State of World Population 2012 - UNFPA Haiti

Most unintended pregnancies ending inabortion result from non-use of a contraceptivemethod or from method failure, particularlyof a traditional method such as withdrawal.Despite their lower rate of effectiveness, 11per cent of all contraceptive users globally(less than 7 per cent of all married women) relyon withdrawal, rhythm, and other traditionalmethods (Rogow, 1995). While lack of access tomodern methods is often a factor in this choice,many prefer so-called “natural” methods becauseof the absence of side effects, their lack of cost,and the fact that they can be used at home withno trip to a clinic.“All countries should, over the next several years, assessthe extent of national unmet need for good-quality familyplanning services and its integration in the reproductivehealth context, paying particular attention to the mostvulnerable and underserved groups in the population.”— ICPD Programme of Action 1994, Paragraph 7.16Addressing women’s concerns about modernmethods and helping women who stopusing one method to find a new and effectiveone could reduce unintended pregnancies insub-Saharan Africa, South Central Asia andSoutheast Asia by 60 per cent, and reduce abortionsin those regions by more than half (Cohen,2011). Addressing unmet need globally wouldavert 54 million unintended pregnancies andresult in 26 million fewer abortions—a declinefrom 40 million to 14 million abortions (Singhand Darroch, 2012).A study of abortion in 12 countries in CentralAsia and Eastern Europe found that manywomen had used modern contraceptives but haddiscontinued for a variety of reasons (Westoff,2005). The majority of pregnancies resultingfrom discontinuation of a modern methodended in abortions. This highlights the importanceof offering a range of methods from whichto choose, of providing high-quality counsellingand “accompaniment” to clients, and of providershelping women who are dissatisfied with amethod to switch to another method before anunintended pregnancy occurs.In the Ukraine, fertility rates have beendeclining as more women have an opportunityto have careers outside of the home, and morecouples are choosing to have fewer children.Immediately after the dissolution of the SovietUnion, couples relied on abortions as familyplanning. Today, however, because family planningis more readily available and understood,there are fewer unplanned pregnancies, andtherefore fewer abortions.In Latin America and the Caribbean, abortionrates have fallen from 37 per 1,000 womenbetween the ages of 15 and 44 in 1995 to 31 per1,000 in 2008 (Kulcycki, 2011), as use of moderncontraceptive methods has risen throughoutthe region to about 67 per cent among marriedwomen (United Nations, Department ofEconomic and Social Affairs, 2011). However,access to contraceptives remains difficult in someregions and for some groups, especially the poorand adolescents. High rates of unintended pregnancylead many women to seek abortion, whichis restricted in most countries in the region. In anumber of countries, abortion is permitted onlyto save a woman’s life. As a consequence, almostall of the 4.2 million abortions annually in theregion are performed clandestinely or underunsafe conditions; the rates of abortion and theproportion that are unsafe are the highest in theworld (United Nations, Economic Commissionfor Latin America and the Carribean, 2011).While wealthier women can seek private providers,poor women more often suffer the medicaland legal consequences of their limited choices(World Health Organization, 2011a). Unsafe32 CHAPTER 2: ANALYSING DATA AND TRENDS TO UNDERSTAND THE needs