Population Action International

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Planned pregnancies lead to healthy mothers and families.

Family Planning is an urgent global priority. Women and men are entitled to determine the number, timing and spacing of their children, with access to the appropriate contraceptive methods and health information and services, as affirmed at the International Conference on Population and Development (ICPD). Still, more than 120 million women say they would prefer to avoid a pregnancy, but are not using any form of contraception.1 In recognition of the widespread benefits of assuring that pregnancies are voluntary and intentional, unmet need for family planning is under consideration for inclusion in the MDG monitoring framework.2

A recent study found that outside of sub-Saharan Africa, rural, poor and uneducated women are at increased risk of unplanned pregnancies.3 However, no single pattern of risk of unmet need could be ascribed to sub-Saharan Africa. For example, unmet need is highest among wealthier, educated urban women in the Central African Republic, and in Rwanda, the need is roughly equitable across differentials.4 As such, programs need to identify and focus on populations with the greatest need in each particular country.

An inadequate supply of methods and services is the most common barrier to contraceptive use by married women.5 If women are to be able to have the number of children they choose, shortfalls in services and supplies must be addressed. Ensuring that women and men can access the contraceptive method that best suits their particular circumstances and fertility preferences contributes to increased contraceptive use, continuation and safety for the user. For example, in sub-Saharan Africa, unmet need for spacing is close to twice the unmet need for limiting of births. Patterns of method preference (by region, gender, place of residence, etc.) need to inform programmatic and budgetary decisions, including those related to the range and mix of contraceptive supplies. The contraceptive method mix should thus be tailored to various settings.6

Meeting the demands for family planning can prevent many, if not most, deaths from unsafe abortion. It is estimated that up to 100,000 maternal deaths could be avoided each year if unintended pregnancies were prevented.7 Although the relationship between birth intervals and maternal health outcomes is in dispute,8 9 it is generally accepted that planned pregnancies improve child health.10 When a pregnant woman has not fully recovered from a previous birth, the new baby is more likely to die in infancy or contract infectious diseases during childhood.11

 

Notes

  1. Ronsmans, Carine and Wendy J Graham. 2006. “Maternal mortality: Who, when, where and why.” The Lancet 368: 1189-1199.

  2. Ross, John and William Winfrey. 2002. “Unmet Need for Contraception in the Developing World and the Former Soviet Union: An Updated Estimate.” International Family Planning Perspectives 28(3): 138-143.
  3. UNESCAP. 2007. Statistical Newsletter, 29 June 2007. Available from http://www.unescap.org/STAT/nl/nl_June2007.asp#New_targets_MDGs; accessed on September 4, 2007.
  4. Sedgh G, et al. 2007. “Women with an Unmet Need for Contraception in Developing Countries and Their Reasons for Not Using a Method.” Occasional Report No. 37. New York: Guttmacher Institute.
  5. Ibid.
  6. Ibid.
  7. Ross, John and William Winfrey. 2002. “Unmet Need for Contraception in the Developing World and the Former Soviet Union: An Updated Estimate.” International Family Planning Perspectives 28(3): 138-143.
  8. WHO. 2005. World Health Report 2005. Geneva: WHO.
  9. Conde-Agudelo A and Belizan JM. 2000. “Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study.” British Medical Journal 321: 1255-59.
  10. Ronsmans C and Campbell O. 1998. “Short birth intervals don’t kill women: evidence from Matlab, Bangladesh.” Studies in Family Planning 29: 282-90.
  11. Conde-Agudelo A, et al. 2006. “Birth spacing and risk of adverse perinatal outcomes: a meta-analysis.” Journal of the American Medical Association 295: 1809-23.
  12. Rustein, Shea O. 2005. “Effects of Preceding Birth Intervals on Neonatal, Infant and Under-Five Years Mortality and Nutritional Status in Developing Countries: Evidence from the Demographic and Health Surveys.” International Journal of Gynecology and Obstetrics 89, Suppl 1:s7-s24.