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State Facts About Unintended Pregnancy: Texas

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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 (the remainder would have resulted in miscarriages).(7) Absent publicly funded family planning services, the numbers of unintended pregnancies, unplanned births and abortions in the United States would be two-thirds higher than they currently are. (2012 data on events averted are available only for services provided at publicly funded family planning centers; these data are not available for Medicaid enrollees served by private providers). (7)

Births resulting from unintended pregnancy are also costly to the federal and state governments, resulting in $12.5 billion in government expenditures in 2008.(8) 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.(7)

Incidence and Outcomes of Unintended Pregnancy in Texas

• In 2008, 52% of all pregnancies (301,000) in Texas were unintended.(9)

• Texas’s unintended pregnancy rate in 2008 was 58 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.(9)

• The teen pregnancy rate in Texas was 73 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.(10)

• In 2008, 60% of unintended pregnancies in Texas resulted in births and 26% in abortions; the remainder resulted in miscarriages.(9)

• In Texas in 2008, 44% of all births (179,300) resulted from unintended pregnancies, compared with 39% nationally.(8)

Public Cost of Unintended Pregnancy in Texas

• In 2008, 127,300 or 71% of births that resulted from unintended pregnancy in Texas were publicly funded. Nationally, 65% of births that resulted from unintended pregnancy were publicly funded, ranging among the states from a low of 38% in North Dakota to a high of 83% in Mississippi.(8)

• In Texas in 2008, the federal and state governments spent $1.3 billion on births resulting from unintended pregnancies; of this, $812 million (61%) was paid by the federal government and $529 million (39%) was paid by the state.(8)

• The total public cost for births resulting from unintended pregnancies in 2008 was $257 per woman aged 15–44 in Texas, compared with $201 per woman nationally.(8)

Preventing Unintended Pregnancy in Texas

• In 2012, 1,749,450 Texas women aged 13–44 were in need of publicly funded family planning services.(6)

• Publicly supported family planning centers in Texas served 228,040 female contraceptive clients in 2012. Those centers met 13% of Texas women’s need for contraceptive services and supplies, compared with 31% met by family planning centers nationally.(6)

• In 2010, the reported public expenditures for family planning client services in Texas totaled $148.4 million; this includes $92.1 million through Medicaid and $13.9 million 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, Texas contributed $19.6 million. (11)

• The services provided by family planning centers in Texas helped avert 55,900 unintended pregnancies in 2012, which would likely have resulted in 27,700 unplanned births and 19,100 abortions.(6)

• Averting these unintended pregnancies in Texas helped save the federal and state governments $503 million in Medicaid costs for pregnancy-related and newborn care in 2010.(7)

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. Sonfield A, Hasstedt K and Gold RB, Moving Forward, Family Planning in the Era of Health Reform, <http://www.guttmacher.org/pubs/family-planning-and-health-reform.pdf> New York: Guttmacher Institute, 2014.

6. Guttmacher Institute, Contraceptive Needs and Services, 2012, New York: Guttmacher Institute, 2014, <http://www.guttmacher.org/ pubs/win/contraceptive-needs-2012.pdf>, accessed August 12, 2014.

7. 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.

8. 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.

9. 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.

10. 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>

11. 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>.