National Reproductive Health Profile
BACKGROUND AND CONTEXT
Despite the demonstrable importance and ubiquity of contraception, the truth is that ensuring that every pregnancy is wanted and planned is difficult, at both the individual and the societal levels. For the typical American woman to have two children, she will spend about five years pregnant, postpartum or attempting to become pregnant, and three decades—more than three-quarters of her reproductive life—trying to avoid pregnancy. Not all women, however, are successful: About half of all pregnancies in the United States each year—more than three million of them—are unintended. At least half of American women will experience an unintended pregnancy by age 45, and, at current rates, one in 10 women will have an abortion by age 20, one in four by age 30 and three in 10 by age 45. Nonetheless, contraceptive use can and does dramatically reduce women’s odds of having an unintended pregnancy.
- In 2008, there were 65,917,200 women of reproductive age (aged 13-44) in the United States, 35,951,170 of whom were in need of contraceptive services and supplies. Of these:
- AGE: 5,047,030 were under the age of 20; 30,904,120 were aged 20-44.
- INCOME: Among women aged 20-44, 4,480,970 were below 100% of the federal poverty level.
- RACE/ETHNICITY: 22,027,980 were non-Hispanic white; 5,105,070 were non-Hispanic black; and 6,016,730 were Hispanic.
- In 2008, there were 17,428,270 women in need of publicly supported contraceptive services and supplies. Of these, 5,047,030 were in need of publicly supported services because they were sexually active teenagers, and 12,381,240 because they had incomes below 250% of the federal poverty level.
- In 2008, 20% of women aged 15-44 in the United States were uninsured, as were 39% of poor women of reproductive age; 13% of all women aged 15-44 were enrolled in Medicaid.
For more information see Contraceptive Needs and Services, 2006
- Forty-three million women of reproductive age, or seven in 10, are sexually active and do not want to become pregnant, but could become pregnant if they or their partners fail to use a contraceptive method.
- Virtually all women (98%) aged 15-44 who have ever had intercourse have used at least one contraceptive method.
- Overall, 62% of women of reproductive age are currently using a contraceptive method.
- Thirty-one percent do not need a method because they are infertile; are pregnant, postpartum or trying to become pregnant; have never had intercourse; or are not sexually active.
- Thus, only 7% of women of reproductive age are at risk of unwanted pregnancy but are not using contraceptives.
- The two-thirds of women at risk of unintended pregnancy who use contraceptives consistently and correctly account for only 5% of unintended pregnancies.
- Using any contraceptive method reduces a couple's chances of having an unintended pregnancy by 85%, and properly using the most effective methods virtually eliminates that risk.
- Sixty-four percent of reproductive-age women who practice contraception use reversible methods, such as oral contraceptives or condoms. The remaining women rely on female or male sterilization.
- The pill and female sterilization have been the two leading contraceptive methods overall in the United States since 1982.
For more information see Facts on Contraceptive Use
PUBLICLY FUNDED CONTRACEPTIVE SERVICES
- In 2006 in the United States, 8,199 publicly funded family planning centers provided contraceptive care to 7,198,210 women—including 1,794,940 teenagers.
- Family planning centers in the United States served 40.8% of all women in need of publicly supported contraceptive services and supplies in 2008.
- In the United States, $106 in public funds was spent on contraceptive services and supplies per woman in need in 2006.
- In the United States, 4,261 publicly funded family planning centers that received some support through the federal Title X family planning program provided contraceptive care to 4,728,950 women—including 1,208,210 teenagers in 2006.
- Title X-supported centers in the United States served 26.9% of all women in need of publicly supported contraceptive services and supplies in 2008.
For more information see Contraceptive Needs and Services, 2006
IMPACT OF PUBLICLY FUNDED CONTRACEPTIVE SERVICES
- Publicly funded family planning services help women to avoid pregnancies they do not want and to plan pregnancies they do. In 2008, these services helped American women avoid 1,476,300 unintended pregnancies, which would likely have resulted in about 656,400 unintended births and 616,300 abortions.
- Contraceptive services provided at Title X-supported centers in the United States helped prevent 973,000 unintended pregnancies, which would likely have resulted in about 432,600 unintended births and 406,200 abortions.
- Without publicly funded family planning services, the number of unintended pregnancies and abortions occurring in the United States would be nearly two-thirds higher among women overall and among teens; the number of unintended pregnancies among poor women would nearly double.
- The services provided at publicly funded clinics saved the federal and state governments an estimated $5.1 billion in 2008; services provided at Title X-supported clinics accounted for nearly $3.4 billion of that total.
