Live births resulting from unintended pregnancies: Is there variation among states?

Context: States need data on live births resulting from unintended pregnanc ies in order to assess the need for family planning services; however, many states do not collect such data. Some states may use extrapolated rates fr om other states. Methods: Pregnancy Risk Assessment Monitoring System (PRAMS) data were asse ssed to explore the feasibility of extrapolating data on the percentage of live births resulting from unintended pregnancies from states that collect these data to states that do not. Data on women who had live births between 1993 and 1995 were examined for eight states: Alabama, Florida, Georgia, M ichigan, New York (excluding New York City), Oklahoma, South Carolina and W est Virginia. Logistic regression was used to determine state variation in the odds of delivering a live birth resulting from an unintendedpregnancy a fter adjustment for maternal race, marital status, age, education, previous live birth and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Results: The percentage of live births resulting from unintended pregnancy ranged from 33% in New York to 49%:, in Alabama, Georgia and South Carolina . Compared with women in Alabama, women in Oklahoma were more likely to del iver a live birth resulting from an unintended pregnancy (odds ratio of 1.2 , confidence interval of 1.1-1.3) and women in New York State were less lik ely (odds ratio of 0.7, confidence interval of 0.6-0.8) to have such a birt h. However, unmarried white women in New York had lower odds of having a li ve birth resulting from an unintended pregnancy and married black women in Michigan had higher odds of having a live birth resulting from unintendedpr egnancy than their counterparts in Alabama. Although the percentages varied , in all eight states women who were black, were unmarried, were younger th an 20 years of age, had less than 12 years of education or had more than on e child had higher percentages of live births resulting from unintended pre gnancy than women with other demographic characteristics. Conclusions: Data on which women have the greatest risk of delivering a liv e birth resulting from an unintended pregnancy may be extrapolated from one state to another, but the rate of such births may overestimate or underest imate the problem from one state to another.