Nearly half of all pregnancies around the world, 121 million each year between 2015 and 2019, were unintended, a report of the UN Population Fund (UNFPA) has revealed.
The number of unintended pregnancies represents a global failure to uphold a basic human right for women and girls. And that failure is expected to grow, warns the “State of World Population 2022” report.
While recent data show that the unintended pregnancy rate worldwide fell between 1990 and 2019, continued global population growth means that the absolute number of unintended pregnancies will keep rising without decisive action. Delivering sexual and reproductive health services will only become more difficult in the face of tectonic shifts like climate change, conflicts, public health emergencies and mass migration, Xinhua news agency quoted the report as saying.
The report finds that social and economic development and higher levels of gender equality strongly correlate with lower rates of unintended pregnancy.
The incidence of unintended pregnancy varies widely by region. In 2015-2019, there were about 35 unintended pregnancies annually per 1,000 women aged 15-49 years in Europe and North America, compared with 64 in Central and Southern Asia and 91 in sub-Saharan Africa.
Many factors linked to reducing unintended pregnancy are themselves core development goals, from poverty reduction to improved maternal health, says the report.
One clear illustration of these intersecting forces is the extraordinary cost — to individuals, health systems and whole societies — of unsafe abortion, an issue that undercuts both rights and development.
Over 60 per cent of unintended pregnancies end in abortion, safe or unsafe, legal or illegal. Given that an estimated 45 per cent of all abortions remain unsafe, this is a public health emergency, it says.
Unsafe abortion hospitalized about 7 million women a year in developing countries, costing an estimated 553 million U.S. dollars per year in post-abortion treatment costs alone, and resulting in an estimated 193,000 maternal deaths between 2003 and 2009, it says.
The report also finds that the erosion of female agency leads to unintended pregnancy.
The most recent data that look at partnered women of reproductive age in 64 countries show that 23 per cent of women are unable to say no to sex, 24 per cent are unable to make decisions about their own healthcare and 8 per cent are unable to make decisions specifically about contraception. Together, this means that only 57 per cent of women are able to make their own decisions over their sexual and reproductive health and rights.
Violence, particularly sexual violence, and coercion against women and girls also contribute to unintended pregnancy, says the report.
Contraception is one of the most obvious areas for investment in reproductive health and rights. Globally, an estimated 257 million women who want to avoid pregnancy are not using safe, modern methods of contraception, and of them, 172 million women are using no method at all, says the report.
However, research shows that lack of awareness about, and lack of access to, contraception are no longer leading causes for non-use. Instead, these barriers are now overshadowed by concerns over side effects, myths, stigma and opposition from others. Addressing these reasons for unmet needs will require a much broader range of responses, says the report.