Challenges
to choice
Contraception is the most obvious way to prevent an unintended pregnancy.
And while all methods can fail or be used incorrectly, the biggest issue by far is people not being able to get the contraception that they need, when they need it.
Globally, around 257 million women who want to avoid pregnancy are not using safe, modern methods of contraception.
Among them, 172 million are using no method at all. Most women who do not want to become pregnant say they do not use modern contraception because of:
- (26%)
- (24%)
- (23%)
- (20%)
Myths and misinformation are everywhere and peddled by all sources, from teachers to health workers, policymakers or parents.
Many women have concerns about side effects, which can be dismissed by health providers. Their contraceptive needs might also change over time, which health systems aren’t always responsive to, while alternative methods may be in short supply or not available at all.
Family planning programmes have made huge strides in opening up access to and information on contraceptives – but there’s still far to go. To reach those left behind, these programmes need to tackle stigma, misinformation, health provider training, comprehensive sexuality education and gender inequality head on.
The problem with abstinence-only approaches:
Abstinence from sexual activity is considered by many to be a “fail-safe” method of controlling fertility.
Surveys show that, among people using periodic abstinence as a method of contraception, about 40 per cent discontinue the method within 12 months. And even people who faithfully adhere to abstinence may experience rape or coercive sex, which are alarmingly pervasive.
We need more research into other kinds of contraceptives, including those with fewer side effects and male contraceptives.
Yes. Weight gain, acne, nausea, moodiness, headaches, diarrhoea, stomach cramps. USA, 39 years old
Yes, blurry vision and mood swings. No one told me about the side effects beforehand, not the doctor, nor the pharmacist. Jordan, 44 years old
Yes, heavy bleeding and abdominal pain in the first few months. Nigeria, 37 years old
No. India, 62 years old
Yes. Fatigue and decreased libido. Mexico, 38 years old
I had a health insurance plan that made it impossible to access oral contraceptives. USA, 39 years old
Yes, many young people hesitate to access contraceptives because of fear and stigma. Nepal, 23 years old
No, but sometimes doctors were embarrassed to talk about contraception. Ukraine, 39 years old
Yes! When I was 21 years old, the doctor at a health unit scolded me. Mexico, 38 years old
Yes, there are regular stock-outs. Uganda, 35 years old
Many unmarried girls are scared to go for consultations because of a lack of privacy. Doctors might not keep it secret. Tajikistan, 30 years old
I was embarrassed to ask for condoms, because it is believed that only a man should ask for them. Nicaragua, 50 years old
Note: An informal questionnaire elicited about 60 responses from nearly 30 countries at the end of 2021. Responses here have been excerpted and edited for clarity.