Context Little is known about the preconception health status of women that are at risk for an unintended pregnancy. Objective We hypothesized that women at high risk for an unintended pregnancy would engage in less healthy behaviors and would have fewer health care encounters than women at lower risk. Design Using the Behavioral Risk Factor Surveillance System (2002 and 2004 datasets), we examined health factors of 18- to 44-year-old, fertile women who were not intending a pregnancy, grouped into high-risk ( n = 16,113) or low-risk ( n = 39,426) groups. Women were designated as high risk for an unintended pregnancy based on their non-use of birth control, and women were designated as low-risk for an unintended pregnancy based on their use of birth control. Results Controlling for variables that mask or exacerbate relationships between risk factors and outcomes was an important component of this study. After controlling for the effects of demographic characteristics, we found that high-risk women remained 1.23 times more likely to be obese (confidence interval [CI], 1.12–1.34) and 1.2 times more likely to smoke (CI, 1.11–1.31), both significant findings. We also found high-risk women to be 27% less likely to exercise (CI, 0.67–0.79), 62% less likely to receive a Pap test (CI, 0.31–0.46), 19% less likely to have HIV testing (CI, 0.75–0.87), and 44% less likely to have received sexually transmitted diseases counseling (CI, 0.50–0.63) compared with low-risk women. Interestingly, high-risk women were 27% less likely to use any alcohol (CI, 0.67–0.79) and 11% less likely to binge drink (CI, 0.80–0.99) compared with women at low-risk for an unintended pregnancy. Conclusions Nearly one third of women at risk for an unintended pregnancy are not using any contraceptive method (29%), and these high-risk women also have higher proportions of unhealthy behaviors and significantly lower clinical health encounters than women using any form of birth control (low-risk women).