Ensuring that Every Pregnancy is Wanted

At least 200 million women want to use safe and effective family planning methods, but are unable to do so because they lack access to information and services or the support of their husbands and communities. And more than 50 million of the 190 million women who become pregnant each year have abortions. Many of these are clandestine and performed under unsafe conditions.

The need for voluntary family planning is growing fast, and it is estimated that the 'unmet need' will grow by 40 per cent during the next 15 years. But even though it is an economically sound investment, family planning has been losing ground as an international development priority. Funding is decreasing, and the gap between the need and the available resources is growing.

The international community has agreed that reproductive choice is a basic human right. But without access to relevant information and high-quality services, that right cannot be exercised.

Family planning saves lives

Guided by paragraph 8.25 of the Cairo Programme of Action, UNFPA does not support or promote abortion as a method of family planning. It accords the highest priority and support to voluntary family planning to prevent unwanted pregnancies so as to eliminate recourse to abortion. UNFPA supports governments to strengthen their national health systems to deal effectively with complications of unsafe abortions, thereby saving women’s lives (every year, an estimated 74,000 women die as the result of unsafe abortions).

UNFPA works to make reproductive rights a reality by supporting family planning services throughout the developing world. These services, as well as the information needed to make good choices, are usually provided as part of a constellation of reproductive health services.

Contraceptive use rises, but unmet needs remain

Most women today want two, three or four children - fewer than in generations past. The use of modern contraceptive methods, including voluntary sterilization, has increased rapidly over the past 30 years, especially in countries with strong family planning programmes. In less developed regions, contraceptive use approaches 60 per cent of couples.

Most of this increase reflects greater contraceptive use by women. But in many countries, poverty and profound inequalities between men and women limit women's ability to plan their pregnancies. So does lack of access to effective contraceptive protection.

Differing patterns of contraceptive use may not reflect women's personal preferences as much as political and economic decisions made by governments to emphasize certain methods, the attitudes of medical professionals, cost, the limited range of methods offered in some countries or an uneven availability of contraceptive supplies.

Widening the options

Two new contraceptives for women: o­nce-a-month injectables and the female condom have become available since 1994. Fewer than 5 per cent of couples in the majority of developing countries rely o­n modern male methods (the condom or vasectomy).

The level of unintended pregnancy is lowest in countries with greatest access to effective methods of contraception and where women play a major role in family decision-making. This goal of universal access to services needed to allow couples to exercise their full reproductive rights remains elusive: o­ne evaluation found that family planning services are routinely made available to women at a reasonable cost in o­nly 14 of 88 developing countries studies.

Moving forward

UNFPA supports family planning services that:

*offer a wide selection of methods

*reflect high standards of medical practice

*are sensitive to cultural conditions

*provide sufficient information about proper use or possible side effects

*address women's other reproductive health needs

UNFPA is committed to closing the gap between the number of individuals who use contraceptives and those who would like to space or limit their families. The Fund rejects any form of coercion with respect to family planning, including the use of targets or quotas for the recruitment of clients.

Excerpt from the ICPD Programme of Action 1994

All countries should, over the next several years, assess the extent of national unmet need for good-quality family-planning services and its integration in the reproductive health context, paying particular attention to the most vulnerable and underserved groups in the population. All countries should take steps to meet the family-planning needs of their populations as soon as possible and should, in all cases by the year 2015, seek to provide universal access to a full range of safe and reliable family-planning methods and to related reproductive health services which are not against the law. The aim should be to assist couples and individuals to achieve their reproductive goals and give them the full opportunity to exercise the right to have children by choice. (Paragraph 7.16)