Report reveals heavy death toll from unintended pregnancies

Posted: 30 September 2002

A new report on the impact of unintended pregnancies on maternal deaths in developing countries details more than 300 million unintended pregnancies and the resulting deaths of nearly 700,000 women between 1995 and 2000.

The report Promises to Keep: The Toll of Unintended Pregnancies on Women's Lives in the Developing World, published by the Global Health Council, claims to be the first comprehensive global analysis of the problem.

"Most of these unintended pregnancies and needless deaths could have been prevented had basic reproductive health services been made available to these women. Failure to provide women with the means to plan, prevent or appropriately space their next pregnancy poses an extraordinary public health threat, one that can readily be addressed with modest resources," said Nils Daulaire, President and CEO of the Global Health Council.

"The report confirms the strong correlation between maternal mortality and inadequate access to quality reproductive health. Reproductive health is about saving lives," said Daulaire.

The Council conducted its study to help progress on pledges to reform and fund reproductive health services made at the 1994 International Conference on Population and Development (ICPD).

According to the study, between 1995 and 2000, the world's 1.3 billion women between the ages of 15 and 45 experienced more than 1.2 billion pregnancies. Of these, more than 300 million - or more than one quarter - were unintended. Over those six years, nearly 700,000 women died from unintended pregnancies. While more than one-third died from the myriad problems associated with pregnancy, labour and delivery, the majority - over 400,000 - died as a result of complications resulting from abortions carried out in unsafe, unsanitary and often illegal conditions.

The deaths detailed in the report were the result of inadequate access to effective reproductive health services, poverty, ignorance, social and economic marginalization, and entrenched gender bias.

The report confirms the consequences of the growing disparity between healthcare available in industrialized nations and in the developing world. Women in some developing nations run several hundred times the risk of dying during pregnancy and childbirth compared to their counterparts in wealthier nations. In North America and Europe, one woman in 4,000 is likely to die from maternal causes. In Africa, one of every 15 women will die of these causes.

The reasons for this continued high prevalence of maternal mortality are complex, the result of flagging funding for essential health services, and the low priority placed on women's reproductive health.

Maternal mortality is highest in countries where women are least likely to have access to modern contraceptive services and in those countries where women do not have access to trained birth attendants or any type of care during labour and delivery. In Burkina Faso, where only four per cent of women use family planning methods, one in 14 will die of maternal causes over the course of her lifetime. In Brazil, the opposite is true; nearly three-quarters of the female population regularly use family planning services and their lifetime risk of maternal mortality sinks to one in 130.

"We also found that where women have little or no access to simple and reliable methods of contraception, an unintended pregnancy often leads to the decision to have an abortion," Daulaire noted. Deaths as a result of unsafe abortions account for 64 per cent of the nearly 700,000 women who have died as a result of unintended pregnancies since 1995.

The analysis of national data demonstrates that in countries where women desire to limit their family sizes and have access to family planning services, the number of women both seeking abortions and dying as a result of them remains relatively low.

Daulaire cited estimates by the World Health Organization and the World Bank that $3.00 per person per year would provide basic family planning, maternal and neonatal health care to women in developing countries. The package would include contraception, prenatal, delivery and post-natal care in addition to postpartum family planning and the promotion of condoms to prevent sexually transmitted infections.