Thursday, March 31, 2022


Unplanned pregnancy is 'a crisis all around us'

A report from the UN's Population Fund says pregnancy is an inevitability, not a choice, for many women lacking education, autonomy or contraception.




Unintended pregnancies are common in crisis situations that cause mass migration, like the war in Ukraine

Pregnancy isn’t always planned. For many women, this is because they can’t access contraception. For others, it is because their contraception fails. And for others, it is because they don’t have a choice.

Pregnancy isn't always planned. For many women, it is because they can't access contraception. For some, it is because their contraception fails. And for others, it is because they don't have a choice.

Each year, about 121 million pregnancies across the globe are unintended, according to a report published Wednesday by the United Nation's Population Fund (UNFPA). The UNFPA studies, among other things, sexual and reproductive health trends.

"This is a crisis that's all around us," said UNFPA Executive Director Natalia Kanem in an interview with DW. "But it's unseen. It's unrecognized and that is part of a global failure to prioritize women and girls and to uphold the basic human rights for women and adolescents."

Many pregnancies end in unsafe abortions

Over 60% of those unplanned pregnancies end in abortion. The rest are carried to term.


For women in rich countries where abortion is legal, termination procedures are largely safe. But nearly half — the UNFPA says it's 45% — are unsafe abortions.

Those unsafe abortions account for up to 13% of maternal deaths worldwide.


In developed countries, the number of unintended pregnancies has fallen dramatically since the 1990s. That is due in part, says the report, to an increase in the availability of contraceptives and sexual education.

That is not the case in sub-Saharan Africa, where the number of unintended pregnancies has fallen by a mere 12%. And when you account for global population growth, the report says the absolute number of women who experience an unintended pregnancy worldwide has in fact increased by 13%.

Women often feel at a loss if they get pregnant unintentionally. They don't know how to feel or what to do about it. The UN report says that although some pregnancies are terminated and others are celebrated, many are met with ambivalence.

"These pregnancies may be not quite unintended but not fully deliberate either, taking place when an individual lacks the possibility to fully articulate what they want in their lives — or even to imagine a life in which pregnancy is a choice," write the report authors.

Contraception: From access to misconception

Methods for contraception exist. But the report says that many women are prevented from exercising a basic right to bodily autonomy — for example, a right to choose to use contraception if they want. That is why, say the report authors, there is no material "magic bullet" or solution to "solve" the problem.

Some women who can access contraception methods abstain from using them. There are many reasons for this, ranging from stigmatization in certain communities or misconceptions — such as some perimenopausal women think they don't need contraception.

Many other women are in relationships with men who want children and deny their partners a right to birth control. That can either force the women to use birth control in secret or carry children for whom they feel unprepared.

The report notes that the responsibility to prevent pregnancy falls, in most cases, on women. But that does not mean they always have a choice. The report cites data collected in sub-Saharan Africa between the mid-1990s to the mid-2000s, which showed that the majority of men desired children more than women desired them.

Kanem told DW this indicated a "mismatch between what women want and need and what men believe to be the ideal."

"It's the mother of the family who typically is selfless. She plans the meals. She decides who is going to get which shoes to go to school. And she's a realist when it comes to [questions like]: How much can I bear? What is the investment in each of my children going to cost?" Kanem said.

Even when contraception is used perfectly, it can fail. For every 100 women who use condoms as their main method of birth control, 13 will become pregnant. And even for women who use highly effective forms of contraception, such as an Intrauterine Device (IUD), unintended pregnancies can still happen.

The report refers to the British Pregnancy Advisory Service, which conducts abortions in the UK. In 2016, the service says that more than half of about 60,000 women who had an abortion at one of their centers that year were using birth control.

Crisis situations upend routines

Conflicts and other crises can exacerbate the problem.

"If you have 15 minutes or half an hour to decide what you are going to do and you're caught up in a conflict… as you grab your children and race out the door, contraception, your menstrual supplies — they may not really be top of mind. I mean, if you have a passport, you're going to grab it, you're going to make sure that you can fit whatever you can into a little backpack and go," said Kanem.

Kanem said that this makes women fleeing conflict situations especially vulnerable to unintended pregnancies. Many women rely on monthly supplies of birth control. When they are displaced, they no longer have access to their usual supplies.

Damaged health care systems can also result in unintended pregnancies, Kanem said.

In Afghanistan, for instance, disruption to the healthcare system is expected to lead to around 1 million extra unintended pregnancies through to 2025.

Poor communities lack education most

Unintended pregnancies can affect any woman, regardless of financial or educational background. But they are more likely to happen in countries where women have lower levels of education and autonomy, says the report.

Africa has the highest rates of unplanned pregnancies, viewed country by country. The continent sees the highest number of women giving birth under the age of 18 and outside of marriage.

"While the overall rates around the world dropped in the 1990s, it was slowest in sub-Saharan Africa," Kanem said. "Regions of Africa showed some of the lowest scores on the index of bodily autonomy."

Kanem said this was largely due to a lack of education. And education is linked to access to contraception.

If women don't know what they want and need, they can't ask for it. And when sexual education is spread through word of mouth, it can easily get tangled up in misconceptions.

