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.

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.

Unplanned pregnancy is common among abused women. Research has found that some abusers force their partners to have sex without birth control and/or sabotage the birth control their partners are using, leading to unplanned pregnancy. If you have an abusive partner, get help now. Violence can hurt you and your pregnancy and have long-lasting effects on your children. About 1 in 2 men who abuse their wives also abuse their children. And children who grow up with violence in the home are more likely to become abusers as adults and have physical and emotional problems.

To get help right now, call the National Domestic Violence Hotline at 800-799-SAFE (7233) and 800-787-3224 (TTY). Spanish speakers are available.

If you have an unplanned pregnancy, you might not know what to do next. You might worry that the father won't welcome the news. You might not be sure you can afford to care for a baby. You might worry if past choices you have made, such as drinking or drug use, will affect your unborn baby's health. You might be concerned that having a baby will keep you from finishing school or pursuing a career. If you are pregnant after being raped, you might feel ashamed, numb, or afraid. You might wonder what options you have. Here are some next steps to help you move forward:

• Start taking care of yourself right away. Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) folic acid every day. Stop alcohol, tobacco, and drug use.
• Make a doctor's visit to confirm your pregnancy. Discuss your health and issues that could affect your pregnancy. Ask for help quitting smoking. Find out what you can do to take care of yourself and your unborn baby.
• Ask your doctor to recommend a counselor who you can talk to about your situation.
• Seek support in someone you trust and respect.

Preconception health and health care services 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.

In the United States, there are two types of FDA-approved ECPs available for emergency contraception:

• ella® (ulipristal acetate)
• Plan B One-Step® (LNG-only) — Plan B One-Step® has several generic versions. Some common generic versions include AfterPill™, My Way®, Next Choice One Dose™, and Take Action™.

Emergency Contraception (EC): May be used if you did not use birth control or if your regular birth control fails (such as a condom breaks). It should not be used as a regular form of birth control.

What is it?

• A pill that blocks the hormone progesterone.
• It helps prevent pregnancy after a birth control failure or unprotected sex.
• It works mainly by stopping or delaying the ovaries from releasing an egg. It may also work by changing the lining of the womb (uterus) that may affect attachment (implantation).

How do I use it?

• For the best chance for it to work, you should take the pill as soon as possible within 120 hours after unprotected sex.

How do I get it?

• You need a prescription from a healthcare provider.

Chance of getting pregnant

• In two large studies, 60 to 66% of expected pregnancies were prevented with correct use of ulipristal acetate.

Most Common Side Effects

• Headache
• Nausea
• Abdominal pain
• Menstrual pain
• Tiredness
• Dizziness

Does it protect me from sexually transmitted infections (STIs)? No.

Emergency Contraception (EC): May be used if you did not use birth control or if your regular birth control fails (such as a condom breaks). It should not be used as a regular form of birth control.

Levonorgestrel 1.5 MG (1 pill)

What is it?

• It is a single pill containing progestin hormone.
• It helps prevent pregnancy after a birth control failure or unprotected sex.

How does it work?

• It works before release of an egg from the ovary. As a result, it usually stops or delays the release of an egg from the ovary.
• For the best chance for it to work, you take the pill as soon as possible within 72 hours after unprotected sex or birth control failure.

How do I get it?

• You can buy it over-the-counter. You do not need a prescription.

Chance of getting pregnant

• One large study showed 7 out of every 8 women who would have gotten pregnant did not become pregnant after taking emergency contraception; other studies have resulted in lower pregnancy prevention rates.

Some Side Effects

• Menstrual changes
• Headache, nausea, vomiting, dizzines
• Lower stomach (abdominal) pain
• Breast pain
• Tiredness

Does it protect me from sexually transmitted infections (STIs)? No.

An abortion is a procedure to end a pregnancy. It can be done two different ways:

• Medication abortion, which uses medicines to end the pregnancy. It is sometimes called a "medical abortion" or "abortion with pills."
• Procedural abortion, a procedure to remove the pregnancy from the uterus. It is sometimes called a "surgical abortion."

If you are thinking of having an abortion, talk with your health care provider. Your provider can explain how the procedures are done, as well as the risks and benefits of each.

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.