000, the number declined from 37 to 29 unplanned pregnancies for each 1,000 women.
©2006 San Francisco Chronicle