essay about unplanned pregnancy

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Iran J Public Health
• v.44(1); 2015 Jan

Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article

Mansureh yazdkhasti.

1. Dept. of Reproductive Health, School of Nursing & Midwifery, Tehran University, Tehran, Iran

Abolghasem POURREZA

2. Dept. of Health Management & Economics, School of Public Health, Tehran University, Tehran, Iran

Arezoo PIRAK

Fatemeh abdi.

3. Dept. of Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University, Tehran, Iran

Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation.

Introduction

Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception. Unintended pregnancies include unwanted pregnancies at least for one of couples. Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue including accidental pregnancy and defined as a pregnancy that was undesired for one or both of the partners ( 1 ). Regarding the World Health Organization (2005) approximately 210 million pregnancies occur each year worldwide of which 87 million are unplanned and 41 million continue to birth. According to the reports ( 2 ) the total number of unsafe abortion in 2008 was 21-22 million worldwide and there were 22 unsafe abortions per 1000 women aged 15-44 years. While the report on mortality due to unsafe abortion estimates 47000 maternal deaths (that is 13% of maternal mortality in 2008. Approximately fifty percent of pregnancies in United States of America are unintended and about 48% of reproductive-age American women ( 15 – 44 ) have experienced at least one unintended pregnancy ( 2 , 3 ).

Contrary to extensive coverage of family planning in Iran and the efforts in this regard unplanned pregnancies are common problem as well. A research in different parts of Iran revealed the prevalence of unintended pregnancies to be 22% while in Ardebil it was 61% ( 3 , 4 ). Another survey reported it to be 31% (of which 56% were unwanted and 44% were unplanned ( 5 ). Unintended pregnancy is also considered as a high-risk pregnancy associated with high rates of negative consequences for mother, partner and the baby. These groups of women are more exposed to suicide ( 6 ) and depression rate, poor nutrition during gestation ( 7 ), mental health issues, unstable family relationships, experiencing physical and psychological violence, risk of miscarriage and having low birth weight infants ( 8 ) and delayed onset of prenatal care ( 9 ).

Statistics show that when compared to wanted ones, unwanted children are exposed to greater risk factors, so that they more likely experience negative psychological and physical health issues and dropout of high school and tend to show delinquent behavior during adolescence ( 2 ). The participants of a research in Australia reported higher level of depression, anxiety and delinquency than compared with those in wanted children group thus child smoking were self-reported at 14-years ( 10 ).

According to several micro-level studies, a child’s overall health has an impact on his or her ability to achieve academic success. Existing studies at the macro level suggest population health has a significant effect on a nation’s economic performance and growth ( 11 ). Overall, the evidence suggests that unintended pregnancy is one of the most critical challenges facing the public health system and imposes significant financial and social costs on society. Long-term studies confirm that reducing unintended pregnancy incidences would increase labor force participation rates, improve academic achievement, have better economic efficiency, increase the level of health and reduce in crime rates among vulnerable groups ( 2 , 10 ). Thus in this paper we focus on the socio-economic impacts of unwanted pregnancy from the viewpoint of health system.

The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 1245 scientific journals were found in various databases including Pub-Med, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Related keywords included unwanted pregnancy, economic outcomes, social outcomes, cost, socio-economic consequences, health indicators, Reproductive health. After reading to topics, 53 relevant articles were identified. During this search, 20 studies were found which met the inclusion criteria. Inclusion criteria: 1-published articles in English and Persian (Original articles, review articles, published books about the purpose of the paper were used). 2-coordination between articles and Research Goals (Socio-economic consequences of unintended pregnancy). Socio-economic variables influencing unintended pregnancy were selected based on Socio-economic determinants of reproductive health (2010). Socio-economic determinants of reproductive (2010) that affect unintended pregnancy including: age, educational level of the spouses, the economic situation, employment of women, number of children, type of contraception, abortion and the number of children are living or dead.

Unintended pregnancy and unsafe abortion: An economic approach

Unintended pregnancies are classified as the high-risk gestations and occur across society regardless of race are socioeconomic status and its rates are highest among poor and low-income women ( 12 ). Furthermore, the number of illegal abortion is rising dramatically. According to global statistics annually 19 million women in developing countries and more than 15 million in Asia experience unsafe abortion, it is estimated that each year about 500000 women in developing countries die because of pregnancy complications. Therefore, unsafe and illegal abortion is among the main causes of death worldwide. The annual cost of treating a woman for complications of unsafe and illegal abortion is considerably higher than the cost of providing medical and safe abortion ( 13 ). The incidence of induced abortion is an important indicator of the frequency with which women experience unintended pregnancies ( 14 ). In 2008, 43.8 million abortions occurred worldwide while nearly half of all was unsafe and 98% of all unsafe abortions occurred in developing countries ( 15 ).

Forty percent of pregnancies are unplanned in Iran ( 16 ). Abortion is illegal due to religious, cultural and social beliefs in Iran and most of the unwanted pregnancies are terminated by clandestine and unsafe abortion procedures. This can cause irreparable damage to mother including death and serious disabilities; an unsuccessful abortion may influence the child’s health, too. These can negatively influence quality of life and impose heavy expenditures on the health system that are not defined or recorded in the balance sheet ( 2 ). Regarding the allocation of funds the health sector, problems related to pregnancies place heavy financial burden on governments (especially federal government). Most of money spent by taxpayers to comply with the health system may be spent for issues associated with unintended pregnancies.

Economic analysis shows that U.S. taxpayers spend more than 12 billion each year on unintended pregnancy ( 17 ). In the analysis of medical costs Children’s Health Insurance Program (CHIP) reported that 12.1 billion is spent each year for as estimated 1.25 million unwanted pregnancies that 103 million is allocated to abortion services. On the other hand studies suggest that eliminating medical costs by preventing unwanted pregnancies can help to save about three- quarters of the budget allocated by the federal government allocated for UNICEF projects in 2010.

Reducing the incidence of unintended pregnancies can lead to reducing maternal mortality. Maternal mortality ratios is a major indicator of development in the world and according to the Millennium Development Goals, it should be reduced by three- quarters (75%) between 1990 and 2015. In our country the maternal mortality ratio is 21 per on hundred thousand live birth. Indeed any decrease in the rate of unintended pregnancy will significantly affect mortality rate. In developing countries including Iran it is somehow impossible to find out the exact number of unintended pregnancies and the statistics are ambiguous and, therefore, increase the tax burden on taxpayers and subsequent economic costs are unknown, too ( 2 ).

Family planning policy has recently been changed in Iran so adopting a new approach in increasing population in our country may place the country at a higher risk of increasing the unintended childbirth rate. Variables of quantitative economics, micro and macro socio-economic interactions on social variables such as unemployment, dropout and social harm to restate that this is considered in this paper ( 12 ).

Review literature: Unintended pregnancies and population, from a socio economic perspective

Demographic changes in the last two centuries, along with fundamental changes in lifestyle, technology development and various rising of expectations in promoting physical, mental and social welfare have led to the further consideration of population issues and developing strategies to manage the population ( 18 ).

Health status of a population is affected by various factors such as age structure, exposing to risk of different carriers, and also level of population welfare behavior and characteristics as well as reproductive behaviors healthcare needs do affect a country’s economic performance. Commission on the Macroeconomics and Health reports that population health has a significant impact on different aspects of microeconomics and health labor market and saving variables that will eventually affect the macroeconomic outcomes of a country ( 19 ). The problem of unwanted pregnancy is one of the main challenges facing developing countries due to its effect on uncontrollable population growth and mother and child health. The world population doubles every 40 years while in poor countries it will probably happen in less than 20 years. Thus unintended pregnancy can be among the factors negatively affects the growth of population. This issue can be approached in two ways: prevention of uncontrolled excessive population growth and its impact on both mother and baby ( 14 ). The risk factors associated with unintended pregnancy include unwanted pregnancy in adolescents, inadequate family planning services, low socio economic status, lack of or improper use of family planning methods and unawareness of it. Unwanted pregnancy rate among low-income American teens is reported to be about 60%. Teenage (15-19 yr) unintended pregnancy often leads to academic failure and school dropout. It is also associated with a greater risk of psychological distress, suicide and unsafe abortion and may threaten the health of the individual ( 17 ). Health is the basis of job and learning efficiency increasing physical — mental and intellectual abilities development and is essential for productive adulthood. So the incidence of unplanned pregnancy, affecting health of children and adults, leaves costs and financial burden to the governments ( 20 ).

Unintended pregnancies are more common among poor adolescents. Poverty and disease are the major causes of suffering that accelerates population growth and unequal distribution of health services and health inequalities ( 13 , 21 ). “Health inequalities” is a term used to socioeconomic and health inequalities. Many epidemiological studies have shown that developing countries grapple with the poor health consequences and higher burdens of diseases compared to countries that are more affluent. This kind of pregnancies will lead to decline in welfare of couples, reducing socio-economic development ( 22 ). Unintended pregnant teens will be more exposed to risk factors including lower education and income levels and being focused to take low status jobs. Gini coefficient based on Lorenz curve is used measure of inequality income, which is a cumulative frequency graph that compares distribution, which represents equality of incomes. In this regard, there is a range of problems associated with data sources on health status of population that can potentially cause serious bias in the measurement of health in equalities. There is also a risk of serious bias due to the lack of definitive statistics concerning health status of Iranians ( 23 ).

In a system of public financing and in the systems that medical bills are paid by third-party payers (employer- based insurance systems) insured groups or people put pressure to meet its demand that rising budgetary pressure for the state is its minimal impact. These additional costs will eventually be reflected in Consumer Price Index (CPI) ( 24 , 25 ). Budgetary pressures resulting from unintended pregnancies and taxpayers costs are high so that the average cost per unintended pregnancy in United States is calculated to be about 10 thousands of public funds ( 2 , 26 ). Clearly, the incidence of unplanned pregnancies can impose a significant burden on taxpayers. Use strategy to prevent unintended pregnancy (Method of family planning and contraceptive methods such as condoms, pills, etc.) will reduce the financial burden on taxpayers. Because of economic and social variables on the interaction, so improving economic variables, social variables can also be improved.

Unintended pregnancy and Health: Socioeconomic approach

Health and safety issues are intertwined with comprehensive progress and development including economic growth. Healthy people are more happy and motivated ones that increase productivity and economic development by reducing direct and indirect costs. Therefore, most of the communities have paid special attention to promotion of health indicators Health indicators are quantifiable characteristics of a population, which researchers use as supporting evidence for describing the health of a population ( 21 , 27 ). Indeed the most important factors affecting economic growth are labor, physical and human capital ( 28 ).

The concept of human capital in economic literature defined by including education, training, health, skills, expertise, experience, migration and other investments that enhance an individual’s productivity and improve economic growth ( 29 ). When speaking of improving the quality of labor productivity the issue is not unique to education, skill or experience but the impact of public health should also be considered as an important factor in the accumulation of human capital. Unplanned pregnancy interferes with health and wellness in different ways ( 30 ). Unintended pregnancy not only effects on various aspects of individual and family health state, but also reduces the labor productivity ( 31 ). In the regards different domains relevant to quality of life: socio economic, familial, psychological, spiritual, health and performance aspects ( 32 , 33 ). Unintended pregnancy due to complications that can reduce quality of life ( 34 , 35 ). Several reports suggest that incidence of unintended pregnancy predicts a range of negative outcomes like labor market challenges and increasing the number of working days lost ( 2 , 36 ). There is a reciprocal relationship between them so the level of public health (especially Health promotion labor force) is directly related to the economic growth and consequently socio economic development. Reciprocally economic growth is associated with increasing level of public health ( 23 , 37 ). Implementation of public health interventions to reduce unintended pregnancy can cause growth and economic development ( 26 ).

Unplanned pregnancies can reduce labor productivity through declining health stock for individuals that in turn lowers the standards of living) 32). According to Myrdal cumulative causation theory low-income leads to lower levels of life, so human productivity level will be limited and the vicious circle will be repeated because of low incomes ( 22 , 38 ).

Unintended pregnancy and reproductive health from a socioeconomic perspective

Health development is driven by public health that in turn driven by reproductive health ( 39 ). Reproductive health can be divided into some subcategories: consultations, information, education and communication about family planning, promoting right to freely choose marriage (partner), contributing gender equality and equity in decision making for marriage, family planning services, improving reproductive decisions, providing prenatal care and healthcare for women, securing reproductive and sexual health, preventing infertility, inappropriate treatment of infertility and abortion and treating its complications as well as treating reproductive tract infections, dealing with sexually transmitted diseases and appropriate treatment ( 40 – 42 ).

Demographic studies in the second half of the 20 th century indicate progression in fertility transition in different parts of the world, especially in developing countries. Studies showed a correlation between fertility transition and the rate of unintended pregnancy. Model of Bongaart, suggested that with the onset of the fertility transition, unwanted fertility typically rises substantially that will stabilize at the end of the phase and will not decrease. Then he argues that the reason for increase unplanned pregnancy rate during the first half of the transition is a decrease in desired family size (or ideal number of children). Unplanned pregnancy is the major reproductive health issue that seriously affects its indicators ( 44 ).

Infant mortality rate, as one of the major indicators, is affected by unintended pregnancy incidence. According to a number of studies infant mortality and malnutrition levels and the rate of abuse and mental illnesses including schizophrenia are high among the babies from unwanted pregnancies and they are more likely fail in academic achievements in later life. Unintended pregnancy increases the risk of low birth weight and affects the infant growth indicators ( 43 ). Mortality rate of children under 5 years of age is an important indicator for reproductive health that can be affected by incidence of unplanned pregnancy. This kind of pregnancy is the leading cause for death of 14 million children under 4 years worldwide ( 45 , 46 ).

Maternal death indicator is affected by unplanned gestation due to unsafe and criminal abortions. The results of “Reasons women give for contemplating or undergoing abortion”, indicate that the private decision of the mother, number of children she has, opinion of the partner and people significant in her life have direct impact on her abortion decision ( 16 ).

43.8 million abortions occurred worldwide, of which 86% occurred in low-/middle-income countries. Between 2003 and 2008, the proportion of unsafe abortions increased and they were believed to account for 13% of maternal deaths, with the majority of these concentrated in countries with restrictive laws on abortion ( 15 , 47 ). Nevertheless, global studies have mostly focused on psychological impact of induced abortion on the woman however; there have been few studies on the issues of the ones choose to continue their pregnancy.

Women with unintended pregnancy did high-risk activities when facing unwanted childbearing including hitting, lifting heavy objects, using unhealthy vulva objects, using injections and eating herbal and chemical medicines ( 47 , 48 , 50 ). A research on reproductive health indicators including prenatal care and stated concluded that average weight gain in women with unintended pregnancy is significantly less than the ones with wanted gestation ( 18 , 48 ).

There are significant differences between women with intended and unintended pregnancies in the indicators for family planning in reproductive health services. Ineffective use of family planning methods are associated with increased rates of maternal mortality due to pregnancy that is a health equity indicator ( 39 ).

The life expectancy indicator is one of the indicators heavily influenced by infant mortality rate (IMR) that is the best indicator of socio-economic development. Accurate statistics on the number of unintended pregnancies resulted in fetal death, is not exist ( 6 ). The stock and investment in health human capital (health expenditures) influenced the growth rate of per capita income positively and were in a significant level of, respectively, 99 and 90 percent ( 22 ). Results from the analysis of reproductive health indicators and impact of unplanned pregnancies on them suggest that this condition leads to more health expenditures and family responsibilities and limits women’s participation in economic activities. Labor force and its productivity lead to increase human capital inventory and it can be said that health expenditures are one of the most effective factors on production. The overall state of the economy (including current and future growth rates) can affect both actual and expected values of variables that are the determinants of health and change health state of community ( 52 ). Then it is necessary to initiatives public policy intelligently aimed at reducing and preventing unwanted pregnancies that will generate significant savings in the governments’ budget ( 2 ). This has resulted in economic growth, increased government revenue especially taxes and income from profit- making activities which may prove useful for development of treatment and in improving the public health ( 52 ).

Prevention of Unintended pregnancy: By separating economic and social variables

Out-of-pocket health care spending imposes a substantial financial burden on government and households and in many countries, health expenditure per capita has risen faster than the rise in Gross Domestic Product (GPD) ( 10 ). Almost all countries with advanced economics are striving to control soaring health costs along with achieving the goals of health care and Medicaid. Reining the healthcare costs is a major priority for policymakers and stimulating healthcare reform ( 11 , 19 ). In order to achieve better outcomes and reduce the costs, it is essential to implement preventive measures, promote health information, advance evidence-based self-care behaviors and improve performance of information systems and electronic applications aimed at treatment detection and follow up.

Prevention is an effective way of dealing with socioeconomic burden of unwanted pregnancies imposed to health sector. Some of the leading causes of unintended pregnancies are non-use and also improper use of contraceptive services and contraceptive failure ( 1 ). Social pressures and expectations overshadowed the needs of women and so they are not allowed to prevent pregnancy. Social sanctions and inequality between men and women, husband’s disapproval of contraceptive methods, inadequate family planning, lack of effective consultation make recommendations incompatible with their conditions that would make them not use contraceptives ( 36 , 52 ).

The costs of unintended pregnancy are classified as the intangible costs, which are not just financial but can indeed cause a decrease in the quality of life of these mothers and their families. In fact, the real damage to quality of life is incalculable. Unintended pregnancies result in a range of adverse consequences including labor market struggles, higher crime rates, more abortions, increased levels of household stress and others that have nothing to do with public balance sheets and creates a huge financial burden for taxpayers given the initial value of the nominal. Prevention of unplanned pregnancies will help to increase national savings and lead to higher rates of economic growth ( 39 ). Obviously, adoption of policies such as: adolescent pregnancy prevention, improving family health literacy based on socio-economic welfare ( 2 ), launching programs promoting contraceptive use. Promotion of consultation and men’s participation, reduction in unprotected sex and implementing programs to improve the quality of family planning services ( 39 ) can lead to significant savings in public spending and many health expenditure inflation rate ( 9 ).

However, unintended pregnancy can be reduced using quality improvement programs. Among socio economic factors, training and education has been proven to be the most effective factors affecting fertility behavior. Women with higher education are more likely to succeed in controlling their fertility advancing their opportunities for childbearing ( 52 , 53 ).

