Volume 43, Issue 2
Pages 94 - 102

The Public Costs of Births Resulting from Unintended Pregnancies: National and State-Level Estimates


Births resulting from unintended pregnancies are associated with substantial maternity and infant care costs to the federal and state governments; these costs have never been estimated at the national and state levels.


The proportions of births paid for by public insurance programs in 2006 were estimated, by pregnancy intention status, using data from the Pregnancy Risk Assessment Monitoring System and similar state surveys, or were predicted by multivariate linear regression. Public costs were calculated using state-level estimates of the number of births, by intention status, and of the cost of a publicly funded birth.


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. The proportion of births resulting from unintended pregnancies that were publicly funded varied by state, from 42% to 81%. Of the 2.0 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 seven states, the costs for births from unintended pregnancies exceeded a half billion dollars.


Public insurance programs are central in assisting American families in aff ording pregnancy and childbirth; however, they pay for a disproportionately high number of births resulting from unintended pregnancy. The resulting budgetary impact warrants increased public eff orts to reduce unintended pregnancy.

Perspectives on Sexual and Reproductive Health, 2011, 43(2):94–102

Authors' Affiliations

Adam Sonfield is senior public policy associate, and Rachel Benson Gold is director of policy analysis, both at the Guttmacher Institute, Washington, DC. Kathryn Kost is senior research associate, and Lawrence B. Finer is director of domestic research, both at the Guttmacher Institute, New York.

The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.

Perspectives on Sexual and Reproductive Health

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