Unintended Pregnancy Among Sexual Minority Women

Despite their perceptions of low pregnancy risk, sexual minority women may experience an unintended pregnancy because many engage in heterosexual behavior at some point. And although sexual minority women are more likely than others to report having experienced early sexual debut and forced sex—both of which have been linked to an increased risk of unintended pregnancy—sexual orientation disparities in mistimed and unwanted pregnancy had not been examined among adult women at the national level until a study by Bethany Everett and colleagues, published in Perspectives in 2017.

Using NSFG data, which included information on both sexual identity and same-sex behavior, the researchers found that disparities do exist: Compared with pregnancies reported by heterosexual women who have sex only with men, pregnancies reported by heterosexual women who have sex with women were more likely to be mistimed, and those reported by bisexual and lesbian women were more likely to be unwanted. Neither forced sex nor early debut accounted for the disparities, but the researchers acknowledged that variables not included in this study may have played a role.

Everett and colleagues offered several possible reasons for the disparities by sexual orientation, including that sexual minority women may have less access to reproductive health services than others or may not receive medically accurate information that meets their sexual health needs. They also noted that they excluded pregnancies ending in termination, because abortions are severely underreported in the NSFG; their findings, therefore, likely underestimate sexual minority women’s risk of unintended pregnancy. The authors suggested that further research to understand “the diversity of sexual and romantic partnerships among sexual minority women” is required to help these women meet their reproductive and sexual health needs.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine