Commentary| Volume 75, ISSUE 3, P168-170, March 2007

Download started.


The cost of unintended pregnancy in the United States



      Despite the many contraceptive options available in the United States, nearly half (49%) of the 6.4 million pregnancies each year are unintended; these represent a significant cost to the health care system.


      The total number of unintended pregnancies and their outcomes were obtained from the literature. Direct medical costs were estimated for each unintended pregnancy outcome.


      The direct medical costs of unintended pregnancies were US$5 billion in 2002. Direct medical cost savings due to contraceptive use were US$19 billion.


      Unintended pregnancies are a costly problem in the United States. Contraceptive use can reduce direct and indirect costs; hence, payers may realize cost savings by providing coverage of contraceptive products.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Finer L.B.
        • Henshaw S.K.
        Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.
        Perspect Sex Reprod Health. 2006; 38: 90-96
        • Ortmeier B.G.
        • Sauer K.A.
        • Langley P.C.
        • Bealmear B.K.
        A cost���benefit analysis of four hormonal contraceptive methods.
        Clin Ther. 1994; 16: 707-713
        • Phillips C.J.
        Economic analysis of long-term reversible contraceptives. Focus on Implanon.
        Pharmacoeconomics. 2000; 17: 209-221
      1. Trussell J, Koenig J, Stewart F, Darroch JE. Medical care cost savings from adolescent contraceptive use. Fam Plann Perspect 1997;29:248���55, 295.

        • Trussell J.
        • Leveque J.A.
        • Koenig J.D.
        • et al.
        The economic value of contraception: a comparison of 15 methods.
        Am J Public Health. 1995; 85: 494-503
        • Chiou C.F.
        • Trussell J.
        • Reyes E.
        • et al.
        Economic analysis of contraceptives for women.
        Contraception. 2003; 68: 3-10
        • Chandra A.
        • Martinez G.M.
        • Mosher W.D.
        • Abma J.C.
        • Jones J.
        Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth.
        Vital Health Stat 23. 1997;
        • Mosher W.D.
        • Martinez G.M.
        • Chandra A.
        • Abma J.C.
        • Wilson S.J.
        Use of contraception and use of family planning services in the United States: 1982���2002. Advance data from vital and health statistics, no 350.
        National Center for Health Statistics, Hyattsville (MD)2004
      2. Brown S.S. Eisenberg L. The best intentions: unintended pregnancy and the well-being of children and families. National Academy Press, Washington (DC)1995: 81
      3. Henshaw SK. Unintended pregnancy in the United States. Fam Plann Perspect 1998;30:24���9, 46.

        • Smith K.
        • Downs B.
        • O'Connell M.
        Maternity leave and employment patterns: 1961���1995. Current population reports. U.S. Census Bureau, Washington (DC)2001: 70-79
        • Trussell J.
        The essentials of contraception: efficacy, safety, and personal considerations.
        in: Hatcher R.A. Trussell J. Stewart F. Contraceptive technology. 18th rev ed. Ardent Media, New York (NY)2004: 224
        • Trussell J.
        Contraceptive failure in the United States.
        Contraception. 2004; 70: 89-96
        • Trussell J.
        • Wiebe E.
        • Shochet T.
        • Guilbert ��.
        Cost savings from emergency contraceptive pills in Canada.
        Obstet Gynecol. 2001; 97: 789-793
        • Trussell J.
        • Shochet T.
        Cost-effectiveness of emergency contraceptive pills in the public sector in the USA.
        Expert Rev Pharmacoecon Outcomes Res. 2003; 3: 433-440
        • Trussell J.
        • Calabretto H.
        Cost savings from use of emergency contraceptive pills in Australia.
        Aust N Z J Obstet Gynaecol. 2005; 45: 308-311
        • Sonfield A.
        • Gold R.B.
        • Frost J.J.
        • Darroch J.E.
        U.S. insurance coverage of contraceptives the impact of contraceptive coverage mandates, 2002.
        Perspect Sex Reprod Health. 2004; 36: 72-79
      4. Insurance coverage of contraceptives. State policies in brief.
        Guttmacher Institute, New York (NY)2006
      5. Women's health care: understanding the cost and value of contraceptive benefits.
        Mercer Human Resource Consulting, New York (NY)2005