Prevalence of birth control

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Globally approximately 45% of those who are married and able to have children use contraception.[1] As of 2007, IUDs were used by about 17% of women of child bearing age in developing countries and 9% in developed countries or more than 180 million women worldwide.[2] Avoiding sex when fertile is used by about 3.6% of women of childbearing age, with usage as high as 20% in areas of South America.[3] As of 2005, 12% of couples are using a male form of contraception (either condoms or a vasectomy) with rates of up to 30% in the developed world.[4]

As of 2012, 57% of women of child bearing age wanted to avoid pregnancy (867 of 1520 million).[5] About 222 million women however were not able to access birth control, 53 million of whom were in sub-Saharan Africa and 97 million of whom were in Asia.[5] Many countries limit access to birth control due to the religious and political reasons.[6]

Africa

prevalence of modern contraception map
Percentage of women using modern contraception as of 2010.

Contraceptive use among women in Sub-Saharan Africa has risen from about 5% in 1991 to about 30% in 2006.[7] However, due to extreme poverty, lack of access to birth control, and restrictive abortion laws, many women still resort to clandestine abortion providers for unintended pregnancy, resulting in about 3% obtaining unsafe abortions each year.[8][9] South Africa, Botswana, and Zimbabwe have successful family planning programs, but other central and southern African countries continue to encounter extreme difficulties in achieving higher contraceptive prevalence and lower fertility for a wide variety of compounding reasons.[10]

China

red downward-pointing triangle
The Red Triangle is used to indicate family planning products and services in many developing countries

The one-child policy of the People's Republic of China required couples to have no more than one child. Beginning in 1979, the policy was implemented to control rapid population growth.[11] Chinese women receive free contraception and family planning services.[12] Greater than 70% of those of childbearing age use contraception.[1] Since the policy was put into place in 1979, over 400 million births have been prevented.[12] Because of various exemptions, fertility rate is about 1.7 children per woman, down from 5.9 in the 1960s. A strong preference for boys and free access to fetus sex determination and abortion has resulted in an artificially high proportion of males in both rural and urban areas.[12]

Beginning January 1, 2016, China officially abolished the one-child policy. The Chinese government decided to allow families to have a second child to supposedly grow a bigger work force and allow the aging population to relax more. They predict that another economic boom will occur in the near future. The new policy was also seen as a solution to the massive gender disparity, with China's current population leaning heavily toward males. There are no concrete estimates for the new rate of growth of the Chinese population, but there are testimonies from the citizens about their new freedom. Some mothers have said that they are excited at the opportunity of having another child, while others still follow the one child tradition.[13]

India

Awareness of contraception is near-universal among married women in India.[14] However, the vast majority of married Indians (76% in a 2009 study) reported significant problems in accessing a choice of contraceptive methods.[15] In 2009, 48.3% of married women were estimated to use a contraceptive method, i.e. more than half of all married women did not.[15] About three-fourths of these were using female sterilization, which is by far the most prevalent birth-control method in India.[15] Condoms, at a mere 3%, were the next most prevalent method.[15] Meghalaya, Bihar and Uttar Pradesh had the lowest usage of contraception among all Indian states with rates below 30%.[15]

Pakistan

In 2011 just one in five Pakistani women aged 15 to 49 used modern birth control.[16] In 1994, Pakistan pledged that by 2010 it would provide universal access to family planning.[17] but contraception is shunned under traditional social norms.[16] Most women who say they do not want any more children or would like to wait a period of time before their next pregnancy do not have the contraceptive resources available to them in order to do so.[17] In the 1990s, women increasingly reported wanting fewer children, and 24 percent of recent births were reported to be unwanted or mistimed.[17] The rate of unwanted pregnancies is higher for women living in poor or rural environments; with two-thirds of women live in rural areas.[17] While 96 percent of married women were reported to know about at least one method of contraception, only half of them had ever used it.[17] The most commonly reported reasons for married women electing not to use family planning methods include the belief that fertility should be determined by God (28%); opposition to use by the woman, her husband, others or a perceived religious prohibition (23%); infertility (15%); and concerns about health, side effects or the cost of family planning (12%).[17]

United Kingdom

Contraception has been available for free under the National Health Service since 1974, and 74% of reproductive age women use some form of contraception.[18] The levonorgestrel intrauterine system has been massively popular.[18] Sterilization is popular in older age groups, among those 45-49, 29% of men and 21% of women have been sterilized.[18] Female sterilization has been declining since 1996, when the intrauterine system was introduced.[18] Emergency contraception has been available since the 1970s, a product was specifically licensed for emergency contraception in 1984, and emergency contraceptives became available over the counter in 2001.[18] Since becoming available over the counter it has not reduced the use of other forms of contraception, as some predicted it might.[18] In any year only 5% of women of childbearing age use emergency hormonal contraception.[18] Despite widespread availability of contraceptives, almost half of pregnancies were unintended circa 2005.[18] Abortion was legalized in 1967, however still remained illegal in Northern Ireland until 2020.[18]

United States

As of 2008, in the United States, 99% of sexually active women have used birth control at some point in time.[19] In 2015-2017, 64.9% of women aged 15-49 used a form of birth control. The most common forms of birth control were female sterilization (18.6%), oral contraceptive pills (12.6%), long-acting reversible contraceptives (10.3%), and male condoms (8.7%).[20] Despite the availability of highly effective contraceptives, in 2011, 45% of pregnancies were unintended.[21] In 2002, contraceptive use saved about $19 billion in direct medical costs.[22]

