Md. Unintended Pregnancy Rate Drops, Remains Higher than National Average


In 2008, 48 percent of unintended pregnancies in Maryland resulted in births, 39 percent in abortions and 13 percent in fetal losses, according to the Guttmacher Institute

COLLEGE PARK, Md.—Maryland’s rate of unintended pregnancies declined during the last decade, but more than half of all pregnancies in the state are still unplanned, according to estimates released this month.

The percent of unintended pregnancies in Maryland dropped from 60 percent to 56 percent between 2002 and 2008 – a 4 percentage point decrease – according to the Guttmacher Institute, a nonprofit organization that seeks to advance sexual and reproductive health.

The decrease can be attributed to a decline in sexual activity and a greater use of effective birth control methods, specifically among teenagers, said Helen P. Koo, a senior research demographer who has conducted research on unintended pregnancies and contraception at RTI International, a nonprofit organization.

“Teens contribute to the biggest portion of unintended pregnancy,” Koo said. “They have a very high rate because when they’re pregnant, in almost all cases they’re not wanting it.”

Maryland’s teen pregnancy rate has dropped 51 percent since 1988, compared with a 39 percent decrease nationally, according to The National Campaign to Prevent Teen and Unplanned Pregnancy.

The decline in teen pregnancy can be attributed to increased education, family planning groups said. Planned Parenthood has reached out to teens on contraception and family planning by expanding education programs and providing more peer educators, said David E. Hale, vice president for external relations of Planned Parenthood of Maryland.

“There has been a historic decline in the teen birth rate,” Hale said. “And we believe we have contributed to part of that through our education program.”

Despite the decline, Maryland’s percent of unintended pregnancies remained 5 percent higher than the national average. In 2008, the most recent year for which detailed data was available, 49 percent of the pregnancies in the United States were unintended.

In that same year, 48 percent of unintended pregnancies in Maryland resulted in births, 39 percent in abortions and 13 percent in fetal losses, according to Guttmacher.

“Unintended pregnancy rates have poor birth outcomes,” said Ilise Marrazzo, director of the Maternal and Child Health Bureau at the Maryland Department of Health and Mental Hygiene. “The state’s infant mortality rate has hit a new record low partly due to the decline of unintended pregnancies.”

Women with the fewest years of education have the highest unintended pregnancy rate, according to the institute. Over the last decade, more women in Maryland graduated from high school and college, helping to reduce the rate.

Between 2005 and 2011, the percentage of Maryland women with a bachelor’s degree or higher increased from 33.1 to 36.9 percent, and from 87.8 to 89.6 percent for high school and higher, according to the U.S. Census.

In addition to teens, low-income women and African-American women have higher than average unintended pregnancy rates. The rate for poor women is more than five times the rate for women earning the most money, according to Guttmacher. And poor women often cannot afford effective birth control methods.

The Choice Project, a research project by Washington University School of Medicine in St. Louis that examined the financial barriers to contraception, found that when cost is not a factor, women chose the most effective methods of contraception. Maryland officials have attempted to help poor women by giving them low-cost access to birth control and family planning.

Marrazzo said expanding the Title X Family Planning program – a federal grant program dedicated to family planning and reproductive health for low-income and uninsured patients – is giving more low-income women access to family planning and alternative methods of contraception, such as implants, IUDs and long-acting reversible contraception.

“No one is ever turned away because of inability to pay,” she said.

Publicly supported family planning and contraceptive services like Title X helped avert 22,300 unintended pregnancies in the state in 2010, saving the federal and state government $139.2 million in Medicaid costs, according to Guttmacher.

Maryland saw a 19 percent increase in the number of clinics providing these publicly supported family planning services from 2001 to 2010, according to Guttmacher.

Marrazzo said she was hopeful the unintended pregnancy rate will continue to decrease as a result of the 2012 state Medicaid expansion that guarantees insured women access to family planning services and contraception without co-pays. And with more women expected to be covered by the Affordable Care Act in 2014, the rate will continue to decline, she said.

“The hope is that when more women become insured, they will be able to utilize the most effective methods of contraception and reduce unintended pregnancy,” Marrazzo said.

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