Rates of unplanned pregnancy soaring
THE UN Population Fund recently released the 2022 State of World Population report. It highlights that almost half of all pregnancies between 2015 and 2019 were unintended. That’s roughly 121 million unintended pregnancies each year.
Unintended pregnancy is defined as pregnancy among women who were not planning to have any (more) children. This includes pregnancies that occurred earlier than desired. The report also says over 60% of unintended pregnancies end in abortion. And 45% of all abortions performed globally are unsafe. About 7 million women a year are hospitalised as a result.
Up to 257 million women who want to avoid pregnancy are not using safe, modern contraception methods. And about a quarter of all women are not able to say no to sex.
A closer look at regional estimates shows how far behind African countries are in preventing these unplanned pregnancies and protecting the reproductive rights. While the global rate of unintended pregnancies in Europe and North America was 35 per 1 000 women aged 15 to 49, in sub-Saharan Africa it was 91 per 1 000 women. Within the region it ranged from 49 in Niger to 145 in Uganda.
Drivers of unintended pregnancies in sub-Saharan Africa are complex and operate at individual, household, community and policy levels. Understanding them is important to develop policies and effective interventions.
In my view, based on research done in a number of African countries, the high rate of adolescent childbearing in Africa could be the main factor contributing to the stark regional differences reported.
Drivers of unintended pregnancy
At the individual level, poverty, lack of autonomy and low education attainment limit women’s and girls’ access to accurate contraceptive information and services. Some women and girls simply cannot afford to pay for contraceptives.
In places where contraceptives are freely available, some women lack accurate knowledge of them and how they work.
In some settings, people interpret religion as prohibiting contraceptive use. They use religion to deny young people accurate contraceptive information. When women and girls lack access to accurate contraceptive information and services, their risk of unintended pregnancy increases.
In a study by the African Population and Health Research Centre, adolescent girls in Kenya told us they got pregnant because they were young and naive about relationships and contraceptives. Some had to exchange sex for their basic needs.
Others were sexually violated. Because they did not seek care in clinics or know about emergency contraception, they were vulnerable to unintended pregnancy. Some had dropped out of school.
At household level, parents seldom communicate well about methods of preventing pregnancy. Where they do talk about it, they focus on abstinence rather than contraceptives, and they sometimes use fear tactics. Another household driver is insufficient financial support from the family, pushing girls into transactional relationships.
Quality contraceptive services consist of accurate and sensitive counselling, a wide range of options, and well-trained providers. Research has shown that in communities where such services are available and accessible, more women and girls are able to plan pregnancies, but access to quality services is lacking in many African communities. |