"Part of choice is being able to choose the method that's right for you and we saw striking myths about contraception very active among young women in Africa," said Kanem, who wanted to stress that contraception does not jeopardize future fertility, but rather safeguards women's health.

Edited by: Zulfikar Abbany

121 Million Unintended Pregnancies Per Year Reveals 'Global Failure' on Women's Rights: Report

Governments around the world must establish "comprehensive sexuality education," the agency said.

"For too many, the most life-altering reproductive choice is no choice at all," said the United Nations Population Fund.


A pregnant woman wearing a face mask walks past a mural in Caracas, Venezuela on January 19, 2021. (Photo: Federico Parra/AFP via Getty Images)

INCLUDING ALL G20 CONTRIES


JULIA CONLEY
COMMON DREAMS
March 30, 2022

The United Nations sexual and reproductive health agency on Wednesday said global policymakers have utterly failed to uphold women's rights as it reported that despite the wide availability of contraception in wealthy countries, nearly half of all pregnancies around the world—121 million per year—are unintended.

"Nothing is more fundamental to bodily autonomy than the ability to decide whether or not to become pregnant," said the U.N. Population Fund (UNFPA) in its new report, titled Seeing the Unseen. "Yet for too many, the most life-altering reproductive choice is no choice at all."

A lack of sexual and reproductive healthcare and education and gender inequality are major drivers of unintended pregnancies, which are especially common in Latin America and Sub-Saharan Africa according to a separate report released last week by the World Health Organization.

"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."

According to the UNFPA, 23% of women report feeling unable to reject demands for sex, while an estimated 257 million women around the world are not using safe, effective forms of birth control despite wanting to avoid pregnancy—in some cases because contraceptives that suit their circumstances are not available to them, and in others because of rampant misinformation.

The agency surveyed women from countries around the world, finding that many women in both the Global North and the Global South avoid using contraceptives due to beliefs that they cause infertility, cancer, and other health conditions.

A 44-year-old respondent in Algeria told the UNFPA that she had learned "condoms should only be used for sex outside marriage, the pill makes you sterile, the IUD causes hemorrhages."

According to the report, more than a quarter of women who don't use contraceptives say they want to avoid side effects.

"We need more research into other kinds of contraceptives, including those with fewer side effects and male contraceptives," the UNFPA said.

Harmful societal norms regarding women's control of their bodies, shaming in health services, and sexual violence—which often increases in places experiencing conflicts—also contribute to high rates of unintended pregnancy.

"I didn't have sexuality education like they have today," another woman said. "You wanted to ask, and the answer was, 'Shut up, you shouldn't ask that.'"



Governments around the world must establish "comprehensive sexuality education," the agency said.

"Done properly, this education can combat myths and misperceptions, and it can promote communication, consent, and respectful relationships," according to the report. "It can address gender and power and teach adolescents about confidential contraceptive care."

Natalia Kanem, executive director of UNFPA, called the report a "wakeup call" regarding an "invisible crisis."

The "staggering number of unintended pregnancies represents a global failure to uphold women and girls' basic human rights," Kanem said in a statement.

Unintended pregnancies can have serious health and safety consequences for women in countries where they can't access safe abortion care. More than 60% of unintended pregnancies result in abortions, and around the world, "a staggering 45% of all abortions are unsafe."

High rates of unintended pregnancies can have "profound consequences for societies, women and girls, and global health," the agency said.

Women and girls around the world "see other opportunities dwindle" after being "robbed of the chance to choose whether or not to become pregnant."

Many girls are forced to leave school or their jobs, increasing the chances that their families will face poverty.

"The slide into poverty can be steep and swift, with poorer nutrition and less schooling following close behind," the UNFPA reported.

With 6% or more of the world's women experiencing an unintended pregnancy each year, the agency said, the rate "begs an uncomfortable question: Do these societies fully value the potential of women beyond their reproductive capacities?"



The report called on policymakers to: 
 
Prioritize bodily autonomy and ensure women and girls are empowered to prevent these pregnancies in the first place;
Strengthen health and education systems, which have a human rights obligation to provide accurate information about reproduction and contraception and should instill in young people the ability to articulate their choices and goals and the duty to respect those of their partners;
Ensure contraceptives are accessible, affordable, and available in a range of forms acceptable to those using them;
Invest in research to better understand the causes and consequences of unintended pregnancy and to spearhead contraceptive technologies that allay women’s anxieties over side effects and broaden the options available for men; and
Address justice systems that too often fail to hold perpetrators of sexual violence and coercion to account, leaving survivors to bear the stigma of both unwanted sex and the consequences of a potential pregnancy.

"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," concluded the UNFPA chief.

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Whose Family Values?

Women and the Social Reproduction of Capitalism

"proletarii, propertyless citizens whose service to the State was to raise children (proles).”
Classical Antiquity; Rome, Perry Anderson, Passages from Antiquity to Feudalism, Verso Press 1974

The issue facing women working at home or in capitalist society is the matter of unwaged servitude versus wage-slavery. The social reproduction of capitalist society is found both in the workplace and the home.

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