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New estimates show that the world has seen a drop in unintentional pregnancies since then
Women in the poorest countries are at greater risk of unintentional pregnancy and do not have access to safe and legal abortion care services
New estimates, published in Lancet Global Health, and together they are the author of the Gittmacher Institute and HRP, show a worldwide decline in unintended pregnancies from 1990 to 1994. In the same period, the proportion of unintentional pregnancies ending in abortion increased.
These findings suggest that over the past 30 years, more women and individuals have managed to limit or deprive their pregnancies. This is possible thanks to an improved approach to contraceptive choice, in addition to comprehensive sexual and reproductive health services including safe abortion in full.
New study considers the frequency of unintentional pregnancies and abortions by income, region, and legal status of abortions from 1990 to 2019.
“The significant decline in unintended pregnancies and abortion rates in some parts of the world is welcome news that reflects important gains in access to effective, safe, acceptable and affordable sexual and reproductive health services,” said Bela Ganatra, head of unsafe abortion prevention. Unit and scientist at HRP.
The poorest women at greatest risk
Despite progress, approximately 214 million women of reproductive age who want to avoid pregnancy do not use the modern method of contraception, so they are much less able to decide whether, how much and when to have children. New estimates show that between 2015 and 2019, almost half of all pregnancies were unintentional.
Moreover, women living in the poorest regions have faced unintended pregnancies almost three times more than those in the richest regions.
Higher abortion rate in countries with higher legal restrictions
The highest abortion rates are found in countries with the most legal restrictions. In high-income countries where abortion is generally legal (the term “broadly legal” means that abortion is available on demand or on a broad socioeconomic basis), there were 11 abortions per 1,000 women of reproductive age, compared with 32 abortions per 1,000 in countries with high-income with multiple legal restrictions on access.
Abortion rates were highest in low-income countries with the most legal restrictions on abortion care. The number of abortions also increased – by 12% – in countries with legal restrictions on the procedure, while it decreased slightly in countries where abortion is generally legal.
Women living in countries with more legal restrictions on access to abortions have also faced significantly higher rates of unintentional pregnancies. This suggests that they have less access to contraception, with wider sexual and reproductive health services to prevent unintentional pregnancies – which is likely to explain the higher number of abortions in these countries.
A new methodology to improve understanding
This study uses an updated, more comprehensive methodology in which the global number of pregnancies is estimated for the first time, followed by an estimate of how many of these pregnancies were unintentional and how many ended in abortion. These numbers are broken down by state revenue status, Sustainable Development Goal region, and legal status.
Countries were considered to have restrictive abortion laws if the procedure was completely banned, available only to save a woman’s life, or available to preserve health. The study found similar abortion rates regardless of the type of legal restriction.
High quality reproductive health care necessary for health, safety and well-being
Sexual and reproductive health care is an important part of universal health insurance. This includes services to help prevent unintended pregnancies, provide comprehensive sexuality education and the selection of effective and affordable modern methods of contraception, and access to safe abortion and post-abortion care in full.
These services are key to meeting global commitments to sustainable development – ensuring universal access to sexual and reproductive health care, reducing maternal deaths and ending discrimination against women and girls.
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