Rates of unintended pregnancy have decreased globally since 1990, according to a new study published today in The Lancet Global Health. While the unintended pregnancy rate fell worldwide from 1990–1994 to 2010–2014, it dropped less sharply in developing regions (16%) than in developed regions (30%). "Global, Regional, and Subregional Trends in Unintended Pregnancy and Its Outcomes from 1990 to 2014," by Guttmacher Institute researcher Jonathan Bearak and colleagues, highlights the incidence of unintended pregnancies in all world regions, using an updated methodology and a broader evidence base than past studies to examine changes over time.
The researchers found that during the most recent period (2010–2014), an estimated 44% of pregnancies worldwide were unintended. This translates to a rate of 62 unintended pregnancies per 1,000 women aged 15–44, a decrease from 74 per 1,000 women in 1990–1994.
The difference between overall unintended pregnancy rates in developing and developed regions is notable: In 2010–2014, there were 65 unintended pregnancies per 1,000 women aged 15–44 in developing regions, compared with 45 per 1,000 women in developed regions. The high unintended pregnancy rate in developing regions corresponds with a substantial unmet need for contraception in these parts of the world.
"Women and couples increasingly want to control the timing and spacing of their births, and to have smaller families," noted Jonathan Bearak, lead author of the study and senior research scientist at the Guttmacher Institute. "Yet progress in reducing unintended pregnancy has been uneven across regions."
Worldwide, more than half (56%) of unintended pregnancies ended in abortion in 2010–2014. From 1990–1994 to this period, the proportion of unintended pregnancies ending in abortion rose in developing countries and fell in developed countries. Both the unplanned and planned birth rates fell in developing regions, which likely reflects the increasingly common preference for smaller family size, whereas those rates remained about the same in developed regions.
"It will be important to examine the reasons why more women are terminating their unintended pregnancies in developing countries, and equally important to understand why women with unintended pregnancies in developed countries increasingly go on to have unplanned births," commented Gilda Sedgh, coauthor of the study and principal research scientist at the Guttmacher Institute.
The authors urge continued investments in health care programs and policies in order to ensure that women and couples have access to contraceptives and family planning services. It is also crucial to make or keep safe abortion services available, since—even if the need for contraceptives is fully met—contraceptive methods may fail from time to time. Together, these efforts are essential to helping women safely achieve their reproductive goals.
"It is critical for governments to prioritize making the full range of contraceptive services available, so that women and couples are able to choose the method that best fits their needs, to plan and space their pregnancies, and to prevent unintended pregnancy," says Sneha Barot, senior policy manager at the Guttmacher Institute.
"Global, Regional, and Subregional Trends in Unintended Pregnancy and Its Outcomes from 1990 to 2014: Estimates from a Bayesian Hierarchical Model," by Jonathan Bearak, Anna Popinchalk, Leontine Alkema and Gilda Sedgh, is available online in The Lancet Global Health.