Unwanted pregnancies over the life course – Results of the “women´s lives 3” study

Funded by the BZgA, “women’s lives 3” conducted representative surveys on family planning in four survey phases in various federal states between 2012 and 2020. To provide additional in-depth insights, it includes over 130 qualitative interviews conducted with women on specific issues or circumstances – such as pregnancies at a very young age or in violent relationships. The key approach of this mixed-method design study is the consistent consideration of the life-course perspective in the investigation of family planning: The desire to have children, contraception, pregnancies and pregnancy termination are not considered as isolated individual events but rather in the context and in the chronological order of biographical experiences. It understands family planning comprehensively, as the totality of all decisions and developments that shape private lives – with or without a child. Prof. Dr Cornelia Helfferich conceived the study as part of her more than 25 years of research on family planning, implemented at the Sozialwissenschaftliches Forschungsinstitut zu Geschlechterfragen Freiburg (SoFFI F.; Social Science Research Institute on Gender Issues Freiburg), which she founded and led until her death in 2021.

The surveys and analyses of “women’s lives 3” focused on individual federal states to offer tailor-made support in the strategic and content planning of prevention and sexuality education at the state level. Now that all surveys have been completed, representative nationwide survey data on family planning and family life are available from over 19,000 women aged between 20 and 44, who report around 22,700 pregnancies – a unique database.

Focal points of “women’s lives 3” were the prevalence and background of unwanted pregnancies. In general, research in this area in Germany and internationally is faced with the challenge of clearly defining the term “unwanted pregnancy”. Undoubtedly, there are wanted pregnancies and, equally undoubtedly, unwanted pregnancies. However, also a key finding of the qualitative analyses from “women’s lives 3” is that, in reality, pregnancy intentions are often less clear and characterised by contradictions, ambivalences and varying degrees of (un)intentionality.

"women’s lives 3” defines unwanted pregnancies in a narrower sense, namely, as those pregnancies the interviewees themselves explicitly described as unwanted. They form a subset of all unintended pregnancies, which includes all pregnancies that are not explicitly wanted. The latter includes, for example, pregnancies with unclear or ambivalent intentions. The assessment of unintended/intended refers to the time at which the pregnancy occurred. The “women’s lives 3” study generally categorises all terminated pregnancies as unwanted pregnancies.

One in five women surveyed (20.6 %) aged 40 and over has unwantedly become pregnant at least once in the course of her life. More than one in three respondents (34.9 %) aged 40 and over have had at least one unintended pregnancy. As Figure 1 shows, around 70 % of all pregnancies carried to term or terminated are wanted at the time. This also includes pregnancies that were actually wanted earlier (approx. 1%).

In contrast, just under 30 % of all pregnancies are unintended. This includes around 12 % of pregnancies that were basically wanted, albeit at a later date. In a further 2-3 % of pregnancies, the women were ambivalent or undecided. Explicitly unwanted pregnancies account for 15 % of all pregnancies; more than half of these are carried to term (55 % of all unwanted pregnancies), and 45 % are terminated.

The “women’s lives 3” data show that unwanted pregnancies occur with a comparable frequency throughout women’s fertile phase of life: Between the ages of 19 and 35, around 10 out of every 1,000 women in an age group become unintentionally pregnant, and the prevalence decreases with age. Among women over 40, like minor women, there are less than 5 unintended pregnancies per 1,000 women of the same age (see Figure 2).

While unwanted pregnancies are similarly widespread across all age groups, intended and planned pregnancies are particularly common between the ages of 28 and 34. If we look at the proportion of unwanted pregnancies among all pregnancies, we see that it is particularly low in this age range. Among younger women under the age of 20, on the other hand, pregnancies are more often unwanted than intended, meaning that the proportion of unwanted pregnancies among all pregnancies is highest in this age group. Nevertheless, it would be misleading to regard unwanted pregnancies as an issue that mainly affects young women.

The biographical situation significantly influences the course of pregnancy. “women’s lives 3” also analysed the links between wanted/unwanted pregnancy and life circumstances regarding partnership, professional and financial situation, health and other aspects. A direct comparison shows that, in all areas analysed, difficult life circumstances are significantly more common in cases of unwanted pregnancies than in cases of wanted pregnancies (see Table 1).