Individual health is considered as a key factor in the accumulation of human capital, reducing the welfare of couples and socio economic development. Briefly concluding the economic analysis, it can be inferred that unintended pregnancy is one of the major challenges facing public health and safety that imposes significant economic and social costs on society.

WHO Report, Poverty and health inequalities are important factors in unintended pregnancy ( 13 , 21 ). Many epidemiological studies have shown that developing countries grapple with the poor health consequences and higher burdens of diseases compared to countries that are more affluent. This kind of pregnancies will lead to decline in welfare of couples, reducing socio-economic development ( 22 , 23 ).

Social stratification ranks individuals based on their education, income and employment status and therefore consolidates their position in the system. Unintended pregnant teens will be more exposed to risk factors including lower education and income levels and being focused to take low status jobs ( 23 , 24 ). In many studies, reducing coverage for family planning is an important factor in unwanted pregnancy ( 3 – 5 , 40 – 42 ). Contrary to extensive coverage of family planning in Iran and the efforts, in this regard unplanned pregnancies are common problem as well. The prevalence of unintended pregnancy is reported 22% in Iran ( 3 ) and 61% in Ardabil ( 4 ).

Unintended pregnancy has a range of negative consequences—abridged educational careers ( 23 , 24 ), labor-market struggles ( 19 , 47 ), higher crime rates ( 2 , 53 ), more abortions ( 48 ), increased levels of household stress ( 47 , 48 ), and other related outcomes—that have nothing to do with public balance sheets and are therefore not incorporated into our analysis. Similarly, due to practical data limitations, we do not account for the likelihood that delaying some mistimed pregnancies will reduce the likelihood that they will require taxpayer support when they eventually occur. Thus, our estimates are inherently conservative ( 47 ).

Overall, the evidence suggests that unintended pregnancy is one of the most critical challenges facing the public health system and imposes significant financial and social costs on society. Long-term studies confirm that reducing unintended pregnancy incidences would increase labor force participation rates, improve academic achievement, have better economic efficiency, increase the level of health and reduce in crime rates among vulnerable groups.

Ethical considerations

Ethical issues (Including plagiarism, Informed Consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.

Acknowledgments

This project was granted by the Tehran University of Medical Sciences. The authors declare that there is no conflict of interests.

• Finer LB, Zolna MR (2011). Unintended pregnancy in the United States: Incidence and disparities , 2006. Contraception , 84 ( 5 ): 478–485. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Sonfield A, Kost K, Gold RB, Finer LB (2011). The Public Costs of Births Resulting from Unintended Pregnancies: National and State-Level Estimates. Perspect Sex Reprod Health , 43 ( 2 ): 94–102. [ PubMed ] [ Google Scholar ]
• Amani F, Bashiri J, Nahan Moghadam N, Tabarraie Y(2010). Applicdation of logistic regression model in surveying effective causes of unwanted pregnancy (Persian). Qom University of Medical Sciences Journal 4 ( 1 ): 32–6. [ Google Scholar ]
• Jahanfar S, Ramazani TehraniI F, Sadat Hashemi S (2002). The prevalence of unwanted cities in Iran 2000 (Persian). TUMJ , 60 ( 4 ): 334–40. [ Google Scholar ]
• Pourheydari M, Souzani A, Shamaiian N (2007). Prevalence of unwanted pregnancy and their correlates in pregnant women in Shahrood, Iran (Persian). Payesh , 6 ( 1 ): 63–70. [ Google Scholar ]
• Afshar M, Delavardevin N, Kianfar S (2004). Comparison of neonatal growth indices in unwanted pregnancies with gestational asked (Persian). Goums , 13 ( 83 ): 40–5. [ Google Scholar ]
• Fourn L, Ducic S, Seguin L (1999). Factors associated with low birth weight: a ultivariate analysis. Sante , 9 ( 1 ): 7–11. [ PubMed ] [ Google Scholar ]
• Sereshti M, Delaram M, Rafieian M (2005). [Prevalence and causes of unwanted pregnancy from the perspective of pregnant women (Persian)]. JRHS , 13 ( 24 )8–15. [ Google Scholar ]
• Karacam Z, Onel K, Gercek E (2011). Effects of unplanned pregnancy on maternal health in Turkey. Midwifery , 27 ( 2 ): 288–93. [ PubMed ] [ Google Scholar ]
• Hayatbakhsh MR, Najman JM, Khatun M, Al Mamun A, Bor W, Clavarino A(2011). A longitudinal study of child mental health and problem behaviours at 14 years of age following unplanned pregnancy. Psychiatry Res , 185 ( 1-2 ): 200–4. [ PubMed ] [ Google Scholar ]
• Fogel R (2004). Health, Nutrition, and Economic growth. Economic Development & Cultural Change , 52 ( 3 ): 643–58. [ Google Scholar ]
• Thomas A, Emily M (2011). The High Cost of Unintended Pregnancy. CCF Brief , 45 ( 5 ): 2–7. [ Google Scholar ]
• Carlin EM, Boag FC (1995). A study on the effective factors of unwanted regnancies in pregnant women of Tehran city. Int J STD AIDS , 6 ( 6 ): 373–886. [ PubMed ] [ Google Scholar ]
• Moss MCN (2003). Unintended pregnancies: Acall for nursing action. Am J Matern Child Nurs , 28 ( 1 ): 24–30. [ PubMed ] [ Google Scholar ]
• Heather W (2012). Indigenous Women of Latin America: Unintended Pregnancy, Unsafe Abortion, and Reproductive Health Outcomes. Pimatisiwin , 10 ( 3 ): 271–282. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kirkman M, Rosenthal D, Mallett S, Rowe H, Annarella H (2010). Reasons women give for contemplating or undergoing abortion: A qualitative investigation in Victoria, Australia. Sex Reprod Healthc , 1 ( 4 ): 149–55. [ PubMed ] [ Google Scholar ]
• Morgan LM, Roberts EFS (2012). Reproductive governance in Latin America. Anthropol Med, 19 ( 2 ): 241–254. [ PubMed ] [ Google Scholar ]
• Abazari F, Arab M, Abbasszadeh A (2003). Relationship of unwanted pregnancy and fertility behavior in pregnant women who visited maternity wards of Kerman hospitals (Persian). J Reprod Infertil , 4 ( 1 ): 39–46. [ Google Scholar ]
• Poorreza A, Khosravi M, Alipoor V, Jafari S (2007). What Should Macroeconomists Know about Health Care Policy? Eds, Heller PS and Hsiao W, 2nd ed, New York, pp.40–5. [ Google Scholar ]
• Spence M, Lewise M (2009). Health and growth. The International Bank for Reconstruction and Development. The World Bank. [ Google Scholar ]
• World Health Organization, World health & Statistics; 2009, 2010. [ Google Scholar ]
• Lotfalipoor M, Falahi MA, Borji M (2011). The effect of health indicators and economic growth in Iran (Persian). Health Management , 14 ( 46 ): 70–5. [ Google Scholar ]
• Ameryoun A, Meskarpour-Amiri M, Lorgard Dezfuli-Nejad M, Khoddami-ishteh HR, Tofighi Sh (2011). The Assessment of Inequality on Geographical Distribution of Non-Cardiac Intensive Care Beds in Iran. Iran J Public Health , 40 ( 2 ): 25–33. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Halpern NA, Pastores SM, Thaler HT, Green-stein RJ (2006). Changes in critical care beds and occupancy in the United States 1985– 2000: Differences attributable to hospital size. Crit Care Med , 34 ( 8 ): 2105–2112. [ PubMed ] [ Google Scholar ]
• Carr BG, Addyson DK, Kahn JM (2010). Variation in critical care beds per capita in the United States: implications for pandemic and disaster planning. JAMA , 3 ( 14 ): 1371–1372. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Gipson JD, Koenig MA and Hindin MJ (2008). The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann , 39 ( 1 ): 18–38. [ PubMed ] [ Google Scholar ]
• Kasule OH (2003). Social and religious dimensions of unwanted pregnancy: an Islamic perspective. Med J Malaysia , 58 ( 3 ): 49–60. [ PubMed ] [ Google Scholar ]
• Fears CS (2013). Teenage Pregnancy Prevention: Statistics and Programs. CSR Report for congress, www.crs.gov . [ Google Scholar ]
• Frankenberg E, Thomas D (2009). Reproductive Health, Empowerment of Women, and Economic Prosperity. POP POV, Research Network, poppov.org/Portals/1/documents/papers/5.Frankenberg.pdf You visited this page on 2/3/14.
• Frankenberg E1, Buttenheim A, Sikoki B, Suriastini W (2009). Do Women Increase Their Use of Reproductive Health Care When It Becomes More Available? Evidence From Indonesia, Stud Fam Plann , 41 ( 1 ): 27–40. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Greene M, Mehta M, Pulrwitz J, Wulf D, Bankole A, Singh S. Involving men in reproductive health: contributes to development. Background paper to the public choices, private decisions: sexual and reproductive health and the millennium development goals. United Nation Millennium Development project 2004.[CITED SEP 5 2009]. Available at: URL: http://www.unmillenniumproject.org/d ocuments/Greene_et_al-final.pdf .
• Skevington SM (2002). Advancing cross-cultural research on quality of life: observations drawn from the WHOQOL development. World Health Organisation Quality of Life Assessment. Qual Life Res , 11 ( 2 ): 135–44. [ PubMed ] [ Google Scholar ]
• Yazdkhasti M, Keshavarz M, Khoei EM et al. (2012). The Effect of Support Group Method on Quality of Life in Post-menopausal Women. Iran J Public Health , 41 ( 11 ): 78–84. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Yazdkhasti M, Keshavarz M, Mahmoodi Z, Hosseini AF (2014). Self-directed Learning and Its Impact on Menopausal Symptoms. Ircm J , 16 ( 5 ): 32–9. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• King J.T, Tsevat J, Moossy J, Roberts M. Preference-Based Quality of Life Measurement in Patients with Cervical Spondylotic Myelopathy. Spine , 2004; 29 : 1271–80. [ PubMed ] [ Google Scholar ]
• Khang YH, Lynch JW, Yun S, Lee SI (2004). Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measyres. J Epidemiol Community Health , 58 ( 4 ): 308–14. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kardesler E, Yetkiner I H. (2009). The Impact of Corruption on FDI: An Application of Efficient Grease Hypothesis to EU Countries. The Empirical Economics Letters , 8 ( 8 ): 409–429. [ Google Scholar ]
• Laporte A (2004). Do Economic Cycles Have a Permanent Effect on Population Health? Revisit-ingthe Brenner Hypothesis. Health Economics , 13 ( 8 ): 767–79. [ PubMed ] [ Google Scholar ]
• Khakki SI, Khani H, Halimi SS, Monemi A (2011). Best practice of comparison of Reproductive health Indicators on the bases on design checklist of family physicians and current guidelines of health Ministry Chaharbid rural health and medical centers in 2011. International Journal of Optimal Experience and Functioning Primary Health Care System , 2 ( 1 ): 1–8. [ Google Scholar ]
• Sadeghi H, AminiSani N, Arshi S, Sezavar Sh (2003). Reproductive factors among migrant tribes (Ashayer) women in Ardabil province (Persian). JAUMS , 3 ( 9 ): 38–41. [ Google Scholar ]
• Mazlumi Mahmudabad SS, Shasidi F, AbbasiShavazi M, Shahrizadeh F (2007). Evaluating knowledge, attitude and behavior of women on reproductive health subject in seven central cities of Iran (Persian). JRI , 4 ( 29 ): 391–400. [ Google Scholar ]
• Mohammadi A, Eftekhar Ardebffi H, Akbari Haghighi F, Mahmoudi M, Poorreza A (2004). Evaluations of services quality based on the pations’expectations and perceptions in Zanjan hospitals. Sjsph , 2 ( 2 ): 71–84 [ Google Scholar ]
• Bongaarts J. Trends in unwanted childbearing in the developing world (1997). Stud Fam Plan , 28 ( 4 ): 267–77. [ PubMed ] [ Google Scholar ]
• Jourabchi Z, Ranjkesh F, Asefzadeh S, Sann LM (2013). Impact of integrated maternal health care on reducing pregnancy and delivery complication in Qazvin province (2009-2011) (Persian). JQUMS , 16 ( 4 ): 47–53. [ Google Scholar ]
• Minnesota Department of Health (2002). Strategies for Public Health: A Compendium of Ideas, Experiences, and Research from Minnesota’s Public Health Professionals. Available from: http://www.health.state.mn.us/strategies/toc.pdf [accessed on July4, 2011].
• Aghababaei S, Bakht R, Moien R(2010). Study of Contraceptives Used in Unwanted Pregnancies (Persian) . Journal of Shaheed Sadoughi University of Medical Sciences , 18 ( 3 ): 307–314. [ Google Scholar ]
• Le Hoa H, Connolly Mark P, Bahamondes Luis et al. (2014). The burden of unintended pregnancies in Brazil: a social and public health system cost analysis. Int J Womens Health , 16 ( 6 ): 663–70. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Major B, Appelbaum M, Beckman L, Dutton MA, Russo NF, West C(2009). Abortion and mental health: evaluating the evidence. Am Psychol , 64 ( 9 ): 863. [ PubMed ] [ Google Scholar ]
• Corbin J, Strauss AL (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. 3 rd ed, Sage publication, Inc. www.sagepub.com/corbinstudysite [ Google Scholar ]
• Wilson EK, McQuiston C (2006). Motivations for pregnancy planning among Mexican immigrant women in North Carolina. Matern Child Health J , 10 ( 3 ): 311–20. [ PubMed ] [ Google Scholar ]
• Beheshti M, Sojudi S (2007). [Empirical Analysis of the Relationship between Health Expenditure and GDP in Iran (Persian)]. Slname-Barresi Ha Ye Eghtesadi , 4 ( 4 ): 115–135. [ Google Scholar ]
• Shovazi MJ, Hoseini Chavoshi M, Delavar B (2003). Unwanted pregnancy and its influencing factors in Iran (Persian). J Reprod Infertil , 1 ( 5 ): 62–7. [ Google Scholar ]
• Weinberger MB (1987). The relationship between women’s education and fertility:selected findings from the World Fertility Surveys. Int Fam Plan Perspec , 1987; 13 ( 2 ): 35–46. [ Google Scholar ]

The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families (1995)

Chapter: summary.

Unintended pregnancy is both frequent and widespread in the United States. The most recent estimate is that almost 60 percent of all pregnancies are unintended, either mistimed or unwanted altogether 1 —a percentage higher than that found in several other Western democracies. Unintended pregnancy is not just a problem of teenagers or unmarried women or of poor women or minorities; it affects all segments of society.

The consequences of unintended pregnancy are serious, imposing appreciable burdens on children, women, men, and families. A woman with an unintended pregnancy is less likely to seek early prenatal care and is more likely to expose the fetus to harmful substances (such as tobacco or alcohol). The child of an unwanted conception especially (as distinct from a mistimed one) is at greater risk of being born at low birthweight, of dying in its first year of life, of being abused, and of not receiving sufficient resources for healthy development. The mother may be at greater risk of depression and of physical abuse herself, and her relationship with her partner is at greater risk of dissolution. Both mother and father may suffer economic hardship and may fail to achieve their educational and career goals. Such consequences undoubtedly impede the formation and maintenance of strong families.

In addition, an unintended pregnancy is associated with a higher probability that the child will be born to a mother who is adolescent, unmarried, or over age 40—demographic attributes that themselves have important socioeconomic and

medical consequences for both children and parents. Pregnancy begun without planning and intent also means that individual women and couples are often not able to take full advantage of the growing field of preconception risk identification and management, nor of the rapidly expanding knowledge base regarding human genetics. Moreover, unintended pregnancy currently leads to approximately 1.5 million abortions in the United States annually, a ratio of about one abortion to every three live births. This ratio is two to four times higher than that in other Western democracies, in spite of the fact that access to abortion in those countries is often easier than in the United States. Reflecting the widespread occurrence of unintended pregnancy, abortions are obtained by women of all reproductive ages, by both married and unmarried women, and by women in all income categories.

Of the 5.4 million pregnancies that were estimated to have occurred in 1987, about 3.1 million were unintended at the time of conception. Within this pool of unintended pregnancies, some 1.6 million ended in abortion and 1.5 million resulted in a live birth. Only 2.3 million pregnancies in that year were intended at the time of conception and resulted in a live birth.

During the 1970s and early 1980s, the proportion of births that were unintended at the time of conception decreased. Between 1982 and 1988, however, this trend reversed and the proportion of births that were unintended at conception began increasing . This unfortunate trend appears to be continuing into the 1990s. In 1990, about 44 percent of all births were the result of unintended pregnancy; 2 the proportion is close to 60 percent among women in poverty, 62 percent among black women, 73 percent among never-married women, and 86 percent among unmarried teenagers.

Many factors help to explain the nation's high level of unintended pregnancy. Most obvious is the failure to use contraceptive methods carefully and consistently—or sometimes even at all—as well as actual technical failures of the methods themselves. Women and their partners relying on reversible means of contraception (about 21 million women) and those using no contraception at all, despite having no clear intent to become pregnant (about 4 million women), contribute roughly equally to the pool of unintended pregnancies. Many women and couples who are not seeking pregnancy move between these two groups, sometimes using contraception, sometimes not.

Contraceptive use and unintended pregnancy are influenced by numerous factors: knowledge about contraceptive methods and reproductive health generally, individual skill in using contraception properly, a wide range of personal feelings and attitudes, varying patterns of sexual behavior, access to

contraceptive methods themselves, cultural values regarding sexuality, religious and political preferences, racism and violence, the sexual saturation of the media, and others as well. The sheer number and complexity of these forces mean that no single or simple remedy is likely to ''solve" the unintended pregnancy problem, particularly because the interrelationships among all of these factors are not well understood. Nonetheless, the information reviewed in this report, past experience in the public health sector with addressing complex health and social problems, and common sense are all helpful in developing a plan of action to address this important national problem.

