Understanding How to Understand “Unintended Pregnancy”

Since the late 1990s, there has been no shortage of discussion about what we mean when we talk about unintended pregnancy—and whether research into the topic has been asking the right questions. Early in the conversation, John Santelli and colleagues reviewed the literature and talked with reproductive health experts and federal officials in an effort to nail down “the measurement and meaning of unintended pregnancy.” The result of their work was a 2003 comment piece in Perspectives, in which they laid out why it’s important to distinguish among various types of unintended pregnancy and how conventional definitions and measures missed the mark; identified underlying concepts that received too little attention; and pointed out social and demographic changes that added complexity. Fifteen years after its publication, this comment is one of our most widely cited pieces ever and remains a go-to source for researchers grappling with an issue that is by no means settled.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine