Unintended pregnancy levels and trends in the American states

Avoiding unintended pregnancy is a personal goal for most couples, and reducing the national rate of unintended pregnancy is a Healthy People 2010 goal. This rate was stagnant between 1994 and 2001, but this constancy masked major differentials, and trends over time, among socioeconomic subgroups. These differentials suggest that there may be differences across the 50 U.S. states. State rates would also be of considerable value to public health officials and policymakers, as they could be compared to existing measures of family planning effort and other health outcomes. However, such rates have never been calculated at the state level.

Using newly available birth data from the Pregnancy Risk Assessment Monitoring System (PRAMS) and data on the incidence of abortion from nationwide surveys, we will calculate the percentage of all pregnancies that are unintended and the unintended pregnancy rate for each state as a whole and for key demographic subgroups whenever possible. State estimates will be modeled on the techniques used by this author to calculate national-level unintended pregnancy rates: Data on the intention status of births (from PRAMS) will be combined with counts of births (from vital statistics reports) and abortions (from national provider censuses) and population data (from the Census Bureau). We will present preliminary results for 2002, 2004 and 2006 by state for the roughly 25-30 states with PRAMS data for each year. In addition, we will present estimates for non-PRAMS states, based on an individual-level regression model using data from the PRAMS states as well as state-level contextual variables.