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Unintended and Uncounted

Between 1967, when Colorado became the first state to loosen its restrictions on abortion, and 1973, when the Supreme Court’s Roe v. Wade ruling established the right of all women to have the procedure, the number of legal abortions in the U.S. soared. By 1977, the number of pregnancy terminations was approaching 1.3 million per year. Did this mean, as some observers feared, that women were abandoning contraceptive use for abortion? No one knew, in part because information on such seemingly basic matters as the incidence of unintended pregnancies wasn’t available.

To provide context for the rising abortion figures, Christopher Tietze of the Population Council published an early estimate of the number of unintended pregnancies in the U.S. Not surprisingly, the analysis, which appeared in Perspectives in 1979, required several assumptions; for example, Tietze estimated, on the basis of the only data available at the time (from Hawaii), that 15% of births to unmarried U.S. women were intended.

Ultimately, the analysis suggested that 2.0–2.3 million births in the United States had been unintended each year during the pre-Roe years of the early 1970s, and that a third of the pregnancies that led to these births had occurred to women who were using contraceptives—figures that Tietze suspected had not changed dramatically in subsequent years. Given these findings, he wrote, the rapid rise in the number of legal abortions seemed “quite predictable,” though he noted that some women likely were not having abortions because the option, for whatever reason, “was not available to them.”

Analyses of unintended pregnancy have since become commonplace, in large part because of the National Survey of Family Growth. Although the first NSFG, conducted in 1973, did not collect information on pregnancies ending in abortion, miscarriage or stillbirth, subsequent cycles did, allowing for detailed analyses of unintended pregnancy; several of these, including a trend analysis of the 1982, 1988 and 1995 cycles, have appeared in Perspectives.

Perspectives on Sexual and Reproductive Health and Family Planning Perspectives may be accessed through Wiley Online Library (2003–) and JSTOR (1969–2011).

Cover illustrations of Margaret Sanger © Matthew and Eve Levine