Determinants of unwanted pregnancies and induced abortions in developing countries

Around the world 120-150 million women who want to limit or space their pregnancies are still without the means to do so effectively. India alone has about 31 million of these women. Altogether 350 million couples lack information about contraception and-access to a range of contraceptive services. As a result, at least 75 million pregnancies each year (out of a total of 175 million) are unwanted, and result in 45 million abortions and over 30 million unwanted live births. Twenty million of these abortions are unsafe resulting in the death of 70,000 women each year. For fecund sexually active women, there are basically only three ways to avoid pregnancy: abstinence, abortion, and contraception. For, many couples, contraception is more acceptable than abortion or abstinence. Why are millions of women who would prefer to avoid becoming pregnant either right away or ever, not using contraception? These women are said to have an unmet need for family planning. Several findings from comparable surveys and in depth studies together explain why many women who would prefer to avoid pregnancies nevertheless do not use contraception. These reasons are: difficulties with access to family planning supplies and services, health concerns about contraceptives and side effects, lack of information, opposition from husband, families and communities and perceived risks of pregnancy. By adopting strategies to address unmet need effectively, many countries that now have demographic goals, could replace them with objectives based on "the stated desires of people served" and at the same time I have equal or greater impact on contraceptive use and fertility levels. The paper identifies some possible strategies for addressing the problem of unmet need.