References

  1. 1.0 1.1 Darney, Leon Speroff, Philip D. (2010). A clinical guide for contraception (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 10. ISBN 978-1-60831-610-6.
  2. Darney, Leon Speroff, Philip D. (2010). A clinical guide for contraception (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. pp. 242–243. ISBN 9781608316106. Archived from the original on 2023-01-14. Retrieved 2022-12-29.
  3. Darney, Leon Speroff, Philip D. (2010). A clinical guide for contraception (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 315. ISBN 978-1-60831-610-6.
  4. Naz, RK; Rowan, S (June 2009). "Update on male contraception". Current Opinion in Obstetrics and Gynecology. 21 (3): 265–9. doi:10.1097/gco.0b013e328329247d. PMID 19469045. S2CID 40507937.
  5. 5.0 5.1 Darroch, JE; Singh, S (May 18, 2013). "Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys". Lancet. 381 (9879): 1756–1762. doi:10.1016/S0140-6736(13)60597-8. PMID 23683642. S2CID 8257042.
  6. Hurt, K. Joseph; et al., eds. (2012-03-28). The Johns Hopkins manual of gynecology and obstetrics (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 232. ISBN 978-1-60547-433-5. Archived from the original on 2023-01-10. Retrieved 2022-12-29.
  7. Cleland, JG; Ndugwa, RP; Zulu, EM (Feb 1, 2011). "Family planning in sub-Saharan Africa: progress or stagnation?". Bulletin of the World Health Organization. 89 (2): 137–43. doi:10.2471/BLT.10.077925. PMC 3040375. PMID 21346925.
  8. Rasch, V (July 2011). "Unsafe abortion and postabortion care - an overview". Acta Obstetricia et Gynecologica Scandinavica. 90 (7): 692–700. doi:10.1111/j.1600-0412.2011.01165.x. PMID 21542813. S2CID 27737728.
  9. Huezo, CM (August 1998). "Current reversible contraceptive methods: a global perspective". International Journal of Gynaecology and Obstetrics. 62 Suppl 1: S3–15. doi:10.1016/s0020-7292(98)00084-8. PMID 9806233. S2CID 9929780.
  10. Lucas, D (May–Jun 1992). "Fertility and family planning in southern and central Africa". Studies in Family Planning. 23 (3): 145–58. doi:10.2307/1966724. JSTOR 1966724. PMID 1523695.
  11. Kane, P.; Choi, C. Y. (Oct 9, 1999). "China's one child family policy". BMJ (Clinical Research Ed.). 319 (7215): 992–4. doi:10.1136/bmj.319.7215.992. PMC 1116810. PMID 10514169.
  12. 12.0 12.1 12.2 Hesketh, T.; Lu, L.; Xing, Z. W. (Sep 15, 2005). "The effect of China's one-child family policy after 25 years" (PDF). The New England Journal of Medicine. 353 (11): 1171–6. doi:10.1056/NEJMhpr051833. PMID 16162890. Archived (PDF) from the original on September 20, 2018. Retrieved December 29, 2022.
  13. Buckley, Chris (29 October 2015). "China Ends One-Child Policy, Allowing Families Two Children". The New York Times. Archived from the original on 24 November 2016. Retrieved 29 December 2022.
  14. B.M. Ramesh; S.C. Gulati; R.D. Retherford. "Contraceptive use in India, 1992–93" (PDF). National Family Health Survey Subject Reports, Number 2, October 1996. International Institute for Population Sciences. Archived (PDF) from the original on 2016-08-05. Retrieved 2009-11-25.
  15. 15.0 15.1 15.2 15.3 15.4 "India and Family Planning: An Overview" (PDF). Department of Family and Community Health, World Health Organization. Archived from the original (PDF) on 2009-12-21. Retrieved 2009-11-25. {{cite journal}}: Cite journal requires |journal= (help)
  16. 16.0 16.1 Brulliard, Karin (15 December 2011). "As Pakistan's population soars, contraceptives remain a hard sell". The Washington Post. Archived from the original on 25 March 2012. Retrieved 19 April 2012.
  17. 17.0 17.1 17.2 17.3 17.4 17.5 Hardee, Karen and Leahy, Elizabeth. "Population, Fertility and Family Planning in Pakistan: A Program in Stagnation." Population Action International. Volume 4, Number 1, 1-12. 2007.
  18. 18.0 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 Rowlands S (October 2007). "Contraception and abortion". J R Soc Med. 100 (10): 465–8. doi:10.1177/014107680710001015. PMC 1997258. PMID 17911129.{{cite journal}}: CS1 maint: url-status (link)
  19. "Contraceptive Methods Women Have Ever Used: United States, 1982–2010" (PDF). Centers for Disease Control and Prevention — National Center for Health Statistics. February 14, 2013. Archived (PDF) from the original on January 27, 2023. Retrieved December 28, 2022.
  20. "Current Contraceptive Status Among Women Aged 15–49: United States, 2015–2017". Centers for Disease Control and Prevention. 2022-10-31. Archived from the original on 2022-09-13. Retrieved 2022-12-29.
  21. Finer, Lawrence B.; Zolna, Mia R. (2016-03-03). "Declines in Unintended Pregnancy in the United States, 2008-2011". The New England Journal of Medicine. 374 (9): 843–852. doi:10.1056/NEJMsa1506575. ISSN 1533-4406. PMC 4861155. PMID 26962904.
  22. Trussell, James (March 2007). "The cost of unintended pregnancy in the United States". Contraception. 75 (3): 168–170. doi:10.1016/j.contraception.2006.11.009. ISSN 0010-7824. PMID 17303484. Archived from the original on 2022-12-29. Retrieved 2022-12-29.