UNFPA report: Nearly half of pregnancies unintended

Nearly half of all pregnancies, about 121 million each year throughout the world, are unintended, says a report by the United Nations Population Fund (UNFPA).

The report paints a picture of a global crisis in a study conducted between 2015 and 2019. UNFPA is an international development agency that works on population and development, sexual and reproductive health and gender.

"This report is a wake-up call. The staggering number of unintended pregnancies represents a global failure to uphold women and girls' basic human rights," says UNFPA Executive Director Natalia Kanem.

"For the women affected, the most life-altering reproductive choice—whether or not to become pregnant—is no choice at all. By putting the power to make this most fundamental decision squarely in the hands of women and girls, societies can ensure that motherhood is an aspiration and not an inevitability."

Reproductive rights

UNFPA is now calling for the realisation of reproductive rights for all and supports access to a wide range of sexual and reproductive health services, including voluntary family planning, quality maternal health care and comprehensive sexuality education.

The report, Seeing the Unseen: The Case for Action in the Neglected Crisis of Unintended Pregnancy, warns that this human rights crisis has profound consequences for societies, women and girls and global health.

The State of World Population 2022 report further states that over 60 per cent of unintended pregnancies end in abortion and an estimated 45 per cent of all abortions are unsafe, causing 5 – 13 per cent of all maternal deaths, thereby having a major impact on the world's ability to reach the Sustainable Development Goals.

In Kenya, thousands of lives of women and girls are being put at risk every day and according to a 2012 study, the latest year for which data is available by the Ministry of Health and the African Population and Health Research Centre (APHRC), about 40 per cent of pregnancies are unplanned.

According to the study, 500,000 abortions were carried out in Kenya in 2012, meaning that at least one abortion was procured in the country in every 21 women capable of giving birth.

The abortion rate for Kenya is estimated to be 55 per 1000 women of reproductive age (15-49). This rate is very high when compared to other rates in Africa. It is on a par only with Uganda, which, in 2003, had a rate of 54 abortions per 1,000 women of reproductive age.

Unsafe abortion

Abortion in Kenya is prohibited except for certain medical circumstances, including danger to the life and health of a mother, or rape.

Unsafe abortions are a major cause of deaths and health complications for women in Kenya, particularly those living in the informal sector where self-induced abortions are rampant, resulting in deaths.

In urban areas, abortions also secretly thrive on backstreets under unhygienic conditions that kill many when the procedure backfires. In the rural areas, many women and girls use traditional concoctions to end their pregnancies.

It is estimated that 20 women succumb to illegal abortions in Kenya every week, according to a 2012 study conducted by the Ministry of Health.

This is the most recent available data on this sensitive matter. Most ministry officials are unwilling to divulge more information on the same.

So sensitive is the matter of abortion in Kenya that in 2013, the Ministry of Health stopped training abortion providers without giving any explanation, prompting many women and girls to risk their lives by resorting to backstreet clinics and traditional herbs.

Interestingly, before stopping training for legal abortion providers, a Ministry of Health study revealed that many women and girls in Kenya were dying because of unsafe abortions conducted by quacks and self-induced abortions using dangerous tools and unauthorised drugs.

However, experts in the health sector unanimously agree that the exact number of abortions in Kenya is rising steadily every day with the increased population now estimated to be more than 56million.

According to recent UN projections, Kenya's population will grow by around one million per year – 3,000 people every day – over the next 40 years and will reach about 85 million by 2050.

Deaths

In 2020, a report by the Centre for Reproductive Rights (CRR), a not-for-profit organisation, estimated that seven women and girls died every day in Kenya from unsafe abortions.

Other key findings in the UNFPA report indicate that gender inequality and stalled development drive high rates of unintended pregnancies.

Globally, an estimated 257 million women who want to avoid pregnancy are not using safe, modern methods of contraception, and where data is available, nearly a quarter of all women are not able to say no to sex.

A range of other key factors also contributes to unintended pregnancies, including lack of sexual and reproductive health care and information, and contraceptive options that don't suit women's bodies or circumstances.

Other factors include harmful norms and stigma surrounding women controlling their fertility and bodies, sexual violence and reproductive coercion, judgmental attitudes or shaming in health services, poverty and stalled economic development and gender inequality.

"All of these factors reflect the pressure societies place on women and girls to become mothers. Unintended pregnancy is not necessarily a personal failure and may be due to lack of the autonomy society allows or the value placed on women's lives," states the report.

It shows how easily the most fundamental rights of women and girls are put on the back burner in times of peace and the midst of war and calls on decision-makers and health systems to prioritise the prevention of unintended pregnancies by improving accessibility, acceptability, quality and variety of contraception and expand quality sexual and reproductive health care and information.

Empowerment

The report urges policymakers, community leaders and all individuals to empower women and girls to make affirmative decisions about sex, contraception and motherhood, and to foster societies that recognise the full worth of women and girls.

"If they do, women and girls will be able to contribute fully to society, and will have the tools, information and power to make this fundamental choice—to have children, or not—for themselves," says the report.

Globally, an estimated 257 million women who want to avoid pregnancy are not using safe, modern methods of contraception, while in 47 countries, about 40 per cent of sexually active women were not using any contraceptive methods to avoid pregnancy.

The report states that nearly a quarter of all women are not able to say no to sex (where data is available), while contraceptive use is 53 per cent lower among women who have experienced intimate partner violence.

Studies show that rape-related pregnancies are equally or more likely to occur than pregnancies from consensual sex and over 60 per cent of unintended pregnancies, and almost 30 per cent of all pregnancies, end in abortions.

In developing countries like Kenya, unsafe abortions cost an estimated Sh64 billion per year in treatment costs alone.

In the first 12 months of the Covid-19 pandemic, the estimated disruption in contraceptive supplies and services lasted an average of 3.6 months, leading to as many as 1.4 million unintended pregnancies.

[email protected]