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Rebecca Wind
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NATION PAYS STEEP PRICE FOR HIGH RATES OF UNINTENDED PREGNANCY

New State-Level Incidence Estimates Provide First-Ever Benchmark for Evaluating Impact of State Policies

Two new studies taking different methodological approaches arrive at the same conclusion: Unintended pregnancy costs U.S. taxpayers roughly $11 billion each year. Both estimates are conservative in that they are limited to public insurance costs for pregnancy and first-year infant care, and both studies conclude that the potential public savings from reducing unintended pregnancy in the United States would be huge. A related new study provides first-ever estimates of unintended pregnancy for each state, and a starting point for future efforts to monitor states’ progress toward reducing unintended pregnancy.

“The Public Costs of Births Resulting from Unintended Pregnancies: National and State-Level Estimates,” by Adam Sonfield and colleagues at the Guttmacher Institute, relied on state-level data from 2006 to estimate costs for each state, which were then added together to arrive at a national total. The study found that two-thirds of births resulting from unintended pregnancies—more than one million births—are publicly funded, and the proportion tops 80% in a couple of states. The cost of those births, and the potential gross saving from helping women to avert them, is estimated at $11.1 billion.

“At a time when policymakers everywhere are looking for ways to cut costs under Medicaid, these findings point clearly to a way to achieve that goal by expanding access to health care, not cutting it,” says Sonfield. “Investing in publicly funded family planning to help women avoid unintended pregnancy has a proven track record: In the absence of the services provided at publicly funded family planning centers, the costs of unintended pregnancy would be 60% higher than they are today.”

“Unintended Pregnancy and Taxpayer Spending,” by Emily Monea and Adam Thomas of the Brookings Institution, estimated the cost of unintended pregnancy by counting 2001 national estimates of the outcomes of publicly financed unintended pregnancies (births, abortions, miscarriages and need for infant medical care) and multiplying those counts by the average cost per outcome. The estimates of the cost to taxpayers of providing medical services to women who experience unintended pregnancies and to the infants who are born as a result of such pregnancies range between $9.6 and $12.6 billion per year, and average $11.3 billion. The estimates of the public savings that would result if these unintended pregnancies were prevented range from $4.7 billion to $6.2 billion per year, and average $5.6 billion.

“Like Sonfield and colleagues, we find that the potential public savings from preventing unintended pregnancy are enormous,” says Thomas. “Our results suggest that if unintended pregnancies could be eliminated altogether, the resulting savings on taxpayer-financed medical care alone would approach the amount that the federal government spends on Head Start each year. Policymakers should protect and even increase investments in such proven cost-saving strategies as publicly subsidized family planning services and evidence-based teen pregnancy prevention programs.”

The third study, “Unintended Pregnancy Rates at the State Level,” by Lawrence B. Finer and Kathryn Kost of the Guttmacher Institute, combined national and state-level sources of information on pregnancy intentions, births, abortions and miscarriages for 2006 to produce the first-ever state-level estimates of the incidence of unintended pregnancy. The authors found significant variation in rates among the states. In 29 states and the District of Columbia, more than half of pregnancies were unintended; in the remainder of states, 38–50% of pregnancies were unintended. Rates of unintended pregnancy were generally highest in the South and Southwest, and in states with large urban populations. These data provide an important benchmark for future assessments of the effectiveness of efforts to reduce unintended pregnancies and their negative outcomes.

The Guttmacher Institute is currently analyzing data on the factors influencing unintended pregnancy at the state level.

All three articles—“Unintended Pregnancy Rates at the State Level,” by Lawrence B. Finer and Kathryn Kost of the Guttmacher Institute; “The Public Costs of Births Resulting from Unintended Pregnancies: National and State-Level Estimates,” by Adam Sonfield, Kathryn Kost, Rachel Benson Gold and Lawrence B. Finer of the Guttmacher Institute; and “Unintended Pregnancy and Taxpayer Spending,” by Emily Monea and Adam Thomas of the Brookings Institution—are currently available online and will appear in the June issue of the journal Perspectives on Sexual and Reproductive Health.

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