Committee Recommendations

The extent of unintended pregnancy and its serious consequences are poorly appreciated throughout the United States. Although considerable attention is now focused on teenage pregnancy and nonmarital childbearing, along with continuing controversy and even violence over abortion, the common link among all these issues—pregnancy that is unintended at the time of conception—is essentially invisible. The committee has concluded that reducing unintended pregnancy will require a new national understanding about this problem and a new consensus that pregnancy should be undertaken only with clear intent. Accordingly, the committee urges, first and foremost, that the nation adopt a new social norm:

• All pregnancies should be intended—that is, they should be consciously and clearly desired at the time of conception.

This goal has three important attributes. First, it is directed to all Americans and does not target only one group. Second, it emphasizes personal choice and intent. And third, it speaks as much to planning for pregnancy as to avoiding unintended pregnancy. Bearing children and forming families are among the most significant and satisfying tasks of adult life, and it is in that context that encouraging intended pregnancy is so central.

The U.S. Department of Health and Human Services, through its National Health Promotion and Disease Prevention Objectives, has urged that the proportion of all pregnancies that are unintended be reduced to 30 percent by the year 2000. The committee endorses this goal and stresses that it is a realistic one already reached by several other industrialized nations. Achieving this goal would mean, in absolute numbers, that there would be more than 200,000 fewer births each year that were unwanted at the time of conception, and about 800,000 fewer abortions annually as well.

• To begin the long process of building national consensus around this norm, the committee recommends a multifaceted, long-term campaign to (1) educate the public about the major social and public health burdens of unintended pregnancy and (2) stimulate a comprehensive set of activities at national, state, and local levels to reduce such pregnancies.

It is essential that the campaign direct its messages to national leaders and major U.S. institutions, as well as to individual men and women. The problem of unintended pregnancy is as much one of public policies and institutional practices as it is one of individual behavior, and therefore the campaign should not try to reduce unintended pregnancies only by actions focused on individuals or couples. Although individuals clearly need increased attention and services, reducing unintended pregnancy will require that influential organizations and their leaders—corporate officers, legislators, media owners, and others of similar stature—address this problem as well. The campaign should also draw on the successful experience of other major efforts to address complicated public health problems, such as the national campaigns to reduce smoking, limit drunk driving, and increase the use of seat belts.

The campaign should emphasize that reducing unintended pregnancy will ease many contemporary problems that are of such concern. Both teenage pregnancy and nonmarital childbearing would decline, and abortion in particular would be reduced dramatically. More generally, the lives of children, women, men, and their families, including those now mired in persistent poverty and welfare dependence, would be strengthened considerably by an increase in the proportion of pregnancies that are purposefully undertaken and consciously desired.

The Campaign to Reduce Unintended Pregnancy

The campaign to reduce unintended pregnancy should stress five core goals:

In the balance of this summary, each of these five campaign goals is outlined in more detail.

• Campaign Goal 1: Improve knowledge about contraception, unintended pregnancy, and reproductive health.

An important reason for inadequate contraceptive vigilance, and therefore unintended pregnancy, is that many Americans lack adequate knowledge about contraception and reproductive health generally. The fact that many people mistakenly believe that childbearing is less risky medically than using oral contraceptives is a sobering example of this problem. The resulting fears and misconceptions that stem from such erroneous beliefs can impede the careful, consistent use of contraception, which in turn contributes to the risk of unintended pregnancy.

Accordingly, the campaign should include a series of information and education activities directed to women of all ages, not just adolescent girls, describing available contraceptive methods and highlighting, in particular, the common occurrence of unintended pregnancy among women age 20 and over, especially those over age 40 for whom an unintended pregnancy may carry particular medical risks. Activities should target boys and men as well, emphasizing their stake in avoiding unintended pregnancy, the contraceptive methods available to them, and how to support their partners' use of contraception. And both men and women need balanced, accurate information about the benefits and risks attached to specific contraceptive methods.

Parents, families, and both religious and community institutions should be major sources of information and education about reproductive health and family planning, especially for young people, and they should be supported in serving this important function. In addition, U.S. school systems should continue developing comprehensive, age-appropriate programs of sex education that build on new research about effective content, timing, and teacher training for these courses. State laws and policies should be revised, where necessary, to allow and encourage such instruction.

Information and education about contraception should include abstinence as one of many methods available to prevent pregnancy. And particularly in programs directed to adolescents, it is important to encourage and help young people resist precocious sexual involvement. Sexual intercourse should occur in

the context of a major interpersonal commitment based on mutual consent and caring and on the exercise of personal responsibility, which includes taking steps to avoid both unintended pregnancy and sexually transmitted diseases (STDs).

The electronic and print media should reinforce the material presented in schools and elsewhere, thereby helping to educate adults as well as school-aged children about contraception and reproductive health. The media should present accurate material on the benefits and risks of contraception and should broaden current messages about preventing STDs to include preventing unintended pregnancy as well. Media producers, advertisers, story writers, and others should also balance current entertainment programming so that, at a minimum, sexual activity is preceded by a mutual understanding of both partners regarding its possible consequences, and accompanied by contraception when appropriate. Similarly, advertising of contraceptive products and public service announcements regarding unintended pregnancy and contraception should be more plentiful.

• Campaign Goal 2: Increase access to contraception.

Through a combination of financial and structural factors, the health care system in the United States makes access to prescription-based methods of contraception a complicated, sometimes expensive proposition. Private health insurance often does not cover contraceptive costs; the various restrictions on Medicaid eligibility make it an unreliable source of steady financing for contraception except for very poor women who already have a child; and the net decline in public investment in family planning services (especially those services supported by Title X of the Public Health Service Act), in the face of higher costs and sicker patients, may have decreased access to care for those who depend on publicly financed services, particularly adolescents and low-income women. Condoms, the most accessible form of contraception, provide valuable protection against STDs but must be accompanied by other contraceptive methods to afford maximum protection against unintended pregnancy. Unfortunately, other accessible nonprescription methods, such as foam and other spermicides, neither prevent the transmission of STDs nor offer the best protection against unintended pregnancy.

The campaign to reduce unintended pregnancy should promote increased access to contraception generally, but especially to the more effective prescription-based methods that require contact with a health care professional. Financial barriers in particular should be reduced by (1) increasing the proportion of all health insurance policies that cover contraceptive services and supplies, including both male and female sterilization, with no copayments or other cost-sharing requirements, as for other selected preventive health services; (2) extending Medicaid coverage for all postpartum women for 2 years following

childbirth for contraceptive services, including sterilization; and (3) continuing to provide public funding—federal, state, and local—for comprehensive contraceptive services, especially for those low-income women and adolescents who face major financial barriers in securing such care.

This last point speaks to the major role that such public financing programs as Title X and Medicaid have played in helping millions of people secure contraception. Although evaluation research has not yet defined the precise effects of these programs on unintended pregnancy, there is no question that they help to finance contraceptive services for many women (and some men), the principal means by which unintended pregnancy is prevented. Accordingly, it is essential that such public investment be maintained. In addition, foundations and government should fund high-quality evaluation studies of the impact that both Title X and Medicaid have on unintended pregnancy and related outcomes. Without better data on the effects of these and other publicly funded programs active in the area of reproductive health, such programs remain particularly vulnerable to attack, and it is difficult to know how best to strengthen them.

As another way to increase access to contraceptive services, the campaign should also broaden the range of health professionals and institutions that promote and provide methods of birth control. Campaign leaders, for example, should work with medical educators to revise the training curricula of a wide variety of health professionals (physicians, nurses, and others) to increase their competence in reproductive health and contraceptive counseling for both males and females and, where appropriate, in actually providing contraceptive methods. The campaign should also encourage those who provide social work, employment training, educational counseling, and other social services to talk with their clients about the benefits of pregnancy planning and how to do so.

• Campaign Goal 3: Explicitly address the major roles that feelings, attitudes, and motivation play in using contraception and avoiding unintended pregnancy.

Although increasing knowledge about and access to contraception (Campaign Goals 1 and 2) are important first steps, they are not enough. The campaign to reduce unintended pregnancy must also address the fact that the personal attitudes, motivation, and feelings of individuals and couples clearly affect contraceptive use and therefore the risk of unintended pregnancy. Similarly, partner preferences, and particularly the quality of a couple's relationship, are also important influences, as is overall comfort with sexuality; and feelings about specific contraceptives can affect an individual's choice of method and the success with which it is used as well.

In truth, avoiding unintended pregnancy can be hard to do, requiring specific skills and steady dedication over time, often from both partners. The

strong, consistent motivation that many forms of reversible contraception require is typically fueled by a view of life in which pregnancy and childbearing are seen, at a given point in time, as less attractive than other alternatives. Being pregnant and bearing a child often bring significant psychological and social rewards, and there must be good reason to forego them.

In order to address feelings, attitudes, and motivation more directly, contraceptive services should be sufficiently well funded (through adequate reimbursement rates and/or public sector support) to include extensive counseling—of both partners, whenever possible—about the skills and commitment needed to use contraception successfully. Similarly, school curricula and programs that train health and social services professionals in reproductive health should include ample material about the skills that contraception requires and about the influence of personal factors on successful contraceptive use, along with more conventional information about reproductive physiology and contraceptive technology.

The influence of motivation in pregnancy prevention also underscores the importance of longer-acting, coitus-independent methods of contraception (e.g. hormonal implants and injectables and, when appropriate, intrauterine devices) because they require only minimal attention once the method is established. Although few women and couples rely on these methods, their long-term potential for reducing unintended pregnancy is great. When offered with careful counseling and meticulous attention to informed consent, these methods constitute an important component of the contraceptive choices available in this country. They do not, however, protect against the transmission of STDs, which requires that condoms be used also.

On a broader level, policy leaders need to confront the notion that, especially for those most impoverished, reducing unintended pregnancy may well require that more compelling alternatives than pregnancy and childbearing be available. Such alternatives include better schools, realistic expectations that a high school diploma will lead to an adequate income, and jobs that are available and satisfying. Increasing knowledge about contraception and improving access to it as well may not be enough to achieve major reductions in unintended pregnancy when the surrounding environment offers few incentives to postpone childbearing. This comment is not meant to suggest that unless poverty is eliminated unintended pregnancy cannot be reduced. The point is rather than, in the poorest communities especially, only modest reductions in unintended pregnancy will likely be achieved by the usual prescription of "more education, information, and services." In this context, it is important to note that research findings do not support the popular notion that welfare payments (i.e., AFDC) and other income transfer programs exert an important influence on non-marital childbearing.

• Campaign Goal 4: Develop and scrupulously evaluate a variety of local programs to reduce unintended pregnancy.

Little is known about effective programming at the local level to reduce unintended pregnancy. Accordingly, the campaign to reduce unintended pregnancy should encourage public and private funders to support a series of new research and demonstration programs in this field that are designed to answer a series of clearly articulated questions, evaluated very carefully, and replicated when promising results emerge.

The focus and design of these new programs should be based, at a minimum, on a careful assessment of 23 programs identified by the committee whose effects on specific fertility measures related to unintended pregnancy have been carefully assessed. Evaluation data from these programs support several broad conclusions: (1) even those few programs showing positive effects report only small gains, which demonstrates how difficult it can be to achieve major decreases in unintended pregnancy; (2) because most evaluated programs target adolescents, especially adolescent girls, knowledge about how to reduce unintended pregnancy among adult women and their partners is exceedingly limited; (3) there is insufficient evidence to determine if "abstinence-only" programs for young adolescents are effective, but encouraging results are being reported by programs with more complex messages stressing both abstinence and contraceptive use once sexual activity has begun; (4) few evaluated programs actually provide contraceptive supplies; and (5) only mixed success has been reported from programs trying to prevent rapid repeat pregnancies among adolescents and young women.

The new research and demonstration programs should reflect several additional themes as well. Unintended pregnancies derive in roughly equal proportions from couples who report some use of contraception, however imperfect, and from couples who report no use of contraception at all at the time of conception. Although many individuals move back and forth between these two states over time, it may nonetheless be useful to develop specific strategies for each group, especially for the very high-risk group of nonusers. Another theme that should shape these research and demonstration programs is the need to develop and test out new ways to involve men more deeply in the issue of pregnancy prevention and contraception. And finally, these programs should explore how to build community support for contraception. Although contraceptive use is ultimately a personal matter, community values and the surrounding culture clearly shape the actions of individuals and couples. Accordingly, at least some demonstration programs should target both the community and the individual, and some might also work exclusively at the community level.

• Campaign Goal 5: Stimulate research to (a) develop new contraceptive methods for both women and men, (b) answer important questions about how best to organize contraceptive services, and (c) understand more fully the determinants and antecedents of unintended pregnancy.

The need to develop new contraceptive methods for both men and women is compelling. One of the reasons that unintended pregnancy continues to occur is that the available contraceptive methods are not always well suited to personal preferences or to various ages and life stages. Particularly glaring is the lack of effective male methods of reversible contraception other than the condom.

There is also a clear need for more health services research in the field of pregnancy prevention. For example, little is known about how access to prescription-based methods of contraception is enhanced or restricted by the many managed care arrangements now shaping health services.

Finally, there is a pressing need for more interdisciplinary research to understand the complex relationships among the cultural, economic, social, biological, and psychological factors that lie behind widely varying patterns of contraceptive use and therefore unintended pregnancy. Research on personal feelings, attitudes, and beliefs as they affect contraceptive use, and especially several recent ethnographic investigations of motivation, offer particularly intriguing explanations for the observed phenomena. Careful work is needed to integrate these ideas with the more traditional explanations of unintended pregnancy, such as inaccessible contraceptive services or insufficient knowledge about how to prevent pregnancy. Research is also needed on factors outside of individuals (such as the impact of media messages on the contraceptive behavior of individuals), on factors within couples (such as the relative power and influence of women and men in decisions to use or not use particular methods of contraception), and on the combination of individual, couple, and environmental factors considered together. In all such multivariate research, it will be important to study the determinants of sexual behavior as well as contraceptive use, inasmuch as the two are often intimately connected and may jointly influence the risk of unintended pregnancy.

Campaign Leadership

Progress toward achieving the five campaign goals outlined above would be enhanced by the existence of a readily identifiable, public–private consortium whose mission is to lead the recommended campaign. Funding and leadership of the consortium should be provided by private foundations, given their proven capacity to draw many disparate groups together around a shared concern. Members of this consortium should be recruited from numerous sectors, both public and private, and especially from the groups that speak on behalf of children and their needs, such as the maternal and child health community.

Experts estimate that nearly 60 percent of all U.S. pregnancies—and 81 percent of pregnancies among adolescents—are unintended. Yet the topic of preventing these unintended pregnancies has long been treated gingerly because of personal sensitivities and public controversies, especially the angry debate over abortion. Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are wanted.

Now, current issues—health care and welfare reform, and the new international focus on population—are drawing attention to the consequences of unintended pregnancy. In this climate The Best Intentions offers a timely exploration of family planning issues from a distinguished panel of experts.

This committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the United States on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention programs.

The Best Intentions explores problematic definitions—"unintended" versus "unwanted" versus "mistimed"—and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they bear.

Why does unintended pregnancy occur? In discussions of "reasons behind the rates," the book examines Americans' ambivalence about sexuality and the many other social, cultural, religious, and economic factors that affect our approach to contraception. The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. And the book looks at such practical issues as the attitudes of doctors toward birth control and the place of contraception in both health insurance and "managed care."

The Best Intentions offers frank discussion, synthesis of data, and policy recommendations on one of today's most sensitive social topics. This book will be important to policymakers, health and social service personnel, foundation executives, opinion leaders, researchers, and concerned individuals.

READ FREE ONLINE

Welcome to OpenBook!

You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

Do you want to take a quick tour of the OpenBook's features?

Show this book's table of contents , where you can jump to any chapter by name.

...or use these buttons to go back to the previous chapter or skip to the next one.

Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

Switch between the Original Pages , where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

To search the entire text of this book, type in your search term here and press Enter .

Share a link to this book page on your preferred social network or via email.

View our suggested citation for this chapter.

Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

Get Email Updates

Do you enjoy reading reports from the Academies online for free ? Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released.

After Roe , moms and babies are still at risk of abortion. Give Hope! DOUBLE YOUR GIFT

Unwanted Pregnancy: Destarra’s Story of Hope

• By Thomas Jeffries
• July 16, 2021

The staff offered baked goods and fresh-squeezed lemonade at the clinic. Everyone did everything they could to make Destarra feel comfortable. It was hot outside, and the cool lemonade was refreshing. They tried to distract her from the pain and the bleeding.

Destarra was 15 at the time. She didn’t know what an abortion was— or understand what was happening to her. All she knew was that she was at track practice after school when she started feeling dizzy. Destarra attributed it to the California heat, so she finished stretching and started to run. She took one step and hit the ground.

Someone called her mother to say her daughter had fainted, and that afternoon a doctor delivered the news. Destarra wasn’t dizzy from the heat but from an early unwanted pregnancy.

“I was pregnant, carrying a baby,” she says. “[But] I was still a baby.”

Unwanted pregnancy and abortion

Destarra’s first thought wasn’t surprise or fear. It was anticipation. “In my head, I was excited,” she says, “and ready to tackle being a mommy at 15.” The decision, however, was already made for her. Destarra was young, an athlete and her pregnancy was a potential embarrassment for her parents. She would have an abortion—end of story.

The clinic members, Destarra says, were friendly and welcoming. They smiled a lot and asked tons of questions. Apparently, she told them what they needed to hear. Destarra had no idea how far along she was. The workers told her she had a little blob of tissue that needed to be removed.

A tiny bean.

“They [said], ‘We’re just going to terminate the unwanted pregnancy.’ ” Unsure what those words meant, Destarra replied, “OK.”

Her mom took her to the clinic and filled out the paperwork; Dad never really knew what was going on. A staff member escorted Destarra to the back of the clinic, to an examination room.

“Take off your clothes and put on this gown,” the clinic worker told her. Though Destarra didn’t recognize what was happening at the time, someone performed an ultrasound. Destarra never saw the monitor— and never asked to.

“We’ll remove the tissue and there will be some bleeding, but you’ll be fine,” someone else told her. “Then, in a week or so, you can go back to school and continue the activities you were doing before. Now, just start counting down from 30. . . .”

“I don’t know how far I made it,” Destarra says. “And when I woke up, I didn’t feel too good. I was throwing up.”