In over two-thirds of unwanted pregnancies (68 %), the professional and/or financial situation of the woman is of limited suitability for having a child. 46 % of women with unwanted pregnancies report health concerns/problems; in 42 % of unwanted pregnancies, one or more characteristics indicate a difficult or absent partnership; and 60 % of the women who did not want to become pregnant mention other difficult or unsuitable life circumstances, such as feeling too young and immature, an inadequate living situation or a heavy workload because of caring for children or other relatives.

While almost half (48 %) of the women who became pregnant intentionally did not mention any difficult life circumstances at all and a further 30 % mentioned difficulties in just one area, an accumulation of unfavourable life circumstances is typical for unwanted pregnancies: Over two-thirds of women who did not want to become pregnant referred to unfavourable circumstances in two or more areas of life, while only 11 % mentioned no difficulties at all. (Note that the respondents were asked about their biographical situation at the time of – and not during or after – pregnancy.) Difficult life circumstances can therefore often be considered the cause of a pregnancy being deemed unwanted.

As shown above, unwanted pregnancies occur with almost the same frequency throughout most of a woman’s fertile phase. What changes with age, however, are the typical difficult biographical situations of unwanted pregnancies. The younger the woman is when she has an unwanted pregnancy, the more common her difficult life circumstances tend to be. This occurs particularly because many young women have not yet fully established themselves in their careers, i.e., typically they have not yet completed their education. But it is also valid for professional and financial uncertainties during early career phases and obstacles in reconciling family and career. Further, younger women’s partnerships are frequently not yet sufficiently consolidated to provide a reliable basis for starting a family. In addition, the self-assessment of being too young and immature for children or living in an inadequate housing situation are more common among younger women. Accordingly, an accumulation of difficult life circumstances occurs more commonly among younger women in particular.

Health concerns – both regarding themselves and the unborn child – are significantly more important to older women who have unwantedly become pregnant than to younger women. More than 60% of women 35 or over who have unwantedly become pregnant cite reduced well-being or health concerns.

Around half of all unwantedly pregnant women over the age of 30 cite occupational and financial circumstances, including in particular obstacles to reconciling family and career, as difficult framework conditions for pregnancy.

Looking beyond difficult life situations, with increasing age the fact that family planning has already been completed and the desired family size has already been reached becomes increasingly relevant as the background to an unwanted pregnancy. This applies to just under half (48 %) of all unwanted pregnancies among women aged 30 to under 35, and to 71 % of unwanted pregnancies among women aged 35 and over.

Pregnancy and family counselling centres are an important pillar of support for pregnant women. As the “women’s lives 3” data clearly show, counselling centres are particularly frequently visited by women who are pregnant for the first time or who find themselves in difficult life situations – and who can therefore be assumed to have a greater need for counselling. Counselling for pregnancies that are ultimately terminated is not included in the analysis presented here, as in Germany counselling is always mandatory for pregnancy termination outside of regulations ­­determining indication. In addition, the analysis is limited to pregnancies from 2007 onwards.

In total, 13 % of all women whose pregnancies ultimately led to births sought consultation in counselling centres. For women bearing their first child, utilisation was significantly higher at 18 %. Pregnancy and family counselling centres also tend to be used more frequently the more the personal situation during the pregnancy is characterised by an accumulation of difficult life circumstances. In cases of three areas of difficult life circumstances, 26 % of the pregnant women consulted the services of pregnancy and family counselling centres. 44 % of particularly stressed pregnant women with difficult circumstances in all four areas of life surveyed sought out counselling centres.

In the case of explicitly unwanted pregnancies, 35 % of the women – and thus particularly frequently – sought consultation at a counselling centre. If it was the woman’s first pregnancy carried to term, the counselling services were used in almost half of the cases (49 %). Women also sought counselling more frequently than average for pregnancies in which the woman was unsure what to do or who only wanted to get pregnant at a later date.

In the case of unwanted and unintended pregnancies, the most frequently requested counselling topics concerned information on help available in financial emergencies, parental benefits and other financial issues as well as personal problems. Pregnancy conflict counselling in accordance with Paragraph 219 StGB was desired by just over a quarter of women experiencing an unwanted pregnancy who attended counselling and ultimately carried the pregnancy to term.

Even though the study posed no in-depth questions assessing the counselling services, these results reveal that the pregnancy and family counselling centres provide a tailor-made service for pregnant women with a particularly urgent need for counselling – and that they also generally successfully reach their target groups.