Abstract

PIP: Comprehensive analysis of contraceptive use, pregnancy intentions and pregnancy outcomes among US women. Although most US women use modern methods of contraception successfully, a considerable number have unintended pregnancies even with the most effective methods. Low income women and teenagers continue to have greater difficulty than others in planning pregnancy successfully, the former mainly because they have higher contraceptive failure rates and are less likely to employ contraceptive sterilization, and the latter because they are relatively more likely to have unprotected intercourse and are increasingly dependent on withdrawal as their contraceptive method (probably because of fear of side effects from the pill). An estimated 4.4 million of America's sexually active, fecund women were unintentionally pregnant in 1978 (including 1.3 million whose pregnancies did not terminate until the next year). Another 4 million were at high risk of having an unintended conception because they used no birth control method or an ineffective method. These categories included 42% of teenagers and 30% of low income women exposed to the risk of unintended pregnancy--compared to just 20% of other women. About 2/3 of the 2.4 million low income women who used the most highly effective methods and avoided having an unintended pregnancy obtained their method from a family planning clinic.