Young adults and unintended pregnancy: Exploring increased risk of critical knowledge gaps and misconceptions about Contraception and Fertility

Older teens and young adults age 18-24 have the highest rates of unintended pregnancy in the United States, and their rates have changed little since the mid-1990s even as teen rates have fallen dramatically. However, little is known about their knowledge and attitudes regarding fertility and contraception, and how these relate to sexual behavior. Data from a new, first-of-its-kind survey of unmarried young adults show this population has serious knowledge deficits concerning fertility and contraception, (defined as answering fewer than half the questions on these topics correctly) and little confidence in their ability to prevent pregnancy (e.g. 49% agreed with the statement “it doesn't matter whether you use birth control or not, when it's your time to get pregnant you will.”). The data are from a nationally representative, cross-sectional survey of 1,800 unmarried young adults age 18-29, including 1,293 respondents age 18-24. Analyses of this age group show contraceptive use to be significantly lower among those having a knowledge deficit compared to those who do not, measured as using no contraception at all in the last three months among sexually active respondents not trying to get pregnant (24% non-use vs. 14%; p-value<0.01). Contraceptive use was also significantly lower among those having negative attitudes about contraception; 23% of those who agreed with the statement above reported non-use, compared to 12% of those who disagreed (p-value<0.01). These results highlight the need to consider and address misconceptions about pregnancy and contraception in order to reduce high rates of unplanned pregnancy among young adults.