Guttmacher Report Cites Increases in Contraceptive Use, Reductions in Unintended Pregnancies and Abortions…and More Work To Do

Jodi Jacobson

More women and men have access to and are using contraception throughout the world, reports the Guttmacher Institute, contributing to a decrease in the number of unintended pregnancies and, in turn, a decline in the number of abortions, from 45.5 million procedures in 1995 to 41.6 million in 2003.

Guttmacher Report Finds Increase in Contraceptive Use, Decline in Unintended Pregnancies and Abortion Worldwide

More women and men have access to and are using contraception throughout the world, reports the Guttmacher Institute, contributing to a decrease in the number of unintended pregnancies and, in turn, a decline in the number of abortions, from 45.5 million procedures in 1995 to 41.6 million in 2003.

greatest progress was made in "developed" or higher income countries,
though positive trends in contraceptive use and reductions in
unintended pregnancy also are evident throughout Asia and Latin
"Within the developing world," according to Guttmacher, "improvement varied widely, with Africa lagging behind other regions."

Worldwide, according to the report, "The
proportion of married women
using contraception increased from 54 percent in 1990 to 63 percent in
2003," said Guttmacher.  These findings include increases in the use
of contraceptive methods among sexually active single women.

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Greater use of contraceptives has resulted in fewer unintended pregnancies.  The rate of unintended pregnancy declined roughly 21 percent, from 69 unintended pregnancies per 1,000 women ages
15 to 44 in 1995 to 55 per 1,000 in 2008.  

However, the research revealed great variation in progress by region.  

While 71 percent of
married women in Latin American and the Caribbean were using
contraceptives in 2003, only 28 percent of married African women were doing
so. Nearly one in four married women in Africa had an unmet need for
contraception in 2002–2007, compared with 10–13 percent of their counterparts
in Asia and in Latin America and the Caribbean.

According to the report, declines in the rates of abortions have paralleled a general trend toward liberalization of laws regulating access to abortion care:

Nineteen countries have significantly reduced restrictions in their abortion laws since 1997, while only three countries have substantially increased legal restrictions. Despite these trends, 40% of the world’s women live in countries with highly restrictive abortion laws, virtually all of them in the developing world. In Africa, 92% of reproductive-age women live under highly restrictive abortion laws, and in Latin America, 97% do so. These proportions have not changed markedly over the past decade.

The United States and a few other countries, such as
the Dominican Republic, are notable exceptions to the trend toward liberalization of such laws.  Anti-choice groups in the US continue their efforts to outlaw both contraception and abortion, and the Dominican Republic, for example, recently passed a total ban on abortions.

As has been long known, the abortion rate in any given country is not related to its legal status.  In short, women continue to seek ways to end unintended pregnancy whether or not abortions are legal.  The Guttmacher report states that:

While the incidence of abortion is closely related to that of unintended pregnancy, it does not correlate with abortion’s legal status. Indeed, abortion occurs at roughly equal rates in regions where it is broadly legal and in regions where it is highly restricted.

The key difference, as Guttmacher notes, is safety—illegal, clandestine abortions remain the leading cause of illness and death among women ages 15 to 49 in many countries worldwide, and most particuarly in poorer countries and/or those countries where women’s status is low and access to reproductive and sexual health services is limited.

The report details progress and challenges, while also making recommendations for building on these gains. 

“The progress made during the past decade in increasing contraceptive use and reducing the need for abortion is fundamentally good news—the world is moving in the right direction,” says Sharon Camp, president and CEO of the Guttmacher Institute. “And yet, we still have two widely disparate realities. In almost all developed countries, abortion is safe and legal. But in much of the developing world, abortion remains highly restricted, and unsafe abortion is common and continues to damage women’s health and threaten their survival.”

Unsafe abortion causes an estimated 70,000 deaths each year, and an additional five million women are treated annually for complications resulting from unsafe abortion. Approximately three million women who experience serious complications from unsafe procedures go untreated.

“The evidence is strong and growing that empowering women with the means to decide for themselves when to become pregnant and how many children to have significantly lowers unintended pregnancy rates and thereby reduces the need for abortion,” adds Dr. Camp.

“Addressing the unmet need for contraception, which remains very high in many parts of world, is critical in promoting the well-being of women and their families. This is especially true in those parts of the developing world where modern contraceptive use is still low and mortality related to clandestine and unsafe abortion is high.”

Guttmacher makes three key recommendations:
·       Expand access to modern contraceptives and improve family planning services.
·       Expand access to legal abortion and ensure that safe and legal abortion services are available to women in need.
·       Improve the coverage and quality of postabortion care, which would reduce maternal death and complications from unsafe abortion.

“The gains we’ve seen are modest in relation to what we can achieve. Investing in family planning is essential—far too many women lack access to contraception, putting them at risk,” notes Dr. Camp. “Legal restrictions do not stop abortion from happening, they just make the procedure dangerous. Too many women are maimed or killed each year because they lack legal abortion access.”

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