Abstract
Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor quality and limited access to family planning services. Moreover, non-use of contraceptive methods and method failure are important reasons for unintended pregnancy. Women of reproductive age experience multiple adverse outcomes due to unintended pregnancy. These women neither care for themselves nor for their family and due to such careless behavior the likelihood of maternal and neonatal morbidity and mortality increases. Research on intervention programs for unintended pregnancy needs to be done in future. It is important to focus on how intervention programs should be designed, delivered and examined. Intervention strategies should aim to reduce unintended pregnancy by focusing on all the identified factors so that infant and maternal mortality and morbidity as well as the need for abortion is decreased and the overall well-being of the family is maintained and enhanced. Thus, improved community efforts are required to educate women about family planning as well about the proper use of family planning methods. Improved counseling and proper follow up is required especially of those women who adopt any method. Since improper treatment, incomplete follow up and limited choice of method might lead the women to discontinue the methods, therefore role of quality of care of existing services in improving women’s ability to achieve their desired reproductive goals should be given an attention. In addition to improving the quality of existing family planning services, the focus should be on the follow up of women for assessing the adherence to method and addressing their problems related to any method.
Highlights
According to World Health Organization (WHO) and Population Reference Bureau statistics, the current population of the world is little over 7 billion and it continues to grow by 75 to 78 million people annually [1,2,3]
It is anticipated that unmet need for contraceptives, growing number of women of reproductive age (15 to 49 years) and a desire in the reduction of family size will increase the number of unintended pregnancies globally to 92 million by 2015 [11, 12]
The findings showed that when the distance from the services is 0-4km the contraceptive prevalence rate (CPR) is 36% on average, while at 5-14km CPR is 33% and at 15+ km CPR is 31% [57]
Summary
According to World Health Organization (WHO) and Population Reference Bureau statistics, the current population of the world is little over 7 billion and it continues to grow by 75 to 78 million people annually [1,2,3]. The reason that developing countries will contribute more towards world’s population is because of their high birth rate, which in turn is due to low contraceptive use [4]. It is anticipated that unmet need for contraceptives, growing number of women of reproductive age (15 to 49 years) and a desire in the reduction of family size will increase the number of unintended pregnancies globally to 92 million by 2015 [11, 12]. The highest rates of unintended pregnancies were in Africa (86/1000 women) and the lowest were in Europe (38/1000 women) Despite such decline in rates of unintended pregnancies, its proportion is still high. About 4 out of 10 pregnancies (40%) were unintended worldwide in 2008, with a high proportion in South America and Southern Africa, where 6 out of 10 pregnancies were unintended [14, 15]. According to the standard DHS (Demographic health survey) definition: “The unmet need group consists of all those fecund women who are married and presumed to be sexually active, who either do not want any more children and who wish to postpone the birth of their child for at least two more years but are not using any method of contraception” [7, 19, 20]
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