The nice clinic workers gave her lemonade and crackers, and her mother was waiting at the door. They spent the next few nights in a hotel room, Destarra says, speaking little of what had just happened. Two weeks later Destarra was still feeling sick and was still bleeding. She was told that her experience was normal, that her body was “working to get back on track.” And that was that. No one mentioned another word about her unwanted pregnancy. Nothing about sex ed or birth control or waiting for marriage. Nothing.

A cycle of unwanted pregnancies

At 19, Destarra was unexpectedly pregnant again. This time she understood what was happening. She remembered the place her mother had taken her and the workers who promised to keep her secrets. Completely confidential, they said.

By her third pregnancy, Destarra had the drill down pat. No matter the clinic, there were always saltines and smiles. “You made the right decision.” “We’ll help you.” “It’s just a blob of tissue and some mucus.” She’d heard it all before, stuck in a cycle she couldn’t escape.

Her best friend convinced Destarra to talk to the father of her child. It didn’t go well. He advised her to get an abortion. Destarra was hurt, but she made up her mind that it was something she should do because he didn’t agree with keeping the baby. He even gave her money for it. She cried afterward.

After her third abortion, Destarra learned she was pregnant again. She steeled herself for another clinic visit, but something was different this time. She felt angry and guilty though she didn’t know why.

Destarra decided to pass on the lemonade. She gave birth to a daughter and named her Khaliya.

The man upstairs

Destarra knew a little about Jesus. Her father told her about “the Man Upstairs,” and her family went to church most Sundays. In young Destarra’s mind, as long as she was in church on Sunday, she was fine for the rest of the week. But older Destarra wasn’t always fine. Yet she never forgot about the Man Upstairs.

“I started to know more about Jesus,” she says, “but I was still not told the truth about abortion, so I continued believing it wasn’t bad.”

Destarra says she had four abortions in all. She admits she has trouble recalling the particulars, but she will never forget what she saw during one

The unwanted pregnancy suprise

As the abortion got underway, the clinic worker neglected to turn the monitor away. On the screen she noticed something . . . moving.

“I saw this baby playing with his or her fingers,” she says, “and it scared me. It felt like my heart dropped to the floor.

“I began to question myself while lying on the table. What am I doing? How are they taking this baby out? What are they doing with the baby? I wanted to run out of that facility, knocking down any and everything I passed. Sadly, I stayed.”

The staffer noticed Destarra staring at the screen, and she turned the monitor around. Then she unplugged it.

Maybe I’m hallucinating, Destarra thought. Maybe I just saw something that wasn’t there. Maybe, but probably not. It was the first time she could tell for certain that her unwanted pregnancy was far more than a blob of tissue or a tiny bean.

The ultrasound changed everything

Destarra had never heard the term pro-life. She certainly didn’t know it was a movement . No one ever told her that every human being—mother or child, aged or preborn, with special needs or not—has dignity and is deserving of protection. She only knew that her abortions were in her past.

She was wrong.

It’s true that she would never again visit a clinic, never again eat the crackers and smell the disinfectant. But while her procedures were over, her dreams were just beginning. Destarra started having bad ones—horrible nightmares filled with wailing babies. She couldn’t stop thinking about what she’d seen on that clinic monitor.

She eventually got pregnant again and gave birth to another daughter and son. She kept having dreams, too, and not just about babies. One night she pictured herself in a small white church, a place that felt extremely familiar. The building seemed an awful lot like the one her family had attended when she was younger.

“I called my mother,” Destarra says, “and asked her if she remembered how to get to that little white church.”

Eventually, Destarra moved home and found that building. She found faith there. And she found Jesus .

When unwanted becomes wanted

In 2015 Destarra met the man who would become her husband. Patrick had regrets of his own, and the pair spent months just talking about God and life—two damaged people working to establish a healthy relationship.

They married in 2017, and a year later had their first child together, Patrick’s namesake. That’s when Destarra told her husband about the abortions. She thanked God that she was still able to give birth, and she rejoiced in being a mother again. Patrick could see how difficult it was for Destarra to revisit the past, so he mostly just listened and loved her.

A Bump in Life

True stories of hope and courage during an unplanned pregnancy.

“I heard about the pro-life movement on Focus on the Family,” Destarra says. “When I first heard the discussions, I thought to myself, what does pro-life mean? Why are these people talking about abortion? I began to understand that the guests were sharing their testimonies to help others heal.”

Additional Reading:

• How to Join the Pro-Life Movement
• Science vs. Bible: When Does Life Begin?
• Hopeful Choice: What is a Pregnancy Help Center?
• Why Teach Children to Be Pro-Life?
• Alternatives to Abortion: Pregnancy Resource Center s

An encounter with God's forgiveness

It was Patrick’s suggestion to attend the 2019 March for Life . Destarra learned about it on the Focus broadcast and had no idea that people even marched for life. Patrick and Destarra ended up bringing the whole family, piling everyone into a friend’s RV for the long drive to Washington, D.C.

Destarra says she lost count of how many people welcomed them at the march and thanked them for coming. She was having a great time—until she saw pictures of babies on the giant screens and heard an abortion survivor share her story.

Destarra listened until she couldn’t focus anymore or process what she was seeing and hearing. The story of this woman— an abortion survivor —awakened something deep inside Destarra, and the memories of her unwanted pregnancy snuck up on her until she unraveled on the streets of the nation’s capital. She wept like never before, her forehead on the ground. Every part of her hurt—mind, body and spirit.

“My kids couldn’t understand what was taking place, and neither could I. It was just me and God,” she says. “People surrounded me to help me, and a lady prayed for me and with me. I was sickened about my past abortions, but at that moment, I knew more was happening. I was having a real encounter with God. He forgave me .”

Hope for others with an unwanted pregnancy

She still weeps sometimes, but she adores being a mother. She and Patrick now have another son, and she has started working as a doula . One of her favorite parts of the job is being there when an ultrasound is performed. For Destarra, it’s always a thrill as parents get to hear their baby’s heartbeat— the music of life—for themselves.

Destarra no longer minds the sound of babies crying. Nowadays it’s a soothing sound, she says, because she is there to catch their tears, to hold the babies and help them. She wants others, particularly young mothers, to hear about her story, to learn from her experience and find the same radio program that changed her life. “If I’d had this teaching when I was a young woman,” she says, “there would have been a different outcome.” •

© 2021 Focus on the Family. This article was originally published as “Destarra’s Awakening“ in the August/September issue of Focus on the Family magazine. All rights reserved.

Dynamic CTA Template Below

⚙📝 instructions & documentation (wip).

• Topics: Biblical Sexuality , Pre-Born , Pro-Life

About the Author

Thomas Jeffries

Read More About:

You May Also Like

#iSEETWO: An Inclusive, Life Affirming Conversation

When some look at a pregnant woman, they see only one life: we see two. That’s the idea behind the social media #iSEETWO campaign.

11 Scriptures About Race

What does the Bible say about race? The Bible hosts a variety of scriptures about race. They can be found in both the Old and New Testaments.

Bible Verses About Slavery and Human Trafficking

Bible verses about slavery, as well as those about how we should treat others, show how seriously God cares about justice, equality and freedom.

• 1-800-A-FAMILY (232-6459)
• [email protected]
• 8605 Explorer Drive Colorado Springs, CO 80920-1051
• Jobs & Volunteering
• Press Center
• Find a Counselor

Shows & Podcasts

• Daily Broadcast
• The Boundless Show
• Adventures in Odyssey
• Radio Theatre
• Focus on Marriage Podcast
• Focus on Parenting Podcast
• Practice Makes Parent
• All Shows >>
• That the World May Know
• The Truth Project
• All Products >>
• Make a Donation
• Other Ways to Give
• Manage My Donor Account
• Donor Tax Statements

Sign Up for Our E-Newsletters

• Get our updates straight to your inbox.

• Search Menu
• Browse content in Arts and Humanities
• Browse content in Archaeology
• Anglo-Saxon and Medieval Archaeology
• Archaeological Methodology and Techniques
• Archaeology by Region
• Archaeology of Religion
• Archaeology of Trade and Exchange
• Biblical Archaeology
• Contemporary and Public Archaeology
• Environmental Archaeology
• Historical Archaeology
• History and Theory of Archaeology
• Industrial Archaeology
• Landscape Archaeology
• Mortuary Archaeology
• Prehistoric Archaeology
• Underwater Archaeology
• Urban Archaeology
• Zooarchaeology
• Browse content in Architecture
• Architectural Structure and Design
• History of Architecture
• Residential and Domestic Buildings
• Theory of Architecture
• Browse content in Art
• Art Subjects and Themes
• History of Art
• Industrial and Commercial Art
• Theory of Art
• Biographical Studies
• Byzantine Studies
• Browse content in Classical Studies
• Classical History
• Classical Philosophy
• Classical Mythology
• Classical Literature
• Classical Reception
• Classical Art and Architecture
• Classical Oratory and Rhetoric
• Greek and Roman Papyrology
• Greek and Roman Epigraphy
• Greek and Roman Law
• Greek and Roman Archaeology
• Late Antiquity
• Religion in the Ancient World
• Digital Humanities
• Browse content in History
• Colonialism and Imperialism
• Diplomatic History
• Environmental History
• Genealogy, Heraldry, Names, and Honours
• Genocide and Ethnic Cleansing
• Historical Geography
• History by Period
• History of Emotions
• History of Agriculture
• History of Education
• History of Gender and Sexuality
• Industrial History
• Intellectual History
• International History
• Labour History
• Legal and Constitutional History
• Local and Family History
• Maritime History
• Military History
• National Liberation and Post-Colonialism
• Oral History
• Political History
• Public History
• Regional and National History
• Revolutions and Rebellions
• Slavery and Abolition of Slavery
• Social and Cultural History
• Theory, Methods, and Historiography
• Urban History
• World History
• Browse content in Language Teaching and Learning
• Language Learning (Specific Skills)
• Language Teaching Theory and Methods
• Browse content in Linguistics
• Applied Linguistics
• Cognitive Linguistics
• Computational Linguistics
• Forensic Linguistics
• Grammar, Syntax and Morphology
• Historical and Diachronic Linguistics
• History of English
• Language Evolution
• Language Reference
• Language Acquisition
• Language Variation
• Language Families
• Lexicography
• Linguistic Anthropology
• Linguistic Theories
• Linguistic Typology
• Phonetics and Phonology
• Psycholinguistics
• Sociolinguistics
• Translation and Interpretation
• Writing Systems
• Browse content in Literature
• Bibliography
• Children's Literature Studies
• Literary Studies (Romanticism)
• Literary Studies (American)
• Literary Studies (Asian)
• Literary Studies (European)
• Literary Studies (Eco-criticism)
• Literary Studies (Modernism)
• Literary Studies - World
• Literary Studies (1500 to 1800)
• Literary Studies (19th Century)
• Literary Studies (20th Century onwards)
• Literary Studies (African American Literature)
• Literary Studies (British and Irish)
• Literary Studies (Early and Medieval)
• Literary Studies (Fiction, Novelists, and Prose Writers)
• Literary Studies (Gender Studies)
• Literary Studies (Graphic Novels)
• Literary Studies (History of the Book)
• Literary Studies (Plays and Playwrights)
• Literary Studies (Poetry and Poets)
• Literary Studies (Postcolonial Literature)
• Literary Studies (Queer Studies)
• Literary Studies (Science Fiction)
• Literary Studies (Travel Literature)
• Literary Studies (War Literature)
• Literary Studies (Women's Writing)
• Literary Theory and Cultural Studies
• Mythology and Folklore
• Shakespeare Studies and Criticism
• Browse content in Media Studies
• Browse content in Music
• Applied Music
• Dance and Music
• Ethics in Music
• Ethnomusicology
• Gender and Sexuality in Music
• Medicine and Music
• Music Cultures
• Music and Media
• Music and Religion
• Music and Culture
• Music Education and Pedagogy
• Music Theory and Analysis
• Musical Scores, Lyrics, and Libretti
• Musical Structures, Styles, and Techniques
• Musicology and Music History
• Performance Practice and Studies
• Race and Ethnicity in Music
• Sound Studies
• Browse content in Performing Arts
• Browse content in Philosophy
• Aesthetics and Philosophy of Art
• Epistemology
• Feminist Philosophy
• History of Western Philosophy
• Metaphysics
• Moral Philosophy
• Non-Western Philosophy
• Philosophy of Language
• Philosophy of Mind
• Philosophy of Perception
• Philosophy of Science
• Philosophy of Action
• Philosophy of Law
• Philosophy of Religion
• Philosophy of Mathematics and Logic
• Practical Ethics
• Social and Political Philosophy
• Browse content in Religion
• Biblical Studies
• Christianity
• East Asian Religions
• History of Religion
• Judaism and Jewish Studies
• Qumran Studies
• Religion and Education
• Religion and Health
• Religion and Politics
• Religion and Science
• Religion and Law
• Religion and Art, Literature, and Music
• Religious Studies
• Browse content in Society and Culture
• Cookery, Food, and Drink
• Cultural Studies
• Customs and Traditions
• Ethical Issues and Debates
• Hobbies, Games, Arts and Crafts
• Lifestyle, Home, and Garden
• Natural world, Country Life, and Pets
• Popular Beliefs and Controversial Knowledge
• Sports and Outdoor Recreation
• Technology and Society
• Travel and Holiday
• Visual Culture
• Browse content in Law
• Arbitration
• Browse content in Company and Commercial Law
• Commercial Law
• Company Law
• Browse content in Comparative Law
• Systems of Law
• Competition Law
• Browse content in Constitutional and Administrative Law
• Government Powers
• Judicial Review
• Local Government Law
• Military and Defence Law
• Parliamentary and Legislative Practice
• Construction Law
• Contract Law
• Browse content in Criminal Law
• Criminal Procedure
• Criminal Evidence Law
• Sentencing and Punishment
• Employment and Labour Law
• Environment and Energy Law
• Browse content in Financial Law
• Banking Law
• Insolvency Law
• History of Law
• Human Rights and Immigration
• Intellectual Property Law
• Browse content in International Law
• Private International Law and Conflict of Laws
• Public International Law
• IT and Communications Law
• Jurisprudence and Philosophy of Law
• Law and Politics
• Law and Society
• Browse content in Legal System and Practice
• Courts and Procedure
• Legal Skills and Practice
• Primary Sources of Law
• Regulation of Legal Profession
• Medical and Healthcare Law
• Browse content in Policing
• Criminal Investigation and Detection
• Police and Security Services
• Police Procedure and Law
• Police Regional Planning
• Browse content in Property Law
• Personal Property Law
• Study and Revision
• Terrorism and National Security Law
• Browse content in Trusts Law
• Wills and Probate or Succession
• Browse content in Medicine and Health
• Browse content in Allied Health Professions
• Arts Therapies
• Clinical Science
• Dietetics and Nutrition
• Occupational Therapy
• Operating Department Practice
• Physiotherapy
• Radiography
• Speech and Language Therapy
• Browse content in Anaesthetics
• General Anaesthesia
• Neuroanaesthesia
• Clinical Neuroscience
• Browse content in Clinical Medicine
• Acute Medicine
• Cardiovascular Medicine
• Clinical Genetics
• Clinical Pharmacology and Therapeutics
• Dermatology
• Endocrinology and Diabetes
• Gastroenterology
• Genito-urinary Medicine
• Geriatric Medicine
• Infectious Diseases
• Medical Toxicology
• Medical Oncology
• Pain Medicine
• Palliative Medicine
• Rehabilitation Medicine
• Respiratory Medicine and Pulmonology
• Rheumatology
• Sleep Medicine
• Sports and Exercise Medicine
• Community Medical Services
• Critical Care
• Emergency Medicine
• Forensic Medicine
• Haematology
• History of Medicine
• Browse content in Medical Skills
• Clinical Skills
• Communication Skills
• Nursing Skills
• Surgical Skills
• Browse content in Medical Dentistry
• Oral and Maxillofacial Surgery
• Paediatric Dentistry
• Restorative Dentistry and Orthodontics
• Surgical Dentistry
• Medical Ethics
• Medical Statistics and Methodology
• Browse content in Neurology
• Clinical Neurophysiology
• Neuropathology
• Nursing Studies
• Browse content in Obstetrics and Gynaecology
• Gynaecology
• Occupational Medicine
• Ophthalmology
• Otolaryngology (ENT)
• Browse content in Paediatrics
• Neonatology
• Browse content in Pathology
• Chemical Pathology
• Clinical Cytogenetics and Molecular Genetics
• Histopathology
• Medical Microbiology and Virology
• Patient Education and Information
• Browse content in Pharmacology
• Psychopharmacology
• Browse content in Popular Health
• Caring for Others
• Complementary and Alternative Medicine
• Self-help and Personal Development
• Browse content in Preclinical Medicine
• Cell Biology
• Molecular Biology and Genetics
• Reproduction, Growth and Development
• Primary Care
• Professional Development in Medicine
• Browse content in Psychiatry
• Addiction Medicine
• Child and Adolescent Psychiatry
• Forensic Psychiatry
• Learning Disabilities
• Old Age Psychiatry
• Psychotherapy
• Browse content in Public Health and Epidemiology
• Epidemiology
• Public Health
• Browse content in Radiology
• Clinical Radiology
• Interventional Radiology
• Nuclear Medicine
• Radiation Oncology
• Reproductive Medicine
• Browse content in Surgery
• Cardiothoracic Surgery
• Gastro-intestinal and Colorectal Surgery
• General Surgery
• Neurosurgery
• Paediatric Surgery
• Peri-operative Care
• Plastic and Reconstructive Surgery
• Surgical Oncology
• Transplant Surgery
• Trauma and Orthopaedic Surgery
• Vascular Surgery
• Browse content in Science and Mathematics
• Browse content in Biological Sciences
• Aquatic Biology
• Biochemistry
• Bioinformatics and Computational Biology
• Developmental Biology
• Ecology and Conservation
• Evolutionary Biology
• Genetics and Genomics
• Microbiology
• Molecular and Cell Biology
• Natural History
• Plant Sciences and Forestry
• Research Methods in Life Sciences
• Structural Biology
• Systems Biology
• Zoology and Animal Sciences
• Browse content in Chemistry
• Analytical Chemistry
• Computational Chemistry
• Crystallography
• Environmental Chemistry
• Industrial Chemistry
• Inorganic Chemistry
• Materials Chemistry
• Medicinal Chemistry
• Mineralogy and Gems
• Organic Chemistry
• Physical Chemistry
• Polymer Chemistry
• Study and Communication Skills in Chemistry
• Theoretical Chemistry
• Browse content in Computer Science
• Artificial Intelligence
• Computer Architecture and Logic Design
• Game Studies
• Human-Computer Interaction
• Mathematical Theory of Computation
• Programming Languages
• Software Engineering
• Systems Analysis and Design
• Virtual Reality
• Browse content in Computing
• Business Applications
• Computer Security
• Computer Games
• Computer Networking and Communications
• Digital Lifestyle
• Graphical and Digital Media Applications
• Operating Systems
• Browse content in Earth Sciences and Geography
• Atmospheric Sciences
• Environmental Geography
• Geology and the Lithosphere
• Maps and Map-making
• Meteorology and Climatology
• Oceanography and Hydrology
• Palaeontology
• Physical Geography and Topography
• Regional Geography
• Soil Science
• Urban Geography
• Browse content in Engineering and Technology
• Agriculture and Farming
• Biological Engineering
• Civil Engineering, Surveying, and Building
• Electronics and Communications Engineering
• Energy Technology
• Engineering (General)
• Environmental Science, Engineering, and Technology
• History of Engineering and Technology
• Mechanical Engineering and Materials
• Technology of Industrial Chemistry
• Transport Technology and Trades
• Browse content in Environmental Science
• Applied Ecology (Environmental Science)
• Conservation of the Environment (Environmental Science)
• Environmental Sustainability
• Environmentalist Thought and Ideology (Environmental Science)
• Management of Land and Natural Resources (Environmental Science)
• Natural Disasters (Environmental Science)
• Nuclear Issues (Environmental Science)
• Pollution and Threats to the Environment (Environmental Science)
• Social Impact of Environmental Issues (Environmental Science)
• History of Science and Technology
• Browse content in Materials Science
• Ceramics and Glasses
• Composite Materials
• Metals, Alloying, and Corrosion
• Nanotechnology
• Browse content in Mathematics
• Applied Mathematics
• Biomathematics and Statistics
• History of Mathematics
• Mathematical Education
• Mathematical Finance
• Mathematical Analysis
• Numerical and Computational Mathematics
• Probability and Statistics
• Pure Mathematics
• Browse content in Neuroscience
• Cognition and Behavioural Neuroscience
• Development of the Nervous System
• Disorders of the Nervous System
• History of Neuroscience
• Invertebrate Neurobiology
• Molecular and Cellular Systems
• Neuroendocrinology and Autonomic Nervous System
• Neuroscientific Techniques
• Sensory and Motor Systems
• Browse content in Physics
• Astronomy and Astrophysics
• Atomic, Molecular, and Optical Physics
• Biological and Medical Physics
• Classical Mechanics
• Computational Physics
• Condensed Matter Physics
• Electromagnetism, Optics, and Acoustics
• History of Physics
• Mathematical and Statistical Physics
• Measurement Science
• Nuclear Physics
• Particles and Fields
• Plasma Physics
• Quantum Physics
• Relativity and Gravitation
• Semiconductor and Mesoscopic Physics
• Browse content in Psychology
• Affective Sciences
• Clinical Psychology
• Cognitive Psychology
• Cognitive Neuroscience
• Criminal and Forensic Psychology
• Developmental Psychology
• Educational Psychology
• Evolutionary Psychology
• Health Psychology
• History and Systems in Psychology
• Music Psychology
• Neuropsychology
• Organizational Psychology
• Psychological Assessment and Testing
• Psychology of Human-Technology Interaction
• Psychology Professional Development and Training
• Research Methods in Psychology
• Social Psychology
• Browse content in Social Sciences
• Browse content in Anthropology
• Anthropology of Religion
• Human Evolution
• Medical Anthropology
• Physical Anthropology
• Regional Anthropology
• Social and Cultural Anthropology
• Theory and Practice of Anthropology
• Browse content in Business and Management
• Business Ethics
• Business Strategy
• Business History
• Business and Technology
• Business and Government
• Business and the Environment
• Comparative Management
• Corporate Governance
• Corporate Social Responsibility
• Entrepreneurship
• Health Management
• Human Resource Management
• Industrial and Employment Relations
• Industry Studies
• Information and Communication Technologies
• International Business
• Knowledge Management
• Management and Management Techniques
• Operations Management
• Organizational Theory and Behaviour
• Pensions and Pension Management
• Public and Nonprofit Management
• Strategic Management
• Supply Chain Management
• Browse content in Criminology and Criminal Justice
• Criminal Justice
• Criminology
• Forms of Crime
• International and Comparative Criminology
• Youth Violence and Juvenile Justice
• Development Studies
• Browse content in Economics
• Agricultural, Environmental, and Natural Resource Economics
• Asian Economics
• Behavioural Finance
• Behavioural Economics and Neuroeconomics
• Econometrics and Mathematical Economics
• Economic History
• Economic Systems
• Economic Methodology
• Economic Development and Growth
• Financial Markets
• Financial Institutions and Services
• General Economics and Teaching
• Health, Education, and Welfare
• History of Economic Thought
• International Economics
• Labour and Demographic Economics
• Law and Economics
• Macroeconomics and Monetary Economics
• Microeconomics
• Public Economics
• Urban, Rural, and Regional Economics
• Welfare Economics
• Browse content in Education
• Adult Education and Continuous Learning
• Care and Counselling of Students
• Early Childhood and Elementary Education
• Educational Equipment and Technology
• Educational Strategies and Policy
• Higher and Further Education
• Organization and Management of Education
• Philosophy and Theory of Education
• Schools Studies
• Secondary Education
• Teaching of a Specific Subject
• Teaching of Specific Groups and Special Educational Needs
• Teaching Skills and Techniques
• Browse content in Environment
• Applied Ecology (Social Science)
• Climate Change
• Conservation of the Environment (Social Science)
• Environmentalist Thought and Ideology (Social Science)
• Natural Disasters (Environment)
• Social Impact of Environmental Issues (Social Science)
• Browse content in Human Geography
• Cultural Geography
• Economic Geography
• Political Geography
• Browse content in Interdisciplinary Studies
• Communication Studies
• Museums, Libraries, and Information Sciences
• Browse content in Politics
• African Politics
• Asian Politics
• Chinese Politics
• Comparative Politics
• Conflict Politics
• Elections and Electoral Studies
• Environmental Politics
• European Union
• Foreign Policy
• Gender and Politics
• Human Rights and Politics
• Indian Politics
• International Relations
• International Organization (Politics)
• International Political Economy
• Irish Politics
• Latin American Politics
• Middle Eastern Politics
• Political Behaviour
• Political Economy
• Political Institutions
• Political Methodology
• Political Communication
• Political Philosophy
• Political Sociology
• Political Theory
• Politics and Law
• Public Policy
• Public Administration
• Quantitative Political Methodology
• Regional Political Studies
• Russian Politics
• Security Studies
• State and Local Government
• UK Politics
• US Politics
• Browse content in Regional and Area Studies
• African Studies
• Asian Studies
• East Asian Studies
• Japanese Studies
• Latin American Studies
• Middle Eastern Studies
• Native American Studies
• Scottish Studies
• Browse content in Research and Information
• Research Methods
• Browse content in Social Work
• Addictions and Substance Misuse
• Adoption and Fostering
• Care of the Elderly
• Child and Adolescent Social Work
• Couple and Family Social Work
• Developmental and Physical Disabilities Social Work
• Direct Practice and Clinical Social Work
• Emergency Services
• Human Behaviour and the Social Environment
• International and Global Issues in Social Work
• Mental and Behavioural Health
• Social Justice and Human Rights
• Social Policy and Advocacy
• Social Work and Crime and Justice
• Social Work Macro Practice
• Social Work Practice Settings
• Social Work Research and Evidence-based Practice
• Welfare and Benefit Systems
• Browse content in Sociology
• Childhood Studies
• Community Development
• Comparative and Historical Sociology
• Economic Sociology
• Gender and Sexuality
• Gerontology and Ageing
• Health, Illness, and Medicine
• Marriage and the Family
• Migration Studies
• Occupations, Professions, and Work
• Organizations
• Population and Demography
• Race and Ethnicity
• Social Theory
• Social Movements and Social Change
• Social Research and Statistics
• Social Stratification, Inequality, and Mobility
• Sociology of Religion
• Sociology of Education
• Sport and Leisure
• Urban and Rural Studies
• Browse content in Warfare and Defence
• Defence Strategy, Planning, and Research
• Land Forces and Warfare
• Military Administration
• Military Life and Institutions
• Naval Forces and Warfare
• Other Warfare and Defence Issues
• Peace Studies and Conflict Resolution
• Weapons and Equipment

