Highest number of unwanted pregnancies in India: WHO
New Delhi: Fifteen million out of 16.7 million unwanted pregnancies a year could be avoided in 35 low- and middle-income countries if women use modern methods of contraception, according to a study carried out by the World Health Organization (WHO) and published on Wednesday.
Out of 12,874 women with undesired pregnancies covered by the study, India contributed the largest number, revealed the findings of the research, according to a statement by the European Society of Human Reproduction and Embryology.
“Health concerns were the most common reason given for not using modern contraception, yet these concerns are not backed up by evidence,” said Howard Sobel, regional coordinator of the reproductive, maternal, newborn, child and adolescent division at WHO, western Pacific regional office, and one of the co-authors of the study.
“Health workers have an important role to play in reassuring, educating, treating symptoms and finding the methods that best suits an individual.”
Modern methods include combined oral contraceptives, male and female condoms, progestogen-only pills, implants, injectable contraceptives, intrauterine devices and sterilisation.
Sobel added that the overwhelming majority of unwanted pregnancies could be avoided if the myths and misperceptions about modern methods of contraception were debunked and long-term methods of contraception, such as implants and intrauterine devices, were adopted.
The researchers carried out an analysis of the demographic and health surveys of 35 countries, conducted between 2005 and 2012. Of the 111,301 non-pregnant women who did not desire pregnancy, Ghana contributed the smallest number, 0.4%, and India the largest, at 17.1%.
In 2014, WHO said that reducing the number of unintended pregnancies could avert 60% of maternal deaths and 57% of the child deaths.
The study found a total of 78,784 (70.8%) out of 111,301 non-pregnant sexually active women who did not want any future pregnancy used contraception; 17,474 (15.7%) women did not use any form of contraception, but expressed the desire to do so, and 15,043 (13.5%) did not desire to use contraception.
The study showed that the poorest and uneducated women were the least likely to use modern contraception. Among the 14,893 women who did not use contraception and did not want to get pregnant, 37% women cited fear of side-effects and health concerns as the main reason for non-use; 22.4% women were simply opposed to it, 17.6% women underestimated the risk of pregnancy, and 2.4% mentioned the cost and another 2.4% said they didn’t know how to obtain modern contraceptives.
Universal access to reproductive health was one of the millennium development goals (MDGs) agreed by the United Nations in 2005, but authors of the study said of all the health-related MDGs, universal access to reproductive health is the one that is most off-track.
“In the next era of the sustainable development goals, strategic investment in methods like implants, though expensive upfront, are far less costly to families, governments and society than having larger families due to undesired pregnancies,” Sobel said.
The use of traditional methods of contraception was associated with a 2.7-fold increase in the likelihood of an undesired pregnancy when compared with the use of modern methods, while non-use of any method was associated with a 14.5-fold increase. Traditional methods included abstinence and calendar methods revolving around the woman’s menstrual cycle.
“Unmet needs for family spacing methods is quite high in highly populated states of India, as per government data. Incorrect information and misconceptions, not knowing where to procure supplies, and families not agreeing are some of the leading causes for these unmet needs,” said Sona Sharma, joint director of advocacy and communications at Population Foundation of India, a Delhi-based civil society group which looks at population and reproductive issues.
In India apart from the unmet needs of contraception, sterilization procedures, too, have courted much controversy.
Last year, a botched sterilization camp in Chhattisgarh led to the death of at least 13 women.
“While the government has shifted focus to family spacing on a policy level, on the ground the focus is still on sterilization. Most of the incentives in government schemes are for sterilization, and frontline workers are also focusing on the same,” said Sharma.
“It can be seen as indirect coercion,” she added