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Options for Unintended Pregnancies

CHRISTINA VALERIO, MD, MPH, MARIAH NORBY, DO, AND PATSY KREMSREITER, MD

Am Fam Physician. 2025;111(4):352-360
This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Unintended pregnancies, which include pregnancies that are unplanned, mistimed, or unwanted, account for 42% of all pregnancies. In addition to obtaining a thorough history and performing a physical examination, family physicians are integral in providing counseling and resources to patients with unintended pregnancies. In accordance with the American Academy of Family Physicians policy statement, counseling should remain nonjudgmental and unbiased. Options include continuing the pregnancy and parenting, continuing the pregnancy and pursuing adoption, or having a medication or procedural abortion. If a patient chooses to parent the infant, physicians should be equipped to offer local resources. Physicians are not authorized to broker adoptions. Medication and procedural abortions are safe and effective for patients who choose abortion.

Unintended pregnancies are unplanned, mistimed, or unwanted. Between 2010 and 2019, the overall pregnancy rate (estimated number of pregnancies in women 15–44 years of age) declined by 12%; however, the rate of unintended pregnancies only declined from 43% to 42%.1 Groups with the highest unintended pregnancy rates include females who are 20 to 24 years of age, patients who are non-Hispanic Black, and those who are unmarried.1 There are limited data on rates of unintended pregnancies in transgender men; one small survey of 41 transgender men found a rate of 24% and showed that this population has unique needs.2 Because most of the cited studies and guidelines use the term women, this article uses the same term or female to include cisgender women and patients with similar reproductive potential.

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