Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth

Context: The incidence of unintended pregnancy has long been used as a prim ary indicator of the state of reproductive health. However, the definition- and therefore the measurement-of this indicator has been elusive. Methods: Data from the 1995 National Survey of Family Growth (NSFG) were us ed to compare levels of unintended pregnancy among contraceptive users base d on two definitions-the standard definition based on women's reports of co ntraceptive failure, and the NSFG definition based on pregnancy timing (wan ted then, wanted later, or not wanted then or in the future). An attitudina l scale was used to examine women's feelings about their unintended pregnan cy. Results: Of pregnancies classified as contraceptive failures under the stan dard definition, only 68% were unintended pregnancies-94% of those ending i n abortion and 60% of those ending in birth. Just 59% of women with a contr aceptive failure classified as an unintended pregnancy reported feeling unh appy or very unhappy about their pregnancy, while 90% of those with a failu re classified as an intended pregnancy reported being happy or very happy. Conclusions: Measures of wantedness based on women's feelings about their p regnancy may correlate more closely with important pregnancy outcomes than do traditional measures of intendedness.