World Development Report 1984

FIGURE 71 88 in Romania (1979). Resort to both legal and ille-
Trends in contraceptive prevalence in 197043, gal abortion often results from lack of information
selected countries about, and access to, safe and effective contracep-
Percentage of married women aged 15-49 using contraception tive methods.
60
hailand'
Unmet need
50 _Clmi
50 olombia In the surveys from which data on contraceptive
KoTea' 7use have been drawn women were also asked
40 / / wMexico whether they would like to have more children.
Forty to 75 percent of married women of childbear-
30 ing age in East and South Asian countries and in
Latin American and Caribbean countries want no
/ Egypt more children. In a few countries women were
20 also asked whether they wished to delay their next
Banglades pregnancy for a year or more. Nineteen percent of
10
Kena_ Nepal
women of. childbearing age in Bangladesh and
Thailand, 25 percent in El Salvador, and 32 percent
Pakistan in Guatemala said yes. In countries where both
0
1970 1975 1980 1983
a. Wife aged fifteen to forty-four.
b. Ever-married women.
Sourres: For Egypt, Kenya, and Pakistan, UN 1983; for others, CPS and
WFS data.
questions have been asked, from 50 to 90 percent
of women want either to limit or to space births.
In virtually all countries surveyed, the number of
women of childbearing age who want no more
children exceeds the number using some kind of
contraception. Some of the women who want no
more children or who wish to delay a pregnancy
are not using a method because they are currently
rhythm or withdrawal had an unwanted preg- pregnant or because they have been breastfeeding
nancy within three years after a birth, compared for less than one year and therefore are afforded
with only 29 percent of women who used the pill, some (but not total) protection. Others are unable
the IUD, or injectable contraceptives. The 1978 to conceive, or their husbands are away. These
Philippines Fertility Survey found that 36 percent women are not "exposed" to the risk of pregof
married women of reproductive age used some nancy, so they do not need contraception, at least
method, but only 16 percent used an efficient not immediately.
method. In contrast, in the Dominican Republic in The remaining women-those who would like to
1975, contraceptive use was 32 percent for all space or to limit births, who are not using contramethods
and 26 percent for efficient methods. ception, and who are exposed to the risk of preg-
Contraception is not the only method of birth nancy-are said to have "unmet need'" for contracontrol.
Induced abortion is widespread, even ception. By this definition, 6 to 12 percent of
where it is illegal. There may be as many as 30 women of childbearing age in Egypt, Kenya, and
million to 50 million induced abortions performed the Philippines have unmet need for contraception
annually worldwide; this wide range is due to to limit births (see Figure 7.2, low estimate). In
uncertainty about the number of illegal abortions. Bangladesh, Korea, and Peru, where both limiting
Illegal abortion carries with it a high risk of compli- and spacing questions were asked, 16 to 33 percent
cations and death and can affect future fertility. In of women of childbearing age have unmet need for
many developing countries abortion is illegal contraception. If women who are breastfeeding
under any circumstances or is permitted only to and those using inefficient methods of contracepsave
the life of the mother; China and India are tion are also considered to have unmet need, more
major exceptions. Elsewhere legal abortion is an than 40 percent of women in Bangladesh and Peru
important method of birth control-in Cuba, have unmet need for limiting and spacing births;
Japan, Korea, the USSR, and eastern Europe. 22 percent of women in Egypt, 10 percent in
Legal abortion rates per thousand women of child- Kenya, and 29 percent in the Philippines have
bearing age range from 11 in Canada (1981) and 25 unmet need for contraception only to limit births
in the United States (1980) to 84 in Japan (1975) and (Figure 7.2, high estimate). Estimates for other
130