Original Investigation

Pregnancy Preferences and Incident Pregnancy in the US

JAMA Network Open 10.1001/jamanetworkopen.2025.36697

October 09, 2025 at 11:00 AM EDT

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What is the association of pregnancy preferences with incident pregnancy, and are there differences by sociodemographic characteristics?In this cohort study of 18 603 longitudinal observations among representative samples of reproductive-aged females in 9 US states, 3% of those who desired to avoid pregnancy became pregnant annually, compared with 25% of those open to pregnancy. Pregnancy, accounting for preferences, differed significantly by age, parity, prior-year birth, cohabitation with a romantic partner, education level, employment, and racial and ethnic identity.These results highlight potential reproductive inequities and may be used to inform public health efforts to provide contraception, abortion, preconception, and fertility care.

Corresponding Author: Corinne H. Rocca, PhD, Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing New Standards in Reproductive Health, University of California, San Francisco School of Medicine, 1330 Broadway, Ste 1100, Oakland, CA 94612 (corinne.rocca@ucsf.edu).

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