More than 60% of unintended pregnancies end in abortion – report
Governments have been urged to make health services more comprehensive in a bid to reduce unintended or unplanned pregnancies, including the extension of greater social protection as a safety net for those vulnerable to poverty.
The warning comes amid ferment in the United States over the looming prospect that the landmark Roe v Wade federal law might be overturned and as women lawmakers in Jamaica press for an amended abortion law.
More than 60 per cent of unintended pregnancies end in abortion and an estimated 45 per cent of all abortions are unsafe, causing five to 13 per cent of all maternal deaths, according to State of the World Population 2022 report published by the United Nations Population Fund (UNFPA).
Between 2015 and 2019, there were roughly 121 million unintended pregnancies each year – nearly half of pregnancies worldwide.
UNFPA outlined that sexual and reproductive health services should address issues ranging from sexually transmitted infection (STI) prevention, prenatal care to maternity care, prevention of stigma and violence, and respect for bodily autonomy.
“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,” a section of the report read.
UNFPA outlined that a range of other factors contribute to unintended pregnancies, which include a lack of sexual and reproductive healthcare and information, harmful norms and stigma surrounding women controlling their own fertility and bodies, sexual violence and reproductive coercion, poverty and stalled economic development, and gender inequality.
“The toll of these pregnancies is – and has long been – unseen. Though we can estimate healthcare costs, monitor school dropout rates, and project levels of workforce attrition due to unintended pregnancies, these only scratch the surface,” the report said.
The “comprehensive package” of health services proposed should be free from mandated parental or spousal notification or consent, the UNFPA said.
“They can signal their openness to adolescents by rebranding from family planning to contraceptive services, given that many adolescents and young people do not identify with the idea of planning a family,”UNFPA said in the 160-page report.
The agency added that contraceptive services themselves must be comprehensive, including screening for pregnancy intentions, counselling around options, side effects and other potential consequences – insertion, removal, replacement or reinsertion of long-acting reversible contraceptives or other contraceptive devices, as well as regular follow-up that includes a prompt response to women who want to change methods.
UNFPA said that the COVID-19 pandemic has demonstrated that many women do not have social protection, even where schemes exist, for reasons that include their disproportionate share of unpaid work at home and concentration in poor quality or poorly paid informal jobs.
“Universal social protection schemes provide a powerful opportunity to reduce the multiple vulnerabilities that can lead to unintended pregnancies by closing gaps in income as well as education and healthcare,” the report said.
Beyond reducing gaps in income, UNFPA said social protection programmes can adopt tools specific to contraceptive access, such as vouchers for services.
UNFPA also urged governments to examine how well contraceptive services are funded and whether they have been identified as essential health services that must be sustained under all contingencies.
“The agency of women and girls is devalued when sexual and reproductive information and services are not fully supported and prioritised. This was evident during the onset of the COVID-19 pandemic, when contraceptive services were among the most extensively disrupted healthcare services,” the United Nations agency said.