Unplanned pregnancy: your choices: A practical guide to accidental pregnancy

• Cite Icon Cite
• Permissions Icon Permissions

This book is written for all women who find themselves unexpectedly pregnant and want information and advice on the available options facing them. It explains what will be inolved if the woman decides on adoptions, abortion, or motherhood. It also discusses why unplanned pregnancies occur and what happens to a woman's body in early pregnancy. The whole book is brought to life iwth many extracts from interviews with women who have had unplanned pregnancies talking about their varied experiences and the choices they took.

Signed in as

Institutional accounts.

• GoogleCrawler [DO NOT DELETE]
• Google Scholar Indexing

Personal account

• Sign in with email/username & password
• Get email alerts
• Save searches
• Purchase content
• Activate your purchase/trial code

Institutional access

• Sign in with a library card Sign in with username/password Recommend to your librarian
• Institutional account management
• Get help with access

Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:

IP based access

Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.

Sign in through your institution

Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic.

• Click Sign in through your institution.
• Select your institution from the list provided, which will take you to your institution's website to sign in.
• When on the institution site, please use the credentials provided by your institution. Do not use an Oxford Academic personal account.
• Following successful sign in, you will be returned to Oxford Academic.

If your institution is not listed or you cannot sign in to your institution’s website, please contact your librarian or administrator.

Sign in with a library card

Enter your library card number to sign in. If you cannot sign in, please contact your librarian.

Society Members

Society member access to a journal is achieved in one of the following ways:

Sign in through society site

Many societies offer single sign-on between the society website and Oxford Academic. If you see ‘Sign in through society site’ in the sign in pane within a journal:

• Click Sign in through society site.
• When on the society site, please use the credentials provided by that society. Do not use an Oxford Academic personal account.

If you do not have a society account or have forgotten your username or password, please contact your society.

Sign in using a personal account

Some societies use Oxford Academic personal accounts to provide access to their members. See below.

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.

Some societies use Oxford Academic personal accounts to provide access to their members.

Viewing your signed in accounts

Click the account icon in the top right to:

• View your signed in personal account and access account management features.
• View the institutional accounts that are providing access.

Signed in but can't access content

Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.

For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.

Our books are available by subscription or purchase to libraries and institutions.

• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Rights and permissions
• Accessibility
• Advertising
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Unintended Pregnancy

An unintended pregnancy is a pregnancy that is either unwanted, such as the pregnancy occurred when no children or no more children were desired. Or the pregnancy is mistimed, such as the pregnancy occurred earlier than desired. The concept of unintended pregnancy helps in understanding the fertility of populations and the unmet need for contraception , also known as birth control, and family planning. Most unintended pregnancies result from not using contraception or from not using it consistently or correctly.

To help women, men, and couples prevent or achieve pregnancy, it is essential to understand their pregnancy intentions or reproductive life plan. A reproductive life plan may include personal goals about becoming pregnant, such as whether they want to have any or more children, and the desired timing and spacing of those children. A reproductive life plan may help identify reproductive health care needs that include contraceptive services, pregnancy testing, and counseling to help become pregnant, or manage a pregnancy with prenatal and delivery care.

Pregnancy Prevention

Women who choose to delay or prevent pregnancy should be offered contraceptive services that include:

• A full range of FDA-approved contraceptive methods .
• A brief assessment to identify the contraceptive methods that are safe for the client .
• Contraceptive counseling to help a client choose a method of contraception and learn how to use it correctly and consistently.
• Provision of one or more selected contraceptive methods, preferably on site, but by referral if necessary.

Preconception Health Promotion

Preconception health and health care services [PDF – 284 KB] aim to promote the health of women (and men) of reproductive age before conceiving a child, and thereby help to reduce pregnancy-related adverse outcomes, such as low birthweight, premature birth, and infant mortality. Moreover, preconception health services may improve a woman’s health and wellbeing, regardless of her childbearing intentions.

Women of reproductive age can make choices about their health and health care that help to keep themselves healthy, and if they choose to be pregnant, have a healthy baby. Adopting healthy behaviors is the first step women can take to get ready for the healthiest pregnancy possible.

Unintended pregnancy is associated with an increased risk of problems for the mom and baby. If the mom was not planning to get pregnant, she may have unhealthy behaviors or delay getting health care during the pregnancy, which could affect the health of the baby. Therefore, it is important for all women of reproductive age to adopt healthy behaviors such as:

• Take folic acid .
• Maintain a healthy diet and weight.
• Be physically active regularly .
• Quit tobacco use .
• Refrain from excessive alcohol drinking .
• Abstain from alcohol if pregnant or planning to become pregnant .
• Take only medicines prescribed by your doctor .
• Talk to your health care provider about screening and proper management of chronic diseases.
• Visit your health care provider to receive recommended health care for your age, learn about possible health risks, and discuss if or when you are considering becoming pregnant .
• Use effective contraception  correctly and consistently if you are sexually active but choose to delay or avoid pregnancy.

Snapshot of Progress

In 2008, women reported that more than half of all pregnancies (51%) were unintended. By 2011, the percentage of unintended pregnancies declined to 45%. That is an improvement, but some groups still tend to have higher rates of unintended pregnancy. For example, 75% of pregnancies were unintended among teens aged 15 to 19 years. Unintended pregnancy rates per 1,000 women were highest among women who:

• Were aged 18 to 24 years.
• Had low income (<100% of federal poverty level).
• Had not completed high school.
• Were non-Hispanic black or African American.
• Were cohabiting but had never married.

Note: Information was obtained from the journal article “ Declines in Unintended Pregnancy in the United States, 2008–2011”published in N Engl J Med.  2016;374(9):843–852 .

The United States set family planning goals in Healthy People 2020 to improve pregnancy planning and spacing, and to reduce the number of unintended pregnancies. Two ways to reach these goals are to increase:

• Access to contraception that includes the full range of methods, such as long-acting, and reversible forms like intrauterine devices and hormonal implants.
• Correct and consistent use of contraception for sexually active women who choose to delay or avoid pregnancy.

What CDC Is Doing

Cdc is working on many things to help prevent unintended pregnancy such as:.

• Examine the need for contraceptive services among women of reproductive age .
• Increase access, use, and dissemination of data to identify groups most at risk for unintended pregnancy; show the health impacts of teen and unintended pregnancy; and close gaps in access to quality, patient-centered family planning services.
• Develop and identify evidence-based strategies to reduce unmet needs for quality family planning services among the most affected groups.
• Provide guidance for health care providers who counsel men, women, and couples about contraception.
• Build capacity for health care providers, states, communities, and partners to improve quality patient-centered family planning services and support states and communities to increase access to contraception services.
• Association of State and Territorial Health Officials: Increasing Access to Contraception Learning Community
• Zika Contraception Access Network (Z-CAN): Increasing Access to Contraception: A Toolkit for Program Development, Implementation, and Evaluation
• CDC Contraceptive Guidance for Health Care Providers: US Medical Eligibility Criteria (US MEC) for Contraceptive Use, 2016
• US Selected Practice Recommendations for Contraceptive Use, 2016 .
• Update: Providing Quality Family Planning Services—Recommendations from CDC and the US Office of Population Affairs, 2017 .

To receive email updates about this page, enter your email address:

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

• Undergraduate
• High School
• Architecture
• American History
• Asian History
• Antique Literature
• American Literature
• Asian Literature
• Classic English Literature
• World Literature
• Creative Writing
• Linguistics
• Criminal Justice
• Legal Issues
• Anthropology
• Archaeology
• Political Science
• World Affairs
• African-American Studies
• East European Studies
• Latin-American Studies
• Native-American Studies
• West European Studies
• Family and Consumer Science
• Social Issues
• Women and Gender Studies
• Social Work
• Natural Sciences
• Pharmacology
• Earth science
• Agriculture
• Agricultural Studies
• Computer Science
• IT Management
• Mathematics
• Investments
• Engineering and Technology
• Engineering
• Aeronautics
• Medicine and Health
• Alternative Medicine
• Communications and Media
• Advertising
• Communication Strategies
• Public Relations
• Educational Theories
• Teacher's Career
• Chicago/Turabian
• Company Analysis
• Education Theories
• Shakespeare
• Canadian Studies
• Food Safety
• Relation of Global Warming and Extreme Weather Condition
• Movie Review
• Admission Essay
• Annotated Bibliography
• Application Essay
• Article Critique
• Article Review
• Article Writing
• Book Review
• Business Plan
• Business Proposal
• Capstone Project
• Cover Letter
• Creative Essay
• Dissertation
• Dissertation - Abstract
• Dissertation - Conclusion
• Dissertation - Discussion
• Dissertation - Hypothesis
• Dissertation - Introduction
• Dissertation - Literature
• Dissertation - Methodology
• Dissertation - Results
• GCSE Coursework
• Grant Proposal
• Marketing Plan
• Multiple Choice Quiz
• Personal Statement
• Power Point Presentation
• Power Point Presentation With Speaker Notes
• Questionnaire
• Reaction Paper
• Research Paper
• Research Proposal
• SWOT analysis
• Thesis Paper
• Online Quiz
• Literature Review
• Movie Analysis
• Statistics problem
• Math Problem
• All papers examples
• How It Works
• Money Back Policy
• Terms of Use
• Privacy Policy
• We Are Hiring

Unwanted Pregnancies, Essay Example

Pages: 6

Words: 1747

Hire a Writer for Custom Essay

Use 10% Off Discount: "custom10" in 1 Click 👇

You are free to use it as an inspiration or a source for your own work.

