Are higher unintended pregnancy rates among minorities a result of disparate access to contraception?
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(2020) 5:16
Contraception and Reproductive Medicine
REVIEW
Open Access
Are higher unintended pregnancy rates among minorities a result of disparate access to contraception? Michele Troutman1, Saima Rafique2 and Torie Comeaux Plowden3*
Abstract: Unintended pregnancy is a major global issue. Women who experience an unintended pregnancy have a significant risk of morbidity and mortality. Additionally, these women also experience substantial financial hardships. Many women, particularly women of color, do not have adequate access to reliable and affordable contraception resulting in major health disparities among this group. This review explores the relationship between unintended pregnancy and inadequate access to contraception and is divided into 5 sections: addressing problems associated with unintended pregnancies, unintended pregnancy rate in the US, disparities of unintended pregnancy rates and access to care, addressing potential solutions, and finally conclusions. Keyterms: unintended pregnancy, healthcare disparities, contraception, access to care.
Introduction An unintended pregnancy is any unplanned, mistimed or unwanted pregnancy at the time of conception [1]. In 2011, 48% of all pregnancies in the United States were unintended [2]. Similarly, women worldwide have high unintended pregnancy rates. In 2010–2014, 44% of all pregnancies worldwide were unintended [3]. Although we’ve begun to see a slow decline in these numbers with the aid of education, LARC methods, and access to family planning services, unintended pregnancy rates remain a major public health problem. Unintended pregnancies have a substantial impact on public health. Women with unintended pregnancies have a higher percentage of late entry to care, alcohol and drugs use during pregnancy and higher rates of preterm birth [4]. Unintended pregnancies are often higher among adolescents, lower income, minority, and single women who have poverty rates twice that of other * Correspondence: [email protected] The views expressed herein are those of the authors and do not reflect the official policy or position of the US Army Medical Department, Department of the Army, Department of Defense, or the US Government. 3 Department of Obstetrics and Gynecology, Womack Army Medical Center, Ft Bragg, NC, USA Full list of author information is available at the end of the article
groups, making the financial impact of an unplanned conception even greater [5]. Improved access to contraception by age 20 has been shown to decrease the likelihood that a woman will subsequently live in poverty and thus increase one’s quality of life [6]. With the onset of coronavirus disease 2019 (COVID-19) and the resurface of a national economic depression, it is important that now more than ever we consider the economic burden of these unintended pregnancies and the strain on national resources. Many organizations are significantly decreasing in-person and telehealth visits and reproductive access organizations have been forced to innovate in a more thoughtful way
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