On World Population Day, July 11, leaders and activists turn their attention to the urgent need to address population issues, including family planning. Access to sexual and reproductive health care is essential for women’s empowerment, safety, gender equality, and to reduce poverty, according to the United Nations Population Fund (UNFPA).
Yet millions of women and adolescent girls still lack access to these services, which are crucial to their well-being and success.
This year marks 25 years since the 1994 International Conference on Population and Development, during which 179 governments recognized the importance of access to reproductive health and gender equality to achieving sustainable development. And while progress has been made in that time, there is still a long way to go to achieve these goals.
These are five ways women, and the world, are held back when both men and women lack access to sexual and reproductive health education and safe, voluntary family planning methods.
1. Girls and women who are unable to make informed decisions over their own bodies and plan their families face greater health risks.
About 23 million girls aged 15 to 19 years in developing countries do not have access to modern contraception, including condoms, birth control pills, and IUDs. As a result, half of the pregnancies among girls aged 15 to 19 years in developing regions are estimated to be unintended, according to the World Health Organization.
Without access to family planning methods — which can include contraceptives, the use of the “calendar method,” and abstinence — girls and women face challenges planning out their pregnancies. But with safe, affordable care and resources, they can avoid having children at a young age when health risks are higher than usual or having multiple children closer together than they would like to. Additionally, family planning methods, such as the use of condoms, can help prevent sexually transmitted diseases from spreading, while also reducing the rates of unintended pregnancies, which prevents women from having unsafe abortions. UNFPA Supplies, a UNFPA program dedicated to expanding access to family planning in developing countries, estimates that 2.3 million potential unsafe abortions were avoided in 2017 as a result of the organization providing safe contraceptives.
A community health worker gives advice on contraception to mother-of-two, Tuni, so she can plan the size of her family.
Because of the stigma attached to young motherhood and lack of access to health services, pregnant girls are at risk of getting inadequate prenatal care, which can jeopardize their health and that of their babies.
According to one study, children born to mothers younger than age 25 or older than 35 experience worse outcomes when it comes to mortality rates, self-rated health, height, obesity, and the number of diagnosed conditions than those born to mothers aged 25 to 34. While mothers under the age of 20 are at higher risk of eclampsia, puerperal endometritis, and systemic infections.
2.Girls who become pregnant unintentionally often leave school and miss out on their education.
Adolescent girls who become pregnant often leave school due to social stigma or to tend to their child — this is true in both developed and developing countries. In the United States, for example, one-third of girls who dropout of high school cite early pregnancy as their main reason. Only about 40% of American teenage mothers finish high school, and less than 2% graduate college by the age of 30. And more than 31 million girls are out of secondary school in sub-Saharan Africa, many due to early marriage and teenage pregnancy.
Lack of education and the opportunities to develop valuable skill sets put these women at a disadvantage in the formal labor market and workforce. Without gainful employment opportunities, many women lack the financial independence to sustain themselves and their families, forcing them to live in poverty.
Children born to adolescent parents are also more likely to perform poorly in school. These children frequently continue to live under the poverty line later in life, and have a higher chance of dropping out of school and become young parents themselves.
3. When women cannot plan their own futures, they lose out on job opportunities.
Women represent about 43% of the agricultural workforce in developing countries, and if they had access to the same productive resources as men, they could increase a farm’s yields by as much as 30%. This would help countries increase their output by up to 4%, according to the UN, and would help reduce the number of hungry people in the world by around 12% to 17%.
But it’s not just women in the agricultural industry who are disadvantaged by a lack of access to sexual health services and family planning resources. Women who are denied access to reproductive care are also three times more unlikely to be unemployed, a new study found.
“This study shows that restrictive legislation really harms women and children’s health, and that the people who should be making those decisions are the patients — the women,” Dr. Jenny Abrams, a fellow with Physicians for Reproductive Health, told Rewire.
When women are unable to plan their families and their futures, they are not able to realize their full potential — whether academic, economic, or personal. An estimated 7.5 million unintended pregnancies were avoided globally through use of contraceptives provided by UNFPA Supplies.
“Restricting someone’s capacity to move up or out of poverty is a huge implication … I often see women who already have large families who feel they just can’t take care of one more kid,” Abrams said. “I also see many low-income families with lots of kids and [I see] the strain it puts on their parents to work multiple jobs and do everything they can to stay afloat.”
Around the world, the burden of child care disproportionately falls on women, forcing many to leave the workforce or take a break from working, which can make it difficult for them to find gainful employment or advance in their careers when returning to the workforce.
4. Lack of access to sexual and reproductive health services and information most impacts those who are already vulnerable.
When it comes to accessing quality, affordable health care, there are visible disparities between and within communities. In New York City, for example, black women are 12 times more likely to suffer from pregnancy-related complications and deaths than white women, due to limited availability of economic and healthcare resources.
Across the world, those who are most at risk of sexual and reproductive health issues, are women and girls who are unable to afford or access contraceptives and care.
“Women in the poorest households may find themselves with little or no access to sexual and reproductive health care, leading to unintended pregnancies, higher risk of illness or death from pregnancy or childbirth, and the need to give birth on their own, without the assistance of a doctor, nurse or midwife,” according to UNFPA.
Approximately 214 million women, girls, and young people want, but do not have access to, reproductive and sexual health services.
5. When girls and women do not have access to sexual and reproductive health care, gender inequality is perpetuated.
In many communities around the world, cultural norms dictate the decision-making power women exercise — this is especially true in rural communities in developing countries. In more patriarchal societies where gender norms are stricter and defined in a more rigid fashion, women are often judged by and valued for their child-bearing abilities.
Men are less likely to concern themselves with family planning and hold all the power to make important decisions that impact women’s lives, including whether to use contraception, when and what kind of health services a woman can seek out, and how large their family will be.
“Despite the increasing availability of contraceptives over the years, hundreds of millions of women today still have no access to them, and to the reproductive choices that come with them,” UNFPA Executive Director Dr. Natalia Kanem said in a press release. “Without access, they lack the power to make decisions about their own bodies, including whether or when to become pregnant.
“The lack of this power — which influences so many other facets of life, from education to income to safety — leaves women unable to shape their own futures,” she explained.