- In other words, nationally, every $1.00 invested in helping women avoid pregnancies they did not want to have saved $3.74 in Medicaid expenditures that otherwise would have been needed.
For more information see Next Steps for America's Family Planning Program
PREGNANCIES, BIRTHS AND ABORTIONS
- In 2008, there were 6.4 million pregnancies to the 62 million women of reproductive age (15–44) in the United States. Sixty-six percent of these pregnancies resulted in live births and 19% in induced abortions.
- Nearly half of pregnancies among American women—more than three million each year—are unintended, and about four in 10 of these are terminated by abortion.
- In 2006, the national unintended pregnancy rate increased to 52 per 1,000 women aged 15–44 years, up from 50 in 2001.
- Unintended pregnancy rates are substantially higher among poor and low-income women, minority women, women aged 18–24, cohabiting women and women with exactly one child than among other groups.
- Disparities in unintended pregnancy rates among subgroups of women have persisted over time, and in some cases have increased. As of 2006, poor women with family incomes below 100% of the federal poverty level have rates five times the rate of higher income women and two to three times the national rate.
- Sixty-seven percent of pregnancies among black women, 53% among Hispanic women and 40% among white women are unintended.
- Unintended pregnancy rates are generally highest in the South and Southwest, and in states with large urban populations.
- In 2006, 64% of births resulting from unintended pregnancies were publicly funded, compared with 48% of all births and 35% of births resulting from intended pregnancies.
- Of the two million publicly funded births, 51% resulted from unintended pregnancies, accounting for $11.1 billion in costs—half of the total public expenditures on births.
- In 2008, 1,212,350 women obtained abortions in the United States, producing a rate of 19.6 abortions per 1,000 women of reproductive age. This rate is virtually unchanged since 2005, when it was 19.4 abortions per 1,000 women aged 15-44.
- Eighty-nine percent of abortions occur in the first 12 weeks of pregnancy.
- Eighteen percent of U.S. women obtaining abortions are teenagers; those aged 15–17 obtain 6% of all abortions, teens aged 18–19 obtain 11% and teens younger than 15 obtain 0.4%.
- Women in their 20s account for more than half of all abortions; women aged 20–24 obtain 33% of all abortions, and women aged 25–29 obtain 24%.
- Non-Hispanic white women account for 36% of abortions, non-Hispanic black women for 30%, Hispanic women for 25% and women of other races for 9%.
- Women who have never married and are not cohabiting obtain 45% of all abortions.
- About 61% of abortions are obtained by women who have one or more children.
- Forty-two percent of women obtaining abortions have incomes below 100% of the federal poverty level ($10,830 for a single woman with no children; $22,050 for a family of four). Twenty-seven percent of women obtaining abortions have incomes between 100–199% of the federal poverty level.
- In 2008, there were 1,793 abortion providers in the United States. This is virtually unchanged from 2005, when there were 1,787 abortion providers.
- In 2008, 87% of U.S. counties had no abortion provider; 35% of women lived in these counties.
- Nearly half (46%) of all 15-19-year-olds in the United States have had sex at least once.
- By age 15, only 13% of never-married teens have ever had sex. However, by the time they reach age 19, seven in 10 never-married teens have engaged in sexual intercourse.
- The average age at which young people start having sex is 17, but they do not marry on average until their middle or late 20s. This means that young adults are at increased risk of unwanted pregnancy and sexually transmitted infections (STIs) for nearly a decade.
- A sexually active teen who does not use contraceptives has a 90% chance of becoming pregnant within a year.
- The majority of sexually experienced teens (74% of females and 82% of males) used contraceptives the first time they had sex.
- The condom is the most common contraceptive method used at first intercourse; it was used by 66% of sexually experienced females and 71% of males.
- Sixty percent of teens younger than 18 who visit a family planning center say their parents know they are there.
- In 2008, there were 733,010 pregnancies to American teens aged 15-19; 59% of these pregnancies resulted in live births and 26% in induced abortions.
- In 2008, 192,090 teens obtained abortions in the United States, producing a rate of 18 abortions per 1,000 women aged 15-19.
- Eighty-two percent of teen pregnancies are unplanned; they account for about one-fifth of all unintended pregnancies annually.
For more information, see Facts on American Teens' Sexual and Reproductive Health.
STATE LAWS AND POLICIES
See these resources for information on state laws and policies:
- An Overview of Abortion Laws
- An Overview of Minors' Consent Law
- Sex and STI/HIV Education
- Emergency Contraception
- Insurance Coverage of Contraceptives
- Refusing to Provide Health Services
- State Family Planning Funding Restrictions
- State Medicaid Family Planning Eligibility Expansions
- Infant Abandonment
- Substance Abuse During Pregnancy