Last Updated: February 2023

Author: Division of Maternal and Child Health, Vermont Department of Health

Unintended pregnancies are associated with many negative health and economic consequences. Unintended pregnancies include pregnancies that are reported by women as being mistimed or unwanted. Almost half of all pregnancies in the United States are unintended. Government expenditures on births resulting from unintended pregnancies nationwide totaled $21 billion in 2010.

For women, negative outcomes associated with unintended pregnancy can include:

• Delays in initiating prenatal care
• Reduced likelihood of breastfeeding, resulting in less healthy children
• Maternal depression
• Increased risk of physical violence during pregnancy

Births resulting from unintended pregnancies can have negative consequences including birth defects and low birth weight. Children from unintended pregnancies are more likely to experience poor mental and physical health during childhood, and have lower educational attainment and more behavioral issues in their teen years.

The negative consequences associated with unintended pregnancies are greater for teen parents and their children. Eighty-two percent of pregnancies to mothers ages 15 to 19 are unintended. Nationally, one in five unintended pregnancies each year is among teens.

Teen mothers:

• Are less likely to graduate from high school or attain a GED by the time they reach age 30.
• Earn an average of approximately $3,500 less per year, when compared with those who delay childbearing until their 20s.
• Receive nearly twice as much Federal aid for nearly twice as long.
• Similarly, early fatherhood is associated with lower educational attainment and lower income.
• The average annual cost of teen childbearing to U.S. taxpayers is estimated at $9.1 billion, or $1,430 for each teen mother per year.

Source: http://www.healthypeople.gov/2020/topics-objectives/topic/family-planning

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on Family Planning indicators, check out our Public Health Data Explorer.

This indicator is part of Healthy Vermonters 2020 which documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. 

• Health care providers
• Community based organizations
• Offices of Local Health
• Title X partners- Planned Parenthood of Northern New England
• Agency of Education

There is strong evidence attesting to the effectiveness and cost-effectiveness of publicly funded family planning services. Each year, publicly funded family planning services prevent 1.94 million unintended pregnancies, including 400,000 teen pregnancies. These services are cost-effective, saving nearly $4 in Medicaid expenditures for pregnancy-related care for every $1 spent. Publicly funded family planning services are a central part of the health care safety net.

Title X provides significant cost savings to taxpayers. The Title X Family Planning program was enacted in 1970 as Title X of the Public Health Service Act (Public Law 91-572 Population Research and Voluntary Family Planning Programs). Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services.

The Office of Population Affairs (OPA) sets the standards for publicly funded family planning services in the U.S. The Title X statute, regulations and guidance offer patient protections by requiring that programs are voluntary, confidential and include a broad range of contraceptive methods.

Emerging evidence indicates that increasing the use of contraceptive implants and IUDs, long acting reversible contraceptives (LARC), will help reduce the rate unintended pregnancy.

Many women of reproductive age can benefit from preconception care (care before pregnancy). Preconception care has been defined as a set of interventions designed to identify and reduce risks to a woman's health and improve pregnancy outcomes through prevention and management of health conditions. A reproductive life plan is a set of goals and action steps based on personal values and resources about whether and when to become pregnant and have (or not have) children.

Increased awareness of the importance of preconception care can be achieved through public outreach and improved collaboration between health care providers.

• Continue to work with family planning service providers to ensure access to free or low cost services for low income people.
• Continue to support the use of best practice approaches related to contraceptive options, with an emphasis on methods that are most effective.
• Support the education and outreach efforts of family planning partners on related preventive health issues and services, preconception health counselling and reproductive life planning.

The Phase 7 (2012 to present) question on pregnancy intention was modified from the Phase 6 version (2009-2011). An additional response option was added at the suggestion of subject matter experts on the topic: I wasn’t sure what I wanted. Trend data, therefore, should be interpreted with caution.

The PRAMS sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each participating state samples between 1,300 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.