In our society, one of the definitions of an unplanned pregnancy can be defined as a woman having a baby when she is not physically or mentally prepared. The term unwanted pregnancy is applied to denote the women who have pregnancies that are neither desired nor intended. The pregnancies which are concluded by abortions are also included in this evaluation (Russo 147). The unwanted pregnancy comes in different points in a woman’s that may not be the best moment to care for a child.In today’s society, the subject of unwanted pregnancy is a very delicate subject. However, a woman has the right to govern her own body and make decisions that is appropriate forthem. Abortion is a right that legislation must protect as a legal act for women to reserve a women’s freedom of choice. We must discuss the parameters of unwanted pregnancy, which is a pregnancy, which a woman did not expect;the pregnancy was unintentional,or not wanted at the time of conception. The universal meaning of abortion is describe as ending an unwanted pregnancy. The epidemic of unwanted pregnancy is prevalent amount adults and young teenagers. The alternative options to birth are seeking a physician to perform an abortion, which is common procedure. Regardless of the circumstances, women should have control over her own body. Abortions should remain legal in the United States. There are instances where abortion needs the legal system to make a decision in courts, in cases of rape and incest. These decisions of unwanted pregnancy because of rape and incest can be argue that every child deserves the right to live; however, a woman should have the right and freedom to make that decision not the courts. If the women decide to have the baby even if society frowns on the birth, it is her personal right to make that decision. Abortion should not be mandated by the government, it should be left up to the woman’s own particular circumstances.

“What would happen if the child were discovered to have a disease which would have the outcome of a serious deformity? These two questions are explored from the perspective of the author with regards to unwanted pregnancy “(Lee 146).

The advantages to unwanted pregnancies are the abortion prevents women from bring a child into the world that is not wanted. In addition, the women are not psychologically, physically, or emotionally prepared to take care of an unwanted child. This abortion helps avoid a life of uncertainty for the child and even death. In our society, teenagers are getting pregnant at earlier ages when they are not mentally prepared for motherhood. The abortion prevents the child from dropping out school and suffering from the shame from being pregnant so young. The abortion gives the young teenager a second chance in life and an opportunity to have a healthy relationship with her child when the time is right. Another advantage is the teenager’s abortion provides a chance for better educational and financial opportunities.

The teenagers today are more educated about contraceptive and preventive measures for unwanted pregnancies, thus there are less teens getting pregnant. There are hotlines, teenage groups, school counselors, local health department, school interventions, and thousands of media outlets that give a woman options and support. The government has spent billions in promoting contraceptive use and abstinence funding for every state. The concentration of changing the trends of teenagers getting pregnant at a young age has proved successful. Finally, the public outrage concerning abortion clinics and social groups that fiercely fight abortion. The societal impact has made it uncomfortable for women to get an abortion, thus women in our society are discourage to visit an abortion clinic.

“The state’s teen pregnancy rate has dropped for the fifth consecutive year, according to data released to the Alabama Campaign to Prevent Teen Pregnancy by the state’s department of public health”(Montgomery Advertisers 1). There are other programs such as the abstinence programs for youths promoted by the government has been successful in decreasing the number of teen pregnancies. “The United States is one of the foremost nations with regards to the lowest rates of unwanted pregnancy. Over the past decade, the United States government has promoted sexual abstinence programs in all of the states” (Stanger-Hall, Kathrin & Hall e24658). There is evidence that teen pregnancies are decreasing because the educational system and the government programs have provide support and funding for reeducation. The high schools are more open in the new millennium than in the 1950s. As a result, teens are more prepared, more educated and they access to contraceptives. In 2009, the teenage pregnancy rate was determined at 61.4 per thousand. In 2001, there was a drastic decrease in the number of teen-agepregnancies, which was at 29.6 per thousand. In 2012, the teenage pregnancy rate was estimated at 27.7 per thousand (Montgomery Advertiser 1). The United States has some of the lowest teenager unwanted pregnancies, however, there are other parts of the world that have higher pregnancy rates. The areas of the Caribbean, Latin America, and Africa demonstrated the most elevated levels of unintended pregnancies. The Asian continent was the next largest source of the unintended pregnancies, followed by North America, Australia- New Zealand, and Europe (Russo 149).

The disadvantages of unplanned pregnancy could lead to poverty and create animosity towards the child because the added burden of motherhood. The women must be prepared to take on the lifelong responsibility for this unwanted child. There are a number of disadvantages to unwanted pregnancies such as untreated diseases such as sexually transmitted diseases (STD) which could lead to birth defects. The unborn child has the potential to be deformed or suffer from premature babies because the women may not be in the best health. The mother may suffer from depression, post-partum illnesses, and emotional problems.Research has shown that fourteen percent of the women experience depressive symptoms during their pregnancy and that twenty- five percent of the women experience higher levels of depressive symptoms during unwanted pregnancies (Somerset 71). The basic need to feel loved by someone else might be a cause for an unforeseen motherhood. An adolescent sometimes have a low self-worth and merely be searching for validation in the bedroom. Nevertheless, numerous young adults who have awesome, passionate loved ones and are extremely confidante are merely searching for the couple of minutes of happiness and stay away from utilizing safeguards. While numerous teenagers make use of the justification that intercourse can feel much better without a condom, an unexpected conception will probably happen. One primary consequence of adolescent childbearing is the fact the toddler might be brought up by a single parent. Although the majority of girls are seeking affection and validation in sexual activity, many males are searching for the simple gratification because they are not thinking about being a teenager parent. The challenges of high school and spending time with close friends might be too much to handle for many teenagers, so they just leave. Raising a young child, as teenager is complicated, however raising a young child on your own will be nearly impossible.

The unplanned pregnancies can be an unnecessary burden on the new mother including the possible malnutrition, resentment towards the unborn child and poor health of both the mother and unwanted child. An unforeseeable conception causes the parent unexpected financial burdens. This could result in the mother to work in very low paying jobs that could result in the mother and newborn living in poverty. The young child grows up without the mothers love. The most cruel thing a person can do to another human being is deny them love and affection. This intentional denial of a close relationship affects the child for a lifetime.

The disadvantage of unwanted pregnancies is the parent normally experiences severe depression and stress. The stress causes many medical complications such as malnutrition, premature birth, mother is unhealthy mental and physically and severe stress harms the baby. In addition, the baby suffers since the mother probably has resentment and ill feeling towards the new baby.

Teenagers do not have a real grip on life because they believe contraceptive or birth control pills will keep them from being pregnant. They form a sense of invincibility because they have never gotten pregnant while being active. However, that is not the only reason they get pregnant. Teenagers get pregnant because they are lack affections and attention from their own homes. This lack of affection makes the teenager vulnerable because they were they hunger for love on their sleeves. The second reason for unwanted pregnancy is peer pressure to gain acceptance from their friends. The third reason is a teenager’s lack of self-esteem, which others can prey on that weakness while they are confusing sex as love.

There is no doubt legal abortion is a good service that is accessible for any women that decides to abort their child. We only have to look back in the past to the days when abortions were down with hangers, unhealthy rooms, drinking harmful solutions that harm the women as well and not to mention how many women died from infections from abortions done in the alley.There may gruesome stories in the abortion history that many have forgotten the inhumane conditions women were forced to endure because abortion was illegal. Today, the benefits of abortion far outweigh the disadvantages because the legal system is respecting the right of women to control her own body. That freedom is worth fighting for because with too much government interventions, we lose our rights given to us by God.

Works Cited

Lee, Nancy Howell, and Miller Mark Crispin. The Search foran Abortionist: The Classic

Study Of How American Women Coped With Unwanted Pregnancy Before Roe V. Wade. [N.p.]: Open Road Media, 2014. Discovery eBooks. Tue. 15 Sept. 2014.

Montgomery Advertiser. ¨Alabama Teen Pregnancy Rate Drops for Fifth Consecutive Year.¨ Montgomery Advertiser , 7 November 2013. Tue. 15 September 2014. http://archivemontgomeryadvertiser.com-article-20131107-NEWS-!·!107012-Alabama-teen-pregnancy-rate-drops-fifth-consecutive

Russo, Nancy Felipe, and Julia R. Steinberg. “Chapter 7: Contraception And Abortion: Critical Tools For Achieving Reproductive Justice.” Reproductive justice: A global concern. 145-171. Santa Barbara, CA, US: Praeger/ABC-CLIO, 2012. PsycINFO. Tue. 15 Sept. 2014.

Somerset, Wendy, et al. “Chapter 4: DEPRESSIVE DISORDERS In Women: From Menarche To Beyond The Menopause.” WOMEN AND DEPRESSION: A handbook for the social, behavioral, and biomedical sciences. 62-88. New York, NY, US: Cambridge University Press, 2006. PsycINFO. Tue. 15 Sept. 2014.

Stanger-Hall, Kathrin F., and David W. Hall. “Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in The U.S.” Plos ONE 6.10 (2011): 1-11. Academic Search Premier. Tue. 15 Sept. 2014.

Stuck with your Essay?

Get in touch with one of our experts for instant help!

Medication Errors: Case Study Analyses, Essay Example

Solving Homelessness, Essay Example

Time is precious

don’t waste it!

Plagiarism-free guarantee

Privacy guarantee

Secure checkout

Money back guarantee

Related Essay Samples & Examples

Voting as a civic responsibility, essay example.

Pages: 1

Words: 287

Utilitarianism and Its Applications, Essay Example

Words: 356

The Age-Related Changes of the Older Person, Essay Example

Pages: 2

Words: 448

The Problems ESOL Teachers Face, Essay Example

Pages: 8

Words: 2293

Should English Be the Primary Language? Essay Example

Pages: 4

Words: 999

The Term “Social Construction of Reality”, Essay Example

Words: 371

ESSAY SAUCE

FOR STUDENTS : ALL THE INGREDIENTS OF A GOOD ESSAY

Essay: Unplanned pregnancy

Essay details and download:.

• Subject area(s): Health essays
• Reading time: 3 minutes
• Price: Free download
• Published: 7 February 2019*
• File format: Text
• Words: 769 (approx)
• Number of pages: 4 (approx)

Text preview of this essay:

This page of the essay has 769 words. Download the full version above.

Women get pregnant without meaning to. Pregnancies are not always planned. For some women and teenagers, it is really bad timing and they are not at all interested in having the child. Other women, however, will have the unplanned baby because either they don’t want an abortion, or they were planning to get pregnant soon anyway and figure they may as well have the baby now. Having a baby is not an easy task and requires lots of patience and responsibility. Some women are not ready to take on this challenge when they find out they are pregnant, so as a result, they have an abortion. An abortion is a medical or surgical procedure that ends a woman’s pregnancy, killing the fetus inside. Abortion is very common in countries today. In some countries, abortion is legal while in others this is illegal and can lead to prosecution. “All around the world each year, 20 to 30 million legal abortions are performed while 10 to 20 million illegal abortions do take place” (Sykes). Even though abortion has been legalized in some countries since 1973, this is still a huge debate topic today. Behind the debates are different views on the rights a woman has over her own body, when human life begins, and government interference in the private lives of individuals. According to Harvey Chadwick, babies are not “actual persons” and therefore should not be guaranteed the moral right to live. Chadwick explains his personal view that newborn children are not actual people because, “Both a fetus and a newborn certainly are human beings and potential persons, but neither is a person in the sense of subject of a moral right to life. We take ‘person’ to mean an individual who can attribute to her own existence (at least) basic such that being deprived of this existence represents a loss to her” (Chadwick). Harvey emphasizes that the murdering of a newborn baby is not very much different than aborting an unborn child. Harvey also states, “The academics strongly defend the notion that parents who are disappointed with having a disabled newborn should have the right to end the life of the infant so as to relieve themselves of the burden of raising it.” Having an abortion is a very tough decision to make, and it comes with lots of serious consequences. Abortion should be made illegal in all countries. Women abuse this action and do not realize the consequences until after it is done. As stated in Frosty Wooldridge’s Article “Abortion, Birth Control, Common Sense, and Reality”, “Abortion has taken the lives of over 40 million babies since 1973.” That is 40 million lives taken as a result of women abusing this horrible action. “I believe we as a country should really try to make enough pro-life groups to show women what could happen, and what mentally happens, and physically” (Wooldridge). Brian Wilson’s Article Outlawing Abortion says that, “Abortion should be outlawed, but until it is, pro-lifers should work to change the hearts of women seeking an end to their pregnancies.” Pro-lifers should take the time and effort to educate women about abortions and try and change their views on this matter. Women should really be educated about the entire issue. Later in life, whether it be months or years, the mother and father of the unborn child might realize that they should’ve kept the child, but now it is too late. Abortion affects many people including society, families, and the mothers who allow the killing to be done. It also teaches people that there is a way out of pregnancy and that is why it should be illegal. Women should know what they are going to go through, both physically and mentally. Abortion is not a quick and easy procedure that is over and done with no issues. There are many complications that women receive by having an abortion. “Ten percent of women who undergo an induced abortion suffer from immediate complications, two percent of which are major” (Cline). “Minor infections, bleeding, fevers, chronic abdominal pain, gastro-intestinal disturbances, vomiting, and Rh sensitization are included in the minor complications. Some common major effects include excessive bleeding, infection, ripping or perforation of the uterus, embolism, anesthesia complications, hemorrhage, convulsions, cervical injury, and endotoxin shock” (Cline). Abortion can also have effects on future pregnancies. A woman is much more likely to bleed within the first three months of their future pregnancies. Abortion of a first pregnancy messes up the hormonal changes and growth which is what allows the breasts to produce milk. As a result, this leaves the breast at a high risk of cancer.

...(download the rest of the essay above)

About this essay:

If you use part of this page in your own work, you need to provide a citation, as follows:

Essay Sauce, Unplanned pregnancy . Available from:<https://www.essaysauce.com/health-essays/unplanned-pregnancy/> [Accessed 08-04-24].

These Health essays have been submitted to us by students in order to help you with your studies.

* This essay may have been previously published on Essay.uk.com at an earlier date.

Essay Categories:

• Accounting essays
• Architecture essays
• Business essays
• Computer science essays
• Criminology essays
• Economics essays
• Education essays
• Engineering essays
• English language essays
• Environmental studies essays
• Essay examples
• Finance essays
• Geography essays
• Health essays
• History essays
• Hospitality and tourism essays
• Human rights essays
• Information technology essays
• International relations
• Leadership essays
• Linguistics essays
• Literature essays
• Management essays
• Marketing essays
• Mathematics essays
• Media essays
• Medicine essays
• Military essays
• Miscellaneous essays
• Music Essays
• Nursing essays
• Philosophy essays
• Photography and arts essays
• Politics essays
• Project management essays
• Psychology essays
• Religious studies and theology essays
• Sample essays
• Science essays
• Social work essays
• Sociology essays
• Sports essays
• Types of essay
• Zoology essays

Teen Pregnancy: Causes, Effects and Prevention Essay

Introduction, socioeconomic effects.

Teenage pregnancy is the pregnancy of underage girls during their adolescent period, normally between the ages of 13 to 19 but this range varies depending on the age of the menarche and the legal age of adulthood, which varies from one country to another. The rate of teen pregnancy is on the rise world wide due to changing lifestyles and increased fertility rate hence raising lot of social and economic concerns in the society.

The possible causes and predisposing factors of teenage pregnancies are early marriages, sexual activity during adolescence, inadequate sex education, sexual abuse, pornography, drug abuse, lower education levels, and high poverty levels.

Teenage pregnancies results into the dropouts of the teenage girls from schools. The dropouts mostly affect high school girls due to the dominant peer pressure factors and inadequate sex education.

The education of teenage a girl is significantly affected because she must drop out of school in order to prepare and take care of her baby. Statistics shows that, the teenage pregnancy is the major reason for the young girls’ dropouts in high school. These dropouts have great negative impacts on the education potential and the bright future of the girl child.

Teenage pregnancies are prone to many obstetrics complications as compared to mature women due to physiological and morphological factors. These complications demands extra healthcare attention that is very expensive, especially to the poor families. There are also serious health’s risks associated with teen pregnancies that can permanently affect the health of a teenage mother if there is no consultation of a professional obstetrician during delivery.

Social stigma and stress negatively affects the self-esteem of a pregnant teenage. When a teenage becomes pregnant, she develops fears about unplanned pregnancy, becomes frustrated, and begins to lose self-esteem and hope, as it seems to her that she has reached a premature destiny of her life.

The pregnant teen has fears of disclosing her pregnancy to any one not even his boyfriend who impregnates her, because she is worried about what they will say about her pregnancy condition. She develops stigma and confusion wondering on what kind of image she will portray to his friends, family, and teachers. She contemplates on the options of either disclosing the bad news and keep her pregnancy or keep the secret and do abortion.

Schools are required to develop programs and workshops that will provide opportunity to the students to develop their youth positively and become busy as idle minds are devils workshops.

Drug abuse and pornography should not be allowed in school because it encourages early sexual activity in teens. Girls need skills on how to avoid and protect themselves against predisposing factors and situations that prove to be very dangerous to their safety. Sex education will enable girls make their informed decisions and be responsible to their own actions and consequences.

Teen pregnancy is a major problem affecting girl child education worldwide. The increased teenage pregnancy rate is due to the change in lifestyles such as availability of pornography, drug abuse, peer pressure, increased fertility, and poverty.

Teenage pregnancy poses many challenges to the families and education system translating into serious socioeconomic problems in the society that need immediate attention to address. Teenagers are young and quite innocent on the consequences of teenage pregnancies, so they need proper parental and school guidance on the knowledge of sexuality and pregnancy.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, November 2). Teen Pregnancy: Causes, Effects and Prevention. https://ivypanda.com/essays/teen-pregnancy/

"Teen Pregnancy: Causes, Effects and Prevention." IvyPanda , 2 Nov. 2023, ivypanda.com/essays/teen-pregnancy/.

IvyPanda . (2023) 'Teen Pregnancy: Causes, Effects and Prevention'. 2 November.

IvyPanda . 2023. "Teen Pregnancy: Causes, Effects and Prevention." November 2, 2023. https://ivypanda.com/essays/teen-pregnancy/.

