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One in three people learn they’re pregnant past six weeks’ gestation

Although at-home pregnancy tests are commonly used, this study shows that many pregnant people still experience delays when confirming a suspected pregnancy. As a result, one in three people confirm their pregnancies past six weeks, and one in five past 7 weeks. Later confirmation of pregnancy is even higher among young people, people of color, and those living with food insecurity, suggesting that gestational bans on abortion in the first trimester will disproportionally hurt these populations.

Key Findings

Three-quarters of respondents to an anonymous survey reported taking an at-home pregnancy test as their first step to confirming a suspected pregnancy. Young people, those who had not had children before, and those with unplanned pregnancies were less likely to use at-home tests as their first step.
Young people were more likely to report access-related reasons, such as cost or difficulty getting to the store, for delaying or not taking an at-home test.
People who took an at-home pregnancy test confirmed their pregnancy about one week earlier than those who tested at a clinic.
One in three people discover pregnancy at six weeks’ gestation or later, and about one in five discover pregnancy past seven weeks. Almost two in three young people (ages 15-19) discover pregnancy at six weeks or later.
People of color, people living with food insecurity, people with unplanned pregnancies, and those who rely on clinic-based testing to confirm a pregnancy are also more likely to discover pregnancy past seven weeks’ gestation.

Study Design

Researchers recruited participants ages 15 through 45 from eight reproductive and primary health care facilities, including one abortion facility, in Arizona, New Jersey, New Mexico, South Carolina and Texas in 2016 and 2017. Clinic front desk staff gave potentially eligible patients a flyer describing the study. After providing verbal informed consent, respondents completed a 30-minute anonymous survey while in the clinic waiting room and received a $20 gift card.

Implications

State legislatures have ramped up efforts to pass bills targeting abortion access in the first trimester, including the six-week ban in Texas that recently made its way to the U.S. Supreme Court. But this study shows that many individuals—and the majority of young people—do not find out they’re pregnant until after that time.

As the researchers write:

Gestational bans in the first trimester will disproportionately prevent young people, people of color, and those living with food insecurity from being able to access abortion.

The article, Home pregnancy test use and timing of pregnancy confirmation among people seeking healthcare, is available in Contraception.