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State Facts About Unintended Pregnancy: North Dakota

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National Background and Context

Unintended pregnancy can have significant, negative consequences for individual women, their families and society as a whole. An extensive body of research links births resulting from unintended or closely spaced pregnancies to adverse maternal and child health outcomes and myriad social and economic challenges.(1,2) In 2008, the last year for which national-level data are available, 51% of all pregnancies in the United States were unintended including eight in 10 teen pregnancies; the U.S. unintended pregnancy rate was 54 per 1,000 women aged 15-44, a level significantly higher than that in many other developed countries.(3,4) If current trends continue, more than half of all women in the United States will experience an unintended pregnancy by the time they reach age 45. And economically disadvantaged women are disproportionately affected by unintended pregnancy and its consequences: In 2008, the unintended pregnancy rate among women with incomes lower than the federal poverty level, at 137 per 1,000, was more than five times as high as the rate among women with incomes greater than 200% of poverty (26 per 1,000)

In any given year, the two-thirds of women in the United States at risk of unintended pregnancy who use contraceptives consistently throughout the year account for only 5% of all unintended pregnancies; fully 95% of unintended pregnancies are attributable to the one-third of women who do not use contraceptives or who use them inconsistently.(5) Public programs—notably Medicaid and the Title X national family planning program—are central to women's access to affordable contraceptive services and supplies and their ability to use contraceptives effectively. In 2010, 8.9 million women received publicly funded family planning services; these services helped women avoid 2.2 million unintended pregnancies, which would likely have resulted in approximately 1.1 million unplanned births and 760,000 abortions.(6) Absent publicly funded family planning services, the numbers of unintended pregnancies and abortions in the United States would be two-thirds higher than they currently are.(6)

Births resulting from unintended pregnancy are also costly to the federal and state governments, resulting in $12.5 billion in government expenditures in 2008.(7) Without publicly funded family planning services, the annual public cost of births from unintended pregnancy nationwide would double, to more than $25 billion. By helping women avoid unintended pregnancies, these services saved taxpayers $10.5 billion in 2010, or $5.68 for every $1 spent.(6)

Incidence and Outcomes of Unintended Pregnancy in North Dakota

• In 2008, 48% of all pregnancies (6,000) in North Dakota were unintended.(8)

• North Dakota’s unintended pregnancy rate in 2008 was 45 per 1,000 women aged 15-44. Nationally, rates among the states ranged from a low of 33 per 1,000 in New Hampshire to a high of 70 per 1,000 in Delaware.(8)

• The teen pregnancy rate in North Dakota was 42 per 1,000 women aged 15-19 in 2008. The national teen pregnancy rate was 68 per 1,000, ranging from 33 per 1,000 in New Hampshire to 93 per 1,000 in New Mexico.(9)

• In 2008, 67% of unintended pregnancies in North Dakota resulted in births and 17% in abortions; the remainder resulted in miscarriages.(8)

• In North Dakota in 2008, 45% of all births (4,000) resulted from unintended pregnancies, compared with 39% nationally.(7)

Public Cost of Unintended Pregnancy in North Dakota

• In 2008, 1,500 or 38% of births that resulted from unintended pregnancy in North Dakota were publicly funded, the lowest proportion in the country. Nationally, 65% of births that resulted from unintended pregnancy were publicly funded, with a high among the states of 83% in Mississippi.(7)

• In North Dakota in 2008, the federal and state governments spent $24 million on births resulting from unintended pregnancies; of this, $15 million (64%) was paid by the federal government and $9 million (36%) was paid by the state.(7)

• The total public cost for births resulting from unintended pregnancies in 2008 was $188 per woman aged 15-44 in North Dakota, compared with $201 per woman nationally.(7)

Preventing Unintended Pregnancy in North Dakota

• In 2010, 42,290 North Dakota women aged 13-44 were in need of publicly funded family planning services.(6)

• Publicly supported family planning centers in North Dakota served 18,580 female contraceptive clients in 2010. Those centers met 44% of North Dakota women’s need for contraceptive services and supplies, compared with 35% met by family planning centers nationally.(6)

• In 2010, the reported public expenditures for family planning client services in North Dakota totaled $2.1 million; this includes $653,000 through Medicaid and $956,000 through Title X. Most states also use some of their own money (in addition to funds required to match federal grants) for family planning services; in 2010, North Dakota contributed $439,000.(10)

• The services provided by family planning centers in North Dakota helped avert 4,600 unintended pregnancies in 2010, which would likely have resulted in 2,300 births and 1,600 abortions.(6)

• Averting these unintended pregnancies in North Dakota helped save the federal and state governments $16.8 million in Medicaid costs for pregnancy-related and newborn care in 2010.(6)

References

1. Guttmacher Institute, Testimony of Guttmacher Institute, Submitted to the Committee on Preventive Services for Women, Institute of Medicine, 2011, <http://www.guttmacher.org/pubs/CPSW-testimony.pdf>, accessed Oct. 23, 2012.

2. Sonfield A et al., The Social and Economic Benefits of Women’s Ability to Determine Whether and When to Have Children, New York: Guttmacher Institute, 2013, <http://www.guttmacher.org/pubs/social-economic-benefits.pdf> accessed July 26, 2013.

3 Finer LB and Zolna MR, Shifts in intended and unintended pregnancies in the United States, 2001–2008, American Journal of Public Health, 2014, 104(S1): S44-S48.

4. Singh S, Sedgh G and Hussain R, Unintended pregnancy: worldwide levels, trends, and outcomes, Studies in Family Planning, 2010, 41(4):241–250.

5. Gold RB et al., Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System, New York: Guttmacher Institute, 2009.

6. Guttmacher Institute, Contraceptive Needs and Services, 2010, New York: Guttmacher Institute, 2013, <http://www.guttmacher.org/pubs/win/contraceptive-needs-2010.pdf>, accessed July 15, 2013.

7. Sonfield A and Kost K, Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy and Infant Care: Estimates for 2008, New York: Guttmacher Institute, 2013, <http://www.guttmacher.org/pubs/public-costs-of-UP.pdf>,accessed October 22, 2013.

8. Kost K, Unintended Pregnancy Rates at the State Level: Estimates for 2002, 2004, 2006 and 2008, New York: Guttmacher Institute, 2013, <http://www.guttmacher.org/pubs/StateUP08.pdf>, accessed September 9, 2013.

9. Guttmacher Institute, U.S. Teenage Pregnancies, Births and Abortions, 2008: State Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2013, <http://www.guttmacher.org/pubs/USTPtrendsState08.pdf>

10. Sonfield A and Gold RB, Public Funding for Family Planning Sterilization and Abortion Services, FY 1980–2010, New York: Guttmacher Institute, 2012, <http://www.guttmacher.org/pubs/Public-Funding-FP-2010.pdf>.