The DHS Program

September 27, 2011 
Effective contraception key to reducing induced abortions and unintended births

Calverton, Maryland, USA
About one-third of unintended births and one-half of all induced abortions in developing countries could be prevented if women switched to more effective contraceptive methods, according to a new analytical study published by ICF Macro. Analyses of reproductive histories among women in 20 low- and middle-income countries included in the new study show that contraceptive failure and unintended pregnancies and births are very common among family planning users. 

“A substantial number of pregnancies in these countries are unintended,” says Sarah Bradley, lead author of the study. Between 14 and 56% of recent births in these 20 countries were either mistimed or not wanted at all. “About one in three unintended births in these countries is due to contraceptive failure,” Bradley reports.

Contraceptive failure accounts for 53% of all recent abortions in 6 of the 20 countries studied where abortion is permitted by law. The vast majority of these failures occurred among women using traditional methods — withdrawal, periodic abstinence (the rhythm method), or local remedies.  

Traditional methods are far less effective in preventing pregnancy than modern contraceptive methods, the study found, similar to previous research. As many as 2 in every 10 women using traditional methods got pregnant within one year, according to the study, compared to almost no unplanned pregnancies among women relying on the most effective long-acting and permanent methods — male or female sterilization, IUDs or implants.

Induced abortion rates could be reduced substantially, the study reports, if women switched from traditional to more effective modern methods. Using estimates from multiple-decrement life tables, the study found that if all family planning users switched to short-term modern methods, over 20% of induced abortions could be prevented; if women switched to long-acting and permanent methods, the level of induced abortions could be cut by half.

“Helping women use the most effective methods could prevent from 5,000 to 316,000 abortions per country per year,” says Bradley. “Women who use family planning clearly do not want to become pregnant. Investing in more effective methods will pay off in fewer unwanted pregnancies and far fewer abortions — a benefit for everyone.”

The new study, The Impact of Contraceptive Failure on Unintended Births and Induced Abortions: Estimates and Strategies for Reduction analyzed 182,791 pregnancies reported in Demographic and Health Surveys carried out since 2002 in 20 countries in Latin America and the Caribbean, Europe, Eurasia, the Middle East, Asia, and sub-Saharan Africa.