Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;6(4):e380-e389.
doi: 10.1016/S2214-109X(18)30029-9. Epub 2018 Mar 5.

Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model

Jonathan Bearak  1 , Anna Popinchalk  2 , Leontine Alkema  3 , Gilda Sedgh  2
Affiliations

Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model

Jonathan Bearak et al. Lancet Glob Health. 2018 Apr.

Abstract

Background: Estimates of pregnancy incidence by intention status and outcome indicate how effectively women and couples are able to fulfil their childbearing aspirations, and can be used to monitor the impact of family-planning programmes. We estimate global, regional, and subregional pregnancy rates by intention status and outcome for 1990-2014.

Methods: We developed a Bayesian hierarchical time series model whereby the unintended pregnancy rate is a function of the distribution of women across subgroups defined by marital status and contraceptive need and use, and of the risk of unintended pregnancy in each subgroup. Data included numbers of births and of women estimated by the UN Population Division, recently published abortion incidence estimates, and findings from surveys of women on the percentage of births or pregnancies that were unintended. Some 298 datapoints on the intention status of births or pregnancies were obtained for 105 countries.

Findings: Worldwide, an estimated 44% (90% uncertainty interval [UI] 42-48) of pregnancies were unintended in 2010-14. The unintended pregnancy rate declined by 30% (90% UI 21-39) in developed regions, from 64 (59-81) per 1000 women aged 15-44 years in 1990-94 to 45 (42-56) in 2010-14. In developing regions, the unintended pregnancy rate fell 16% (90% UI 5-24), from 77 (74-88) per 1000 women aged 15-44 years to 65 (62-76). Whereas the decline in the unintended pregnancy rate in developed regions coincided with a declining abortion rate, the decline in developing regions coincided with a declining unintended birth rate. In 2010-14, 59% (90% UI 54-65) of unintended pregnancies ended in abortion in developed regions, as did 55% (52-60) of unintended pregnancies in developing regions.

Interpretation: The unintended pregnancy rate remains substantially higher in developing regions than in developed regions. Sexual and reproductive health services are needed to help women avoid unintended pregnancies, and to ensure healthy outcomes for those who do experience such pregnancies.

Funding: Dutch Ministry of Foreign Affairs and UK Aid from the UK Government.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests

We declare no competing interests.

Figures

Figure 1
Figure 1. Unintended pregnancy rates per 1000 women aged 15–44 years, by geographical area and time period
Horizontal lines are 90% uncertainty intervals. *Posterior probability of change between 1990–94 and 2010–14 in the estimated direction is greater than 95%.
Figure 2
Figure 2. Percentage of unintended pregnancies that end in abortion, by geographical area and time period
Horizontal lines are 90% uncertainty intervals. *Posterior probability of change between 1990–94 and 2010–14 in the estimated direction is greater than 95%.
See this image and copyright information in PMC

Comment in

References

    1. Sedgh G, Singh S, Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann. 2014;45:301–14. - PMC - PubMed
    1. Ganatra B, Gerdts C, Rossier C, et al. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. Lancet. 2017;390:2372–81. - PMC - PubMed
    1. Tsui AO, McDonald-Mosley R, Burke AE. Family planning and the burden of unintended pregnancies. Epidemiol Rev. 2010;32:152–74. - PMC - PubMed
    1. Logan C, Holcombe E, Manlove J, Ryan S. Child Trends and National Campaign to Prevent Teen Pregnancy. Vol. 28. Washington, DC: 2007. The consequences of unintended childbearing; pp. 142–51.
    1. Sonfield A, Hasstedt K, Kavanaugh ML, Anderson R. The social and economic benefits of women’s ability to decide whether and when to have children. New York: Guttmacher Institute; 2013.

Publication types