Family planning dramatically improves the health and chances of survival of both women and their children. At the same time, when parents are more confident their children will survive, they are more likely to have fewer children and plan the size of their families. U.S. international development and humanitarian assistance should support both child health and family planning programs as complementary initiatives.
Too Many Deaths
Maternal and child deaths in developing countries are unacceptably high. Every year, an estimated 529,000 women die in pregnancy or childbirth, and for every woman who dies as many as 30 others suffer chronic illness or disability. In some places, pregnancy is the leading killer of women of childbearing age. Lifetime risk of maternal death is 1 in 6 in Afghanistan; 1 in 7 in Niger; 1 in 13 in Uganda and 1 in 14 in Ethiopia. In the United States, the lifetime risk of maternal death is 1 in 2,500.
Furthermore, each year 3.3 million babies are stillborn, more than 4 million die within 28 days of birth, and another 6.6 million children die before age five. On average, every minute of every day a woman dies in pregnancy or childbirth and some 20 children die of largely preventable causes. Less than 1 percent of these deaths occur in rich countries.
|Deaths to Children Under Age 5 by Birth Interval
*Average for 36 developing countries based on surveys conducted 2000-2004.
Source: ORC Macro. 2006. MEASURE DHS STATcompiler. Accessed online at http://www.measuredhs.com on March 2, 2006.
Healthy Mothers = Healthy Children
Women who are in poor health are more likely to give birth to unhealthy babies and often cannot provide adequate care. Studies in Bangladesh in the 1980s found that when a mother died after giving birth, her newborn baby had only a small chance of surviving to its first birthday. Children who survive a mother’s death are less likely to receive sufficient nourishment, and older girls often drop out of school to care for younger siblings.
Birth Spacing Improves Child Survival
The timing of births has a powerful impact on a child’s chances of survival. Research shows that children born less than two years after the previous birth are about 2.5 times more likely to die before age five than children born three to five years after the previous birth. When a pregnant woman has not had time to fully recover from a previous birth, the new baby is often born underweight or premature, develops too slowly, and has an increased risk of dying in infancy or contracting infectious diseases during childhood.
Saving Children’s Lives
By preventing closely-spaced births and births to very young mothers, family planning could save the lives of several million children annually. If mothers could achieve their preferred birth intervals, under-five mortality would fall by an estimated 17 percent in Kenya, by 23 percent in Nigeria, and by 46 percent in Pakistan. Modern contraceptives are increasingly needed as traditional, less effective methods of birth control – such as breastfeeding – are abandoned.
Saving Women’s Lives
Women who space births three to five years apart not only have healthier babies, but are also more likely to survive pregnancy and childbirth. By preventing high-risk pregnancies, it is estimated that family planning currently prevents 215,000 maternal deaths each year, including those from unsafe abortion.
Family planning can prevent many if not most deaths from unsafe abortion. Approximately 87 million unintended pregnancies occur each year; more than half result in abortion and 18 million of those take place in unsafe circumstances. About 68,000 women die from unsafe abortions annually; thousands more suffer serious complications. Studies in several countries show that increased contraceptive use contributes to dramatic declines in abortion rates, thereby reducing abortion-related deaths. In Russia, between 1998 and 2001, contraceptive prevalence increased by 74 percent, while the abortion rate declined by 61 percent.
Family planning programs also help prevent the spread of HIV/AIDS and other sexually transmitted diseases (STDs) by providing information about safer sexual practices and encouraging condom use, the most effective means of preventing STDs. In 2005, 17.5 million women were living with HIV and the proportion of women affected by the epidemic continues to increase. HIV infection levels among pregnant women are 20 percent or greater in six southern African countries, and many HIV-positive women have expressed desire to prevent future pregnancies.
Teen Pregnancies Carry Greater Risk
Pregnancy is the leading cause of death for young women aged 15 to 19 worldwide.Pregnancies to young women carry increased risks for both mothers and their babies, as teenage girls are less likely to get prenatal care and are at greater risk of complications during delivery. Compared to girls in their twenties, girls aged 15 to 19 are twice as likely, and girls under 15 five times as likely, to die in childbirth.
Mortality and morbidity rates are higher among infants born to young mothers. The risk of dying in the first year of life is typically greater by 30 percent or more among babies whose mothers are aged 15 to 19 than among those born to mothers aged 20 to 29.
Adolescents are also more likely to undergo unsafe abortions. Even where abortion is legal, access may be difficult for unmarried girls. Worldwide, at least 2.5 million girls under 20 years old have unsafe abortions each year. In Africa, women under age 25 account for almost 60 percent of unsafe abortions. In many countries, the number of unsafe abortions among adolescents is increasing.
More Funds Needed
Family planning is one of the most cost-effective ways to improve maternal and child health, and yet receives only a tiny fraction – on average less than 2 percent – of all official development assistance. Today more than 200 million women say they would prefer to avoid pregnancy, but are not using any form of modern contraception. Family planning must be supported as one of the most assured ways to improve the health and livelihoods of women and their children—saving lives, strengthening families and promoting sustainable development.