CONTEXT: Nearly half of all pregnancies in the United States are unintended. These pregnancies likely represent a
substantial cost to taxpayers, but national-level estimates of these public costs have been lacking.
METHODS: Taxpayer spending on unintended pregnancy is measured by multiplying estimates of the 2001
incidence of publicly financed unintended pregnancy outcomes (abortions, fetal losses, births and need for
infant medical care) by average per-incident costs. Public savings that would result from preventing unintended
pregnancies are estimated by assuming that the prevention of an unwanted pregnancy would save the full cost
of financing the pregnancy, while the prevention of a mistimed pregnancy would save the cost of financing the
pregnancy today minus the present value of the cost of financing the pregnancy when it eventually occurs.
RESULTS: Lower-bound, mean and upper-bound estimates of the annual cost of unintended pregnancy are,
respectively, $9.6 billion, $11.3 billion and $12.6 billion. Corresponding estimates of the savings that would accrue to
taxpayers by preventing unintended pregnancies are $4.7 billion, $5.6 billion and $6.2 billion. The mean estimate of
the taxpayer cost per publicly subsidized unintended pregnancy is $9,000; the prevention of such a pregnancy would
save taxpayers about half that amount.
CONCLUSIONS: The prevention of unintended pregnancy represents an important opportunity for the public to reap
substantial savings, especially given the current fiscal climate. The enactment or expansion of cost-effective policies
to prevent unintended pregnancies is therefore a timely and sensible strategy.