“Half. This is the proportion of all pregnancies that are unintended. That is 121 million pregnancies every year,” said Sarah Craven, Director of the Washington D.C. Office at UNFPA during a recent U.S. launch event for the 2022 UNFPA State of World Population (SWOP) report. “For these women, the most life altering reproductive choice, whether to become pregnant or not, is no choice at all. This is an unseen crisis unfolding right before our eyes.”

Representative Chrissy Houlahan, addressed the complexity of the issue of unintended pregnancy, and the steps needed to address it. “[Unintended pregnancy] is not a simple problem, nor is it just a women’s issue,” she said. Rep. Houlahan observed that as a personal issue, a health issue, a human rights issue, a development issue, and a humanitarian issue, unintended pregnancy requires a concerted and holistic effort to find solutions to all the issues it raises.

 Xavier Becerra, Secretary of the U.S. Department of Health and Human Services (HHS) echoed that sentiment: “Around the world, we remain committed to investing in high quality, client-centered sexual and reproductive health services that improve women’s well-being, promote gender equality, and ensure women’s control over their bodies and futures.”

Secretary Beccera added that “the United States will continue its efforts to make pregnancy and childbirth safer and meet sexual and reproductive health needs. Because these evidence-based efforts do far more to protect lives, protect families, and protect the health and well-being of everyone.”

The SWOP report both sheds light on causes and consequences of unintended pregnancy globally and offers solutions to address it. Bwire Moses, Executive Director of Peer to Peer Uganda, lauded the report for marshaling substantive evidence to demonstrate where we are as a world in terms of unintended pregnancy, and how we are failing to learn from history. 

Drivers of Unintended Pregnancy 

Unintended pregnancy is extremely common, and the SWOP report highlights the importance of addressing an issue which is a crisis not of the few but of the many. “Every fertile woman can experience an unintended pregnancy,” said Gilda Sedgh, Advisor for the State of the World Population Report at UNFPA.

The SWOP report also aims to break down misperceptions about who experiences unintended pregnancies. “We cannot focus on the stereotype of an unmarried pregnant teen,” said Craven. Married women, perimenopausal women, and LGBTQI+ people all experience unintended pregnancies in alarming numbers, she noted.

New insights on the root causes of unintended pregnancy are also featured prominently in the report. Sedgh noted countries where girls don’t get as much schooling as boys, or where women don’t play as large a role in the workforce are especially vulnerable. Lack of representation in government also plays a role. 

“Unintended pregnancy is higher in those countries with high gender inequality,” observed Sedgh.  “Unintended pregnancy is both a cause and a consequence of gender inequality, but it is a cycle that can and should be broken.”

Gender inequality also drives issues such as gender-based violence (GBV). “The report really makes it clear that there’s a real connection between practices like intimate partner violence, sexual violence, and unintended pregnancies,” said Gayatri Patel, Vice President of Advocacy and External Relations at Women’s Refugee Commission (WRC). “We all know that GBV is a violation of human rights but also a symptom of gender inequality.”

Moses added that unintended pregnancy is also influenced by the lack of financial independence among working class women, which makes it more difficult for them to afford contraceptive methods of choice and limits their autonomy. It is an all-too-common scenario that prevents women from accessing programs which empower them.

Craven agreed: “Unintended pregnancy is a cause and an effect of gender discrimination and of restrictions on the agency and bodily autonomy of women and girls.” 

Patel reflected on the impact on unintended pregnancy among people served by the WRC. “In our work,” she said, “we see firsthand the harmful impacts that unintended pregnancies have on displaced women, on refugee women, women and girls, and others from marginalized groups, and how factors such as displacement can really exacerbate these repercussions.”

Policy Solutions

There was broad consensus among the speakers on the far-reaching impacts of reducing unintended pregnancies and providing comprehensive care. “Reducing rates of unintended pregnancy will help achieve the SDGs by increasing women’s agency and ability to fulfill their potential, improving outcomes for families and societies writ large,” said Craven.

Addressing the challenges of global unintended pregnancy requires strong policy solutions, Craven added. Unintended pregnancy cannot be reduced to personal responsibility, morality, or behavior. “It is also about policy decisions and national development.” 

Moses observed that one way to reduce unintended pregnancy is to reduce gender inequality through various forms of empowerment. He said it is essential to have financial independence for all women and girls of reproductive age, so that they are able to have children by choice, not by chance. Craven also offered the notion that policies and programming should increase access to education and employment opportunities for women and girls to encourage them to postpone pregnancy. 

One of the immediate causes of unintended pregnancy for women is not using a contraceptive method, said Sedgh. “So, one of the most direct ways we can help prevent unintended pregnancies is by meeting women’s needs for contraception.”

Patel agreed, noting that “access to long-acting, reversible contraceptives would be a really important policy mechanism and a policy objective to prioritize.”

The SWOP report cited concerns about methods as the most common reason for women not using birth control. Sedgh recommended additional attention and investment to improve the quality and range of services related to access, education, and counseling of contraceptive options, while also developing new contraceptive methods that have fewer side effects and that women are comfortable using.

Global investment in reproductive health services remains important to addressing unintended pregnancy. Rep. Houlahan is the lead sponsor of the Support the UNFPA Funding Act, and reasserted her strong support for addressing the issue. 

 “Wherever women can access quality health services and thrive,” said Rep. Houlahan, “stability, security, and peace will follow.”

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