1. IvyPanda . "Teen Pregnancy: Causes, Effects and Prevention." November 2, 2023. https://ivypanda.com/essays/teen-pregnancy/.

Bibliography

IvyPanda . "Teen Pregnancy: Causes, Effects and Prevention." November 2, 2023. https://ivypanda.com/essays/teen-pregnancy/.

• Pornography and Ethics
• Pornography as a Moral Issue Discussion
• Teenage Pregnancy Concept and Problems
• Pros and Cons of Censorship of Pornography
• FLE Sociological Program Overview
• Child Pornography and Its Regulation
• Internet Pornography Regulation
• Teenage Pregnancy: Statistics, Factors, and Strategies
• Teenage Pregnancy Causes and Effects
• Pornography: The Access Restriction
• American Association of Retired Persons
• Baby Boomers After World War II
• Fear associated with sexuality issues in society
• Vygotsky’s Social-Historical Theory: Towards Facilitating Learning in Kindergarten-Age children
• Are We Too Dependent on Computers?

To revisit this article, visit My Profile, then View saved stories .

The Unbearable Uncertainty of Pregnancy

By Clare Beams

We may earn a commission if you buy something from any affiliate links on our site.

In my first pregnancy it looked like this: At our anatomy scan, the doctor was able to see that the umbilical cord was attached, not in the center of the placenta, where it was supposed to be, but off to the side. In my second pregnancy, it came when they measured a fold at the back of my daughter’s neck, the nuchal translucency. Follow-up testing was recommended if this fold was thicker than 3mm, because too much thickness there might or might not mean chromosomal or structural abnormalities that might or might not be incompatible with life. My daughter’s was 3mm exactly.

“What does that mean?” I asked, both times.

“Don’t worry,” the first doctor said. “Nature knows what it’s doing. It’s probably nothing.”

“Don’t worry,” the second doctor said, and then gave me forms to sign for chorionic villus sampling.

Neither of them actually answered my question.

Even before these moments, I’d found pregnancy uneasy , unknowable terrain. First there were lines on a test, then a little mounding between my hipbones, which I could only feel when I was lying down, and a vague sense of sickness, like reading in the back of a car on a twisty road. With more months came heft and an uncanny internal stirring, like a twitch of a new inner muscle that became distinct flailings, bumpings, and rollings. Here, at my core, was a region I had no access to. A sealed black box on which everything—a whole life—suddenly depended. Were things all right, inside? Who knew? Not my doctors, it seemed—not with the certainty I craved. I’d somehow turned my own body into a sort of restaging of Schrödinger’s cat . My eventual baby, inside the closed container of my uterus—my own organ, but exempt from my conscious control or knowledge, an unseen central zone I’d never been very aware of before—was both all right and not all right at all times. Both possibilities existed, and neither could be ruled out. The baby was utterly inaccessible to me even when I contained it completely, even when I was touching whatever appendage it was jabbing me with through the wall of my own abdomen.

When my doctors didn’t answer my questions to my satisfaction, I set off in search of answers elsewhere. My Google searches from those months read like a staccato seismograph of panic:

nuchal fold how thick is still normal

nuchal fold thick outcomes

umbilical cord attachment placement

umbilical cord off-center what happens.

Yet the whole internet seemed to be an echo chamber of the uncertainty my doctors had given me, a whole world with nothing surer to offer than probably, and the facts I gathered just made my not-knowing noisier. I found my way to the sites of scientific journals and lost hours there, reading about percentages of babies who turned out to have various conditions, babies born alive and not born alive. The numbers were objectively in our favor, yet failed to reassure me. Nowhere could I find enough of the central why I sought: a clear cause-and-effect-based story, some account of what the things the doctors had seen, when they glimpsed inside the black box at my core, might mean. Every possible cause was quickly supplanted by the next, sometimes with wildly different ramifications. The abnormalities on my daughters’ scans could be inconsequential artifacts of being a particular human, or they could be the first stage of a cascading catastrophe. The internet just told me, in the end, that what the doctors had seen could mean nothing or everything, and the seesawing of my mind between these two possibilities felt like actual motion, like the uncanny internal motion of the baby inside me, shifting me around in ways I couldn’t control.

I’ve found, in speaking to friends who’ve been pregnant, that some version of this experience isn’t uncommon. There is an amazing amount we do not know about pregnancy , and about women’s bodies in general , particularly those organs that have anything to do with sex . Pregnant women don’t generally volunteer for invasive studies, of course—but the reasons for our collective ignorance are, I think, deeper. We have a longstanding squeamishness about women’s interiors, which many cultures have historically imbued with a lot of fearful mystery and capacity for wrongness. For centuries, the dominant feeling on the part of the people in charge (mostly men) was that it would be better for everyone—maybe especially for women themselves—to avert their eyes, that no good could come from looking in such places. Medicine hasn’t fully recovered from this view because society hasn’t. I kept coming up against the limits, sometimes deliberately set, of what everyone knew.

By Hannah Jackson

By Hannah Coates

By Christian Allaire

I also think my search failed to reassure me because it was my first real high-stakes experience with the limits of what it’s possible to know at all. I’ve had two pregnancies, and I have two daughters, now 7 and 11, and this is lucky math. But it turns out, of course, that the end of the pregnancy is far from the end of the worrying. Pregnancy itself was only my first taste of the joy and fear my daughters have brought streaming into my life, in quantities that have reset my scales. Every day I find new things I can’t know about my daughters: what their experiences feel like to them, what they’re thinking at any given moment, what the world is doing to them while I’m not with them (or even while I am). My daughter breaks an arm jumping for the same bar she’s caught 500 other times; my other daughter decides, after a snub at recess, that her friend will never love her again; in just the time between when they get off the bus and when they arrive at our door two streets away, there are a million unforeseen ways they could break my heart. Children, after all, are definitionally unprecedented. I’ve had to expand, in every way, to fit mine, but I can never hope to succeed entirely. When my daughters were born one worry ended, yes, but they moved out from my body into a world I can only ever see in part—and their inner worlds, too, are only ever partly accessible to me, a new form of the black box, those realms on which so much depends. And so parenting has brought me constant practice with not knowing the information that matters more to me than any information in the world.

Clare Beams is the author of the novel The Garden , out next week.

Vogue Daily

By signing up you agree to our User Agreement (including the class action waiver and arbitration provisions ), our Privacy Policy & Cookie Statement and to receive marketing and account-related emails from Architectural Digest.. You can unsubscribe at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Home — Essay Samples — Nursing & Health — Teenage Pregnancy — Teenage Pregnancy: Causes and Preventive Measures

Teenage Pregnancy: Causes and Preventive Measures

• Categories: Teenage Pregnancy

About this sample

Words: 813 |

Published: Sep 7, 2023

Words: 813 | Pages: 2 | 5 min read

Table of contents

Causes of teenage pregnancy, preventive measures.

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Verified writer

• Expert in: Nursing & Health

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

1 pages / 596 words

4 pages / 1593 words

6 pages / 2871 words

3 pages / 1486 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Teenage Pregnancy

Teenage pregnancy is a topic that has been widely discussed and debated for many years. It carries significant social, economic, and health implications, prompting researchers, policymakers, and educators to delve deeper into [...]

Becoming a mother is a life-altering experience, and when it happens during the teenage years, it brings a unique set of challenges and triumphs. In this essay, we will explore the journey of teenage mothers, examining the [...]

Teenage pregnancy is a complex issue that affects millions of young people around the world. According to the World Health Organization (WHO), approximately 16 million girls between the ages of 15 and 19 give birth each year, [...]

Centers for Disease Control and Prevention (CDC). (2020). Teen pregnancy in the United States. https://www.cdc.gov/teenpregnancy/about/index.htm Santelli, J., Kantor, L. M., Grilo, S. A., Speizer, S., [...]

Teenage pregnancy is a complex issue that has been a topic of debate and discussion for many years. The phenomenon of teenage moms raises important questions about societal norms, the role of education, and the challenges faced [...]

An unplanned pregnancy is a crisis in a student’s life. On the other hand Teen pregnancy is a term used in reference to young ladies who get pregnant before attainment of legal adulthood that is between the ages of 13-19 [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

'Ozempic babies' are surprising women taking weight loss drugs. Doctors think they know why.

Women are getting pregnant, in most cases unintentionally, they say, while taking weight loss medications like Ozempic and Mounjaro , despite being on birth control or dealing with years of fertility issues.

Facebook groups , Reddit threads and TikTok videos are connecting women who are pregnant with or already had an “Ozempic baby” or “Mounjaro baby,” as they have come to be called, and want to share their surprise pregnancy experiences. 

“I got pregnant on Ozempic & was on the pill! Baby boy is due in June,” one person commented on a TikTok . “My surprise Ozempic baby is almost 4 months old and thankfully very healthy!” another wrote. 

Deb Oliviara, 32, started taking Ozempic the day after Thanksgiving to lose excess weight that had been affecting her mental health. She wasn’t consistent with taking her birth control pill, but that didn’t concern her much because she has a history of unidentified fertility issues that has made it difficult to get pregnant. 

Just two months after starting the medication, and the same week she hit her goal weight, Oliviara learned she was pregnant. “We were open to the idea, but definitely not trying,” she said. “It was very much a surprise and the only pregnancy, aside from my first, that didn’t come after a loss.” 

This is Oliviara’s sixth pregnancy with only two living children. She has had a first trimester loss, second trimester loss and a stillbirth. Now 10 weeks along, Oliviara and her baby are healthy. 

Reproductive and obesity medicine experts told USA TODAY that they’re also noticing the trend in their offices, which they say is likely happening for two reasons. First, weight loss is correcting hormonal imbalances caused by obesity and metabolic disorders and thus boosting fertility. Second, certain drugs may be reducing the efficacy of birth control pills, increasing the chances of pregnancy.

Yet, under no circumstances should women use weight loss drugs to get pregnant, experts warn. Studies on rats, rabbits and monkeys showed that these medications, if taken while pregnant, can lead to miscarriage and birth defects. (No studies have been done on humans.) Drug manufacturers recommend women stop taking weight loss drugs at least two months before a planned pregnancy . 

“It’s true that, from a scientific perspective, these medications may make it easier for people to get pregnant,” said Dr. Allison Rodgers , an OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois. “But people need to be careful because there could be dangerous consequences if taken while pregnant given the drugs can linger in your system.” 

Why weight loss drugs may boost fertility 

Decades of research have established strong connections between obesity, metabolic disorders such as polycystic ovary syndrome (PCOS) and fertility issues, so it isn't too surprising to see that weight loss medications — which can help some people drop up to 20% of their body weight — are helping many women with these conditions get pregnant, said Dr. Utsavi Shah , assistant professor of obstetrics and gynecology specializing in obesity medicine at Baylor College of Medicine in Houston. 

“These weight loss medications are game changers for women with PCOS or infertility, but there’s nothing about them specifically that’s making people more fertile, aside from their interaction with birth control pills,” Shah said. “It’s their effect on weight loss that’s helping regulate their menstrual cycles, thereby increasing their chances of getting pregnant.” 

Hayley Glatfelter, a 27-year-old from Texas, got pregnant in November four months after beginning semaglutide (the active ingredient in Ozempic). She started taking the drug to lose weight and treat her insulin resistance associated with PCOS — a hormonal disorder that causes weight gain, irregular menstrual periods, excess hair growth, and in some cases, fertility problems.

Although Glatfelter wasn’t on birth control, she said her positive pregnancy test was still surprising because she has had problems getting pregnant before, which is what led to her PCOS diagnosis in 2019. At that time, her doctor prescribed her a different diabetes drug called metformin, which is often used to help with PCOS-related insulin resistance. The drug helped Glatfelter get pregnant with her first son. 

“I was told it was a miracle,” Glatfelter said.

More on Ozempic: Sharon Osbourne lost too much weight on Ozempic, but she doesn't regret it. Why her case is uncommon

Fat cells release estrogen, so the more a person gains, the more estrogen they’ll have, Shah said. Excess estrogen can prevent regular menstruation and ovulation, which can make it hard to get pregnant. 

Obesity causes insulin resistance as well, which can lead to high levels of male sex hormones like testosterone that don’t support pregnancy and affect egg quality, Shah said. 

Some weight loss drugs can make your birth control pill less effective 

Studies done in test tubes have found that tirzepatide — the active ingredient in Mounjaro and Zepbound — reduces the efficacy of oral contraception, aka the birth control pill, according to the drugs’ labels . 

Mounjaro and Zepbound “delay gastric emptying,” meaning the stomach takes longer to clear out, which can affect how oral medications are absorbed in the body. The delay is largest after the first dose and diminishes over time. 

Shah advises her patients taking these drugs and birth control pills to use a backup option, like condoms. 

Semaglutide (Ozempic and WeGovy) doesn’t have as strong of an effect on gastric emptying, so its dr u g label doesn't contain warnings about oral contraceptives.

These drugs affect each person’s body differently, so risks vary, said Dr. Marina Kurian, a bariatric surgeon and president of the American Society for Metabolic & Bariatric Surgery. 

“The birth control pill is still getting digested, the absorption rate may just be different in people, which would make its impact on the ovaries different too,” Kurian said. 

That said, there’s always a small likelihood with any contraceptive that you can get pregnant, Shah said. But there’s no need to panic either.

“I know that there are stories out there that get escalated in the media, but if you're using effective birth control and on these weight loss medications, the risk of unintended pregnancy is quite low,” Shah said. 

Only take weight loss medications if you meet criteria for its use, experts say. Zepbound and WeGovy , for example, are approved for weight management in adults who have obesity or are overweight with at least one weight-related condition, such as high blood pressure or Type 2 diabetes .

And if you suspect you’re pregnant while taking a weight loss drug, stop it immediately, Rodgers said, then follow up with your obstetrician. 

After abortion attempts, two women now bound by child

HOUSTON — It had been nearly a year since Evelyn had seen Olivia in person, and she had grown nervous about a planned reunion.

When she finally arrived at the three-story townhouse where a party for the baby she placed for adoption was being held, she was greeted by Carolyn Whiteman, the 44-year-old woman Evelyn had chosen to raise her child. Whiteman held bright-eyed Olivia in the doorway.

“I can’t believe she’s gotten so big. She’s so cute,” Evelyn, 25, said, beaming with tears in her eyes.

For hours, Evelyn’s and Whiteman’s families marveled at Olivia’s eight teeth and how she crawled and grabbed their pant legs to pull herself up on her feet.

“It’s so crazy being here and looking at Olivia,” Evelyn’s dad told Whiteman. “She crawls just the way Evelyn did when she was a baby.” His gaze locked on the infant as her tiny toes gripped the hardwood floors.

But Evelyn’s dad, a retired military veteran, resisted the urge to hold the infant, rebuffing Evelyn’s encouragement until the end of the party. He was confident in his daughter’s choice but didn’t want to become attached to a grandchild he couldn’t help raise.

A year earlier, Evelyn had been consumed by guilt, depression and hopelessness, she recalled in months of interviews. Her world had shattered when two lines appeared on a home pregnancy test.

She lied and hid the pregnancy from her parents for 34 weeks and traveled to two states to try to end it. She detached herself from the baby growing inside her, ignoring the flutters of movement in her expanding stomach.

Her repeated attempts to have an abortion were thwarted by Texas’s six-week ban and a pregnancy clock that worked against her. She and her immediate family spoke to The Washington Post on the condition that their last name would be withheld to protect her privacy.

Now, here she was with a woman she barely knew, visiting the child she birthed despite all of her plans.

The women, Evelyn and Whiteman, couldn’t be more different.

Evelyn, half-Native American and half-Black, with curly, sandy brown hair, felt internally broken as the weight of unmet expectations and the fear of the unknown seemed to overtake her when she accidentally became pregnant. While Evelyn struggled academically, Whiteman had degrees, a community of friends, and a supportive, boisterous Grenadian family. But after struggling to find a Black sperm donor, she would stand in the entryway of the empty guest bedroom in her newly constructed home, praying and longing for a baby.

Now Evelyn and Whiteman were bound together, by a child.

Evelyn spent most of 2022 terrified.

After graduating from high school, she enrolled in a San Antonio community college. But she says she wasn’t motivated, sometimes skipping classes and hanging out with people she knew weren’t the best for her. By January of that year, she was on academic dismissal — for the third time — after her grade-point average dropped below 2.0. This time, she would have to sit out an entire academic year.

Evelyn began talking to a guy she met on social media. They dated for a few weeks and had casual sex.

A few weeks later, in February, the air in her body seemed to disappear as she stared at the positive pregnancy test on her bathroom counter.

A single thought swirled through her head: I can’t have a child. I can’t have a child. I can’t have a child.

Her relationship, brief and tumultuous, went downhill swiftly and ended after she told him about the pregnancy. She immediately began making plans to have an abortion.

She decided not to tell her parents. Her mom (a nurse) and her dad (a former pilot) were retired military veterans who had struggled to conceive. They were in their mid-40s when they adopted Evelyn at 3 weeks old.

Although Evelyn had always felt close to them, she was petrified to tell them about the pregnancy.

“My parents are in their early 70s. I didn’t have a job or any money. I didn’t want to put it on them to raise the baby,” Evelyn remembers thinking. She felt ashamed.

A friend, Bianca Hernandez, accompanied her to Alamo Women’s Reproductive Services, in San Antonio three days after the positive pregnancy test. Around 8 a.m., Hernandez says she watched Evelyn walk past screaming protesters holding antiabortion signs and into the clinic.

Evelyn knew about the new law. A few months before she entered the clinic, Texas had become the first state in history to ban abortions beyond six weeks of pregnancy. It was one of the most restrictive abortion laws to take effect in the United States in nearly 50 years.

Abortion clinics were bombarded with calls from women rushing to get appointments to terminate their pregnancies. Evelyn was one of them.

When it was her turn, she reclined on the exam table and crossed her fingers, hoping she wasn’t too far along.

“You’re six weeks and four days pregnant,” she recalls the doctors saying.

“So it’s too late?” she asked.

Yes, she was told.

The clinic’s staff advised her to go to Oklahoma before that state adopted an abortion ban, too.

Evelyn texted Hernandez, who was waiting outside: “It’s not good.” Back in the car, she started to weep. “I have to go to Oklahoma,” Hernandez remembers her saying.

