Original research article| Volume 97, ISSUE 4, P313-318, April 2018

Race and ethnicity may not be associated with risk of unintended pregnancy

  • Author Footnotes
    1 Present address: University of California, San Francisco Medical School, 513 Parnassus Ave, San Francisco, CA 94143.
    Shakkaura Kemet
    1 Present address: University of California, San Francisco Medical School, 513 Parnassus Ave, San Francisco, CA 94143.
    Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT 06510
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  • Lisbet S. Lundsberg
    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, New Haven, CT 06510
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  • Aileen M. Gariepy
    Corresponding author. Tel.: +1 203 737 4665, +1 203 737 6476; fax: +1 203 737 6195.
    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, New Haven, CT 06510
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  • Author Footnotes
    1 Present address: University of California, San Francisco Medical School, 513 Parnassus Ave, San Francisco, CA 94143.



      The objective was to use improved measures and methodology to investigate whether race and ethnicity are associated with unintended pregnancy.

      Study design

      Cross-sectional study of English- or Spanish-speaking women, aged 16–44, with pregnancies <24 weeks' gestation recruited from pregnancy testing and abortion care sites in New Haven, CT, between June 2014 and June 2015. Participants completed self-assessments of race, ethnicity and multidimensional measures of pregnancy “context,” including timing, intention, wantedness, desirability, happiness and planning (measured with the London Measure of Unplanned Pregnancy). Multivariable analysis was performed, adjusting for maternal demographics, language, recruitment site, substance use and medical conditions including history of depression.


      Among 161 participants (mean age=27.2±6.6 years), mean gestational age was 9±4.6 weeks. Overall, 14% self-identified as White non-Hispanic, 37% Black non-Hispanic, 42% Hispanic and 7% multiracial. Most (85%) were unmarried, and 75% had at least one child. After adjustment, happiness about new pregnancies was more likely among Black non-Hispanic than White non-Hispanic women OR=5.66 (95%CI: 1.51–21.20). Neither race nor ethnicity was significantly associated with pregnancy intention, wantedness, planning, timing or desirability.


      In a diverse cohort with multiple, antenatal measures of pregnancy context, neither race nor ethnicity is significantly associated with unintended pregnancy, as previous studies reported. Black non-Hispanic women were more likely to report happiness about new pregnancies than White non-Hispanic women. This study improves upon previous analyses that used retrospective and limited assessments of pregnancy intention, excluded women with miscarriages or abortions, and lacked adjustment for confounding.


      Evaluation of multidimensional pregnancy contexts assessed antenatally is important and may capture the experiences of women more accurately, especially Black and Hispanic women.


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