The Invisible Crisis of Unintended Pregnancy – A Cost Too High to Ignore

Nearly half of all pregnancies worldwide, or about 121 million each year, are unintended, according to UNFPA’s State of World Population 2022 report. In addition, more than 60% of pregnancies unwanted abortions end in abortion, with around 45% of all abortions performed in unsafe conditions and accounting for between 5 and 13% of all recorded maternal deaths. In addition, almost a quarter of all women are unable to refuse sex and to make decisions about their own health.

With the continued growth of the world’s population, the absolute number of unintended pregnancies is expected to continue to increase. And the profound consequences of unwanted pregnancies for women, girls, societies and global health will continue to grow.

The most basic and life-defining reproductive choice – to get pregnant or not – is no choice at all if the fundamental human right to make informed decisions about one’s own body and health and to decide if, when and how many children to have is not available.

Every country is dealing with the consequences of the silent crisis of unwanted pregnancies. In Bhutan, a study of approximately 500 pregnant women on “Prevalence, determinants and outcomes of unintended pregnancies and perspectives on termination of pregnancy among women in Nganglam, Bhutan” (Choden et al., 2015) revealed that for one in five, the pregnancy was unwanted and the circumstances around each were diverse.

Lhamo (name changed) was unaware of contraceptives when she became pregnant at the age of 19. Medications she took to ease her physical discomfort resulted in a miscarriage and a week-long hospitalization.

18-year-old Pema (name changed) became pregnant in the first year of her Bachelor of Education program. The stress she faced from this unplanned pregnancy was threefold: impact on her studies, life outcomes for her and her child, and domestic violence.

Eden (name changed), 25, a working and breastfeeding mother, became alarmed to be pregnant again less than a year after giving birth to her first child. This heightened her struggles that she was already juggling childcare responsibilities with her career.

The impacts of unwanted pregnancies are clearly far-reaching and lifelong. When a woman is unable to complete her education, to participate in the labor market and her health is poor, the snowball effects can be multiple. In fact, the costs are enormous, not only at the individual level, but also for societies, health systems and the economy in general.

Various factors increase the likelihood of unwanted pregnancies, such as lack of knowledge about sexual and reproductive health, non-use of contraception, sexual assault and reproductive coercion. Shame, stigma, fear, poverty, gender inequality and many other factors undermine the ability of women and girls to exercise choice, to seek and obtain contraceptives, to negotiate the use of condom with a partner, to talk out loud and pursue their desires and ambitions.

The invisible crisis of unintended pregnancy paints an alarming picture of the state of neglect of women’s reproductive freedom and its impact on achieving the 2030 Sustainable Development Goals. themselves fundamental development goals such as gender equality, poverty reduction and improved maternal health. Tackling unwanted pregnancies will also contribute to the achievement of national development goals, including those of Bhutan.

If we really want sustainable development, we must galvanize our efforts to create a world where the vast majority of pregnancies are planned, welcomed and wanted. Policy makers, community leaders and individuals must work together to empower women and girls to be able to make independent decisions about sex, contraception and motherhood. Indeed, we must foster societies that recognize the full value of women and girls to create the conditions for transformative change.

Today, with the availability of quality sexual and reproductive health care and services, Pema has successfully graduated and Eden is keen for her daughter to learn comprehensive sex education so she can make her own choices. The continued return on these investments in health has pushed the needle in the right direction for Bhutan and for the world.

Contributed by

Andrea M Wojnar

UNFPA Representative in India and Country Director in Bhutan

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