It was time to tell her parents, Hernandez told her. Evelyn refused.

Her appointment at Tulsa Women’s Reproductive Services wasn’t until mid-April — nearly four weeks later. She didn’t want to make the six-hour journey alone, so she called her birth mother, Tamela, who lived near the Oklahoma border.

Her birth mother was a teenager when she became pregnant with Evelyn. With the encouragement of her adoptive mom, Evelyn had found her on Facebook in 2016. They stayed in touch. Evelyn hoped she would be able to understand her predicament.

Tamela says she was surprised by Evelyn’s call but immediately understood her fear. “You don’t think it’s going to happen to you, that you’re going to get pregnant so young. And it’s scary. It’s very scary because it happened to me,” Tamela remembers thinking.

During the hours-long car ride to Oklahoma, Evelyn says they sat mostly silent while listening to music. Evelyn thanked her birth mother for accompanying her and keeping the secret from her adoptive parents. She remembers Tamela telling her that she was making a good decision and that ending the pregnancy would be best for her future.

They checked into a DoubleTree hotel, and Evelyn spotted the clinic through the window.

Early the next morning Tamela watched as Evelyn maneuvered past yelling antiabortion protesters and entered the clinic. At the time, the Tulsa clinic’s caseload had tripled to 500 cases per month, says Andrea Gallegos, the executive administrator at the Texas and Oklahoma clinics Evelyn went to. Most of the patients were from Texas.

The clinic’s doctor estimated that she was nine, possibly 10 weeks along and handed her a prescription for mifepristone, Evelyn says. She should dissolve the pills under her tongue to start a medication abortion, according to the prescription she received from the clinic. She was told to take the remaining four pills, misoprostol, “orally” at home within 48 hours.

Back in the car, Tamela says Evelyn showed her the paperwork from the clinic and appeared relieved and happy. “They made me feel welcomed and were really supportive in there,” Evelyn told her birth mother.

She didn’t take the second dose until she returned to her home in San Antonio, nearly two days later. She wanted to be at home where she would have more privacy, Evelyn says. Her stomach had started to cramp. Then she saw the blood clots in the toilet. She bled for hours and had spotting for a couple of weeks.

Confident it had worked, she says she didn’t bother to make the follow-up doctor’s appointment the clinic had strongly recommended.

May and June passed. Evelyn started working as a fulfillment associate at Macy’s. But she still hadn’t gotten her menstrual cycle. She took another pregnancy test and was stunned when it came back positive.

A family friend, Yvette, a registered nurse, says she arranged for Evelyn to get bloodwork done at a hospital. At the hospital, a midwife, Monica, also measured Evelyn’s uterus and conducted an ultrasound. Both women spoke on the condition that their last names be withheld because they were not authorized to speak by their employer.

Evelyn fainted when she saw that there was a heartbeat, and was in and out of consciousness for about five minutes, the midwife recalled in an interview. She was obviously in denial, Monica said. Perhaps it’s time to consider adoption, the midwife told her.

“No, no, no, I can’t go through with the pregnancy,” Evelyn responded.

Evelyn says she didn’t know the pills sometimes didn’t work. It is a rare occurrence, but she later learned that 3 percent of medication abortions fail when gestation reaches 70 days, or 10 weeks, according to the American College of Obstetricians and Gynecologists. The odds of failure increase if the patient waits longer than prescribed to take the second dose of the medication, several medical experts said.

The Oklahoma clinic has since closed, and Gallegos said she doesn’t have access to Evelyn’s medical records. Failure is uncommon, but the clinic advises all patients to make follow-up appointments and receive an ultrasound, she said. “Have we had patients who have failed pills? Yes. Is it the norm? No,” Gallegos told The Post. “We would try to schedule every patient to come back for a follow-up and ultrasound to make sure that everything was completed. Sometimes patients made it to those appointments, sometimes they didn’t.”

Desperate, Evelyn found a website, Aid Access, that shipped abortion medication across the country. After speaking with a doctor by phone and paying $150, she waited for pills that were being mailed from India.

Evelyn had told the doctor she wasn’t sure the date of her last period. At the time, Aid Access prescribed medication abortion pills for patients who were up to 10 weeks pregnant, taking into account the two-week shipping time. “Aid Access trusts women to tell the truth about their situation,” Rebecca Gomperts, the company’s director, told The Post in a statement.

It may already have been too late for the medication to be effective, Evelyn says she told herself. But she was convinced that she didn’t have any other choice.

When the pills arrived, she ripped open the package and read the instructions over and over. She said she wanted to do it right this time.

For a couple of hours she had cramps but no bleeding. She emailed the company. They advised her to take the additional pills they sent, according to the email. Still, Evelyn says, nothing happened.

She was nervous, she wrote the company in another email reviewed by The Post. “I’ve been through this before and started bleeding within two hours,” she told them of her previous experience with a medication abortion.

In the email exchange, the company offered to send more medication to a pharmacy near Evelyn, but she remembered the warning of Yvette, the registered nurse: At this stage, nearly five months into her pregnancy, an abortion was becoming risky to her health. She refused the offer of more medication.

Evelyn spent August and September in an emotional haze, pretending that life was normal around the house she shared with her parents but researching states that offered abortions later in pregnancy. She was still hanging out with friends, most of whom were oblivious to her pregnancy. During family dinners, she and her parents would chat about the latest movies, and they would stress the importance of her returning to school.

She found a clinic in Albuquerque that offered second-trimester abortions. She was past the halfway point in her pregnancy and approaching the third trimester, but she still had time, Evelyn told herself.

The clinic staff warned about the health risks of having a surgical abortion so late in her pregnancy but helped connect her to two abortion organizations that covered the cost of her plane ticket, hotel, food and the $12,000 procedure.

“There are no circumstances surrounding your pregnancy that will make you more or less deserving of assistance,” the New Mexico Religious Coalition for Reproductive Choice wrote Evelyn in an email confirming she was approved for assistance. The organization doesn’t keep abortion seekers’ information, said Janeth Orozco, spokeswoman for the nonprofit group. Evelyn’s travel documents to New Mexico list the coalition as the payee.

At the beginning of October 2022, Evelyn told her parents she was going to visit a friend across town but instead boarded a plane to Albuquerque. She called the midwife who had conducted her ultrasound while waiting to take off. Evelyn needed her bloodwork and lab results. She sounded desperate, the midwife says.

Behind the reporting

The next morning, Evelyn found herself staring up at fluorescent light panels. A nurse moved the curved ultrasound wand across her belly and tickled the long dark line that had emerged in the center of her stomach as the baby grew.

“I’m so sorry,” Evelyn remembers the nurse telling her, looking at the screen. “You are too far along, 32 weeks pregnant,” she said, pausing before adding, “We can’t help you.” The clinic’s doctors aren’t trained to perform abortions after 24 weeks, according to Southwestern Women’s Options.

Evelyn burst into tears.

Suddenly out of options for ending the pregnancy, Evelyn began to consider a future that had once seemed impossible. She would be giving birth.

Her parents were already upset she had been kicked out of school. The weight of disappointing them further and having them find out she had unprotected sex was something she had not wanted to face.

She hadn’t seriously considered adoption until now, despite being adopted herself. But now that seemed to be the only option.

Evelyn says she knew adoption could be positive. Her parents had given her an ideal childhood. There were trips to Argentina and France. She played soccer and basketball before falling in love with volleyball.

She was grateful for her family but sometimes had questions. What was her birth mother like? Did she have any biological siblings?

When she returned home to San Antonio, she called the Gladney Center for Adoption, in Fort Worth, the agency her parents had used.

After concealing her growing belly from her parents for months, it was time to stop lying. She was starting to show.

One day, before heading to the movies for a family outing, she asked her mother to join her in her bedroom. By the time she had the courage to tell her mother, Evelyn was more than seven months pregnant. The words spilled out through tears — the abortion attempt, her fear.

Her mom, she learned, had been suspicious of the big robe she had been wearing around the house. But Evelyn was still too terrified to tell her father about her pregnancy. So her mother did.

His head dropped in disbelief, Evelyn’s mom recalled. “Go talk to her. She needs you,” she told him.

Her dad gave Evelyn a long hug in the kitchen. He was shocked, disappointed and hurt. She should have come to them sooner for help, he told her.

Her parents assured her they would support any decision she made, including placing the baby up for adoption.

Two weeks later, on Nov. 10, her mom began timing Evelyn’s contractions. Evelyn had initially mistaken the throbbing for gallbladder pain. She quickly packed a hospital bag. Six hours later, she gave birth.

Two hours east, in Houston, Carolyn Whiteman, a human resources executive for a chemical company, had been struggling with becoming a mother for years.

In 2020, she had tested positive for BRCA2, a hereditary gene that puts her at increased risk of developing ovarian and breast cancer. Her OB/GYN told her she would need to have her ovaries and uterus removed in her mid-40s.

She had always seen herself as a career-oriented Black woman who should have been married with kids in her mid-30s.

Now she was out of time and couldn’t wait any longer if she wanted to be a mom.

At 41, Whiteman underwent two cycles of egg freezing, in 2021. She froze 24 eggs and felt “pretty lucky.”

For three months, she says she meticulously searched cryobank websites daily for at least an hour. She joined Facebook groups for women looking for donors. There, she read posts from other Black women expressing the same struggle: There were hardly any Black sperm donors .

[ America has a Black sperm donor shortage. Black women are paying the price. ]

A few months after Whiteman ended her sperm donor search, her younger sister, Anika, sent her an Essence magazine article about a single woman who had adopted a baby at 49 after she too froze her eggs. Whiteman began researching private open domestic adoption , an increasingly common choice for keeping birth parents involved in the child’s life.

Whiteman met the income requirements and had good references. She confidently called two adoption agencies in early 2022 but was rejected because she wasn’t married.

She was devastated but contacted three other adoption agencies. They couldn’t help her either. They already had long waitlists and weren’t accepting applications from new prospective parents, they told her. Another door is closed, Whiteman remembers thinking.

Then a co-worker referred her to another agency, Gladney, which accepted her application. There was a need for more Black adoptive parents and it would make her an attractive applicant to many birth parents, she was told. It was expensive — $50,000 — and took months as she went through various interviews and trainings. But she finally had hope.

Her profile went live on the agency’s website in October 2022. “I will ensure you always hold an honored place in your child’s life,” Whiteman wrote in her letter to prospective parents. She prepared for a lengthy wait that she was told could last two years.

Evelyn had not had any prenatal care and didn’t know the gender of her baby until she delivered. But the baby, a girl, was healthy.

It felt like whiplash. She had tried for months not to have the child she was silently cradling. And she says she quickly discovered she was in love.

She took selfie videos, with playful social media filters, holding her daughter. Her photo album quickly filled with videos of Evelyn bottle-feeding, learning to swaddle and admiring the baby’s fussy sounds.

She named her Kaya, the same name Evelyn had been given at birth — before she was adopted.

She was becoming attached but knew the decision she wanted to make.

The next day, Evelyn chose five prospective families to interview. But after reading Whiteman’s profile four or five times, she gravitated toward the woman’s warmth. Evelyn admired all of the pictures of Whiteman’s family and friends and how she talked about traveling, working out and spoiling her goddaughters. To Evelyn, she seemed like someone who was “ready to give a child everything.”

When they met over Zoom, the women say they talked of spirituality, faith and the importance of family time.

Whiteman mentioned that she was on the local board of Girls Inc., a nonprofit that encourages young girls to become leaders. Evelyn smiled. “I was part of Girls Inc. when I was younger,” she told Whiteman.

Eight hours later, Whiteman received a call from the adoption agency.

She was about to become a mom.

She hung up, went online and signed up for an infant CPR class scheduled for 8 a.m. the next day.

The next 10 days were chaotic.

Whiteman hired a nanny and started shopping. She tested strollers and bought a formula maker.

Evelyn and her mom picked out a fluffy, light-pink dress from a children’s store for the baby to wear on adoption day. They went to a craft store and bought soft fabric with rainbows on it. Evelyn knit the fabric into a baby blanket.

Adoption on the rise

The night before Evelyn was to turn her baby over, on Nov. 29, 2022, the women traveled to Fort Worth and met in person for the first time over a chicken quesadilla dinner. Whiteman had grown nervous that Evelyn would change her mind but learned she had already signed the relinquishment papers.

The soon-to-be mom told Evelyn she had always loved the name Olivia.

“In honor of you, I want to keep the name that you had for her. So I will name her Olivia Kaya-Simone,” Whiteman told her.

Evelyn hadn’t taken Olivia home when she left the hospital, worried it would be too hard to parent her while the adoption was finalized.

In the moments before officially handing Olivia over to Whiteman, Evelyn sat alone with Olivia in a Gladney office and whispered: “I love you, I love you, I love you.” She kissed Olivia’s forehead and promised she would have a great life with Whiteman.

Eventually, when she was ready, Evelyn walked into a room as her parents followed her. Nearly all of Whiteman’s family was there recording the moment and taking pictures. Face red with tears, Evelyn handed her child to her new mom. The two women sat and held hands for two hours.

Their case workers allowed them some time alone. Before they left, Evelyn says she wanted to explain to Whiteman how she had become pregnant and tell her about her abortion attempts.

“I really hope you won’t judge me,” she told her.

In the weeks after the adoption, Evelyn says she barely left home. She cried every day and slept with Olivia’s hospital clothes next to her for comfort. Her mother held her and said it would be okay.

She was sad but confident about her decisions, including her failed abortion attempts. A therapist helped her make peace with the guilt.

Olivia was in a good place, and Evelyn would get to watch her grow up, her therapist assured her.

As she grappled with her feelings, she watched the abortion landscape that had tripped up her decision to end her pregnancy continue to tighten. Twenty states had enacted laws limiting abortion access. The clinic in San Antonio she initially went to for an abortion closed, and the Oklahoma clinic that gave her medication abortion pills relocated to Illinois.

Other women should have the same choices she had, Evelyn remembers thinking, including an abortion.

Slowly, Evelyn’s fog began to lift. In January 2023, her academic dismissal period ended, and she enrolled in classes at a community college. To return, she was required to submit a letter to the dean and wrote about her unplanned pregnancy and how much restarting her education meant to her.

She attended every lecture, went to tutoring and turned in her assignments on time. She passed all of her classes and, for the first time, earned straight A’s.

“I’m going to use everything I went through to motivate me,” Evelyn remembers telling her mom. “I want Olivia to grow up and be proud of me.”

In the summer, she applied to a four-year historically Black college near Houston. “So pleased to hear you are back on track to continue your higher education,” the acceptance letter said.

Eleven months after giving birth, Evelyn poured buttermilk pancake mix onto a hot pan, a late breakfast for herself and her new roommate before class. She had moved into an off-campus apartment, her first time living away from her parents, and was basking in life as a college student.

She goes to the gym four days per week, attends a midweek Bible study meeting on campus and is looking for a criminal justice internship. She goes out with her friends on the weekends and hopes to try out for the club volleyball team next year.

But she and her roommate were still getting to know each other, and Evelyn hadn’t told her about her pregnancy yet.

Instead, her roommate watched as Evelyn giggled in excitement about a birthday party planned for a new friend on campus the next night. She reviewed the contents of her overstuffed closet, looking for an outfit and pulling out different crop top options.

“I’m trying to shop my closet. I don’t want to spend money on a new outfit,” Evelyn told her.

But the evidence of Olivia is everywhere. Evelyn sleeps with a gray 6-pound, 11-ounce teddy bear — Olivia’s birth weight — that her Gladney caseworker gave her after she relinquished custody.

In the morning, she fluffs her hair and swipes through videos of Olivia on her phone.

She watches clips of the 1-year-old sitting in a highchair and stuffing cereal into her mouth. In another, Olivia is having her ears pierced.

Receiving Whiteman’s photos and videos of Olivia over the months had comforted Evelyn, but seeing her for the first time in a year, holding her, would be different.

She had longed for this planned reunion for months — circling the date in her spiral planner, buying a small gift.

Whiteman had bought matching mommy-and-daughter multi-print dresses for herself and Olivia. She asked Evelyn to wear a bright-orange top so that they would all coordinate.

On a sunny fall afternoon, Evelyn drove 45 minutes to the townhouse where Whiteman had said they would reunite. Her parents traveled two hours to join her. Evelyn again laid eyes on the baby she had given birth to.

In the kitchen, Whiteman gave her updates about Olivia, telling her about the baby’s love of Elmo, Ms. Rachel videos on YouTube and the more than 90 bows she had collected to coordinate with her outfits. “Bows are the new barrettes,” Whiteman joked.

While sitting next to Whiteman on the couch, Evelyn rolled up the left pant leg of her skinny jeans and showed her a small tattoo on her ankle — a heart inside a triangle.

“The three points represent the birth mother, the adoptive mother and baby,” Evelyn said. “The heart represents the love they all share.”

It was a tattoo she had gotten years earlier to represent her own adoption, but it had taken on new meaning.

Whiteman watched as Evelyn studied Olivia’s every feature, took Snapchat pictures, and bounced her up and down in a corner of the living room.

“The more people who love Olivia, the better,” Whiteman said as she watched the two play.

As the sun began to set, Evelyn and her parents prepared to leave. She caressed Olivia’s soft curls and gently kissed her on the forehead.

She left a children’s book written by Gabrielle Union and Dwyane Wade on the dining room table. On the inside cover, she wrote: “Olivia, With this book, I hope you will grow to love reading. I love you forever! — Evelyn.”

Leaving the reunion, Evelyn felt a flush of calm. Olivia was happy.

On the car ride home, she received a text from Whiteman. It contained details about a garden brunch. Evelyn and her parents were invited to Olivia’s first birthday party the next month, where they would play Olivia Trivia.

There was no doubt, Evelyn knew. She would be there.

About this story

Story editing by Renae Merle . Photo editing by Natalia Jiménez . Design by Elena Lacey. Design editing by Junne Alcantara . Copy editing by Ryan Weber and Phil Lueck. Video editing by Drea Cornejo . Senior video producing by Jayne Orenstein and Tom LeGro . Videography by Reshma Kirpalani and Amber Ferguson . Audio production by Charla Freeland . Project editing by Jay Wang and Ana Carano.