FERTILITY REGULATION BEHAVIORS AND THEIR COSTS
Contraception and Unintended Pregnancies in Africa and Eastern Europe &
Elizabeth Lule, Susheela Singh and Sadia Afroze Chowdhury
Paper prepared with funding from the Swedish International Development Cooperation Agency.
Collaboration between the HNP section of the Human Development Unit of the World Bank, the Guttmacher Institute,
Available online as PDF file PDF [168p.] at:
“….The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (
Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe has increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception….”
Press Release:
WASHINGTON, D.C., July 10, 2008—According to the new report— 35 poor countries in Sub-Saharan Africa and other regions (Timor-Leste, Afghanistan, Djibouti, and Yemen) have the world’s highest birth rates (more than five children per mother) while also reflecting some of the world’s poorest social and economic results, with low levels of education, high death rates, and extreme poverty. Moreover, many poor women turn to abortion as a last-resort means of birth control. Some 68,000 women die each year as a result of unsafe abortion, while another 5.3 million suffer temporary or permanent disability as a result.
The report also says that pregnancies which are less than 15 months spaced apart more than double the risk of the mother dying. Children born 3 years after a previous birth are healthier at birth and more likely to survive. Teenage pregnancies carry a higher risk of obstetric complications such as obstructed labor, eclampsia and fistula formation, and yet teenagers are less likely to receive antenatal or obstetric care, making them twice as likely to die during childbirth as women over the age of 20.
Content
CHAPTER 1: INTRODUCTION AND EXECUTIVE SUMMARY
CHAPTER 2: GLOBAL TRENDS IN FERTILITY, CONTRACEPTIVE USE AND UNINTENDED PREGNANCIES
2.1. INTRODUCTION
2.2. DETERMINANTS OF FERTILITY
2.3. FERTILITY INTENTIONS AND DESIRED NUMBER OF CHILDREN
2.4. UNINTENDED PREGNANCIES
2.5. CONTRACEPTIVE USE AND UNMET NEED
2.6. ABORTION
2.6.1. Global Trends
2.6.2. Unsafe abortion
2.6.3. Consequences of Unsafe Abortion
2.6.4. Costs of Unsafe Abortion
2.7. CONCLUSION
CHAPTER 3: A REVIEW OF THE EVIDENCE ON THE COST OF POSTABORTION CARE IN
CHAPTER 4: ESTIMATING THE COST OF POST-ABORTION CARE IN
CHAPTER 5: RECENT TRENDS IN CONTRACEPTION AND ABORTION IN EASTERN EUROPE AND
CHAPTER 6: PROVIDER ATTITUDES TOWARDS CONTRACEPTIVE METHODS AND ABORTION AND COST OF SERVICES IN
CHAPTER 7: A SUMMARY OF FINDINGS AND IMPLICATIONS FOR POLICIES AND PROGRAMS
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