Why Delaying Pregnancy Is Critical
- Preventing unintended pregnancy is essential to improving adolescents’ sexual and reproductive health and their social and economic well-being.
- Complications of pregnancy and childbirth are a leading cause of death among 15–19-year-old women in developing regions, and babies born to adolescent mothers face greater health risks than those born to older mothers.
- Adolescent childbearing is associated with lower educational attainment among the mothers, and it can perpetuate a cycle of poverty from one generation to the next.
- Almost three-quarters of pregnancies among adolescents aged 15–19 in Latin America and the Caribbean are unintended, and about half of these end in abortion. Nearly all of these abortions occur in countries where the procedure is often unsafe.
Adolescents’ Needs for Contraception
- Among the 27.5 million women aged 15–19 in Latin America and the Caribbean, 34% (9.4 million) need contraception because they are married, or are unmarried and sexually active, and do not want a child for at least two years.
- Of these 9.4 million adolescents, 64% (6.0 million) are using modern contraceptives. The most common methods are the pill and male condoms, followed by injectables.
- The other 36% (3.4 million) are not using a modern method; these adolescent women have an unmet need for modern contraception. The vast majority of these women are using no method at all, and the remainder use traditional methods, which are less effective than modern methods.
- Adolescents from poorer households and those living in rural areas have higher unmet need than do their better-off and urban peers. But levels of unmet need are about the same (36%) whether adolescents are younger (aged 15–17) or older (aged 18–19), and whether they are married or are unmarried and sexually active.
- Among subregions, unmet need is highest in Central America, where 46% of sexually active adolescents who want to avoid pregnancy are not using modern contraceptives. This proportion is 41% in the Caribbean and 34% in South America.
- In Latin America and the Caribbean, young women’s reported reasons for not using contraceptives despite wanting to avoid pregnancy often include having infrequent sex, not being married, having concerns about side effects, breast-feeding or not having resumed menstruation after a birth, and their or their partners’ opposition to contraception.
Cost of Meeting Contraceptive Needs
- In 2016, the estimated annual cost of providing contraceptive services to the 6.0 million women aged 15–19 who currently use modern contraceptives in Latin America and the Caribbean is $119 million. This averages to $20 per user annually.
- Service costs include direct costs for contraceptives, related supplies and health worker salaries, as well as the indirect costs of management functions, construction and maintenance of facilities, information and education activities and other types of program support.
- If services were improved for the 6.0 million adolescent women currently using contraceptives, costs would increase from $119 million to $127 million. Examples of improvements that would benefit adolescents include better contraceptive counseling and follow-up, consistent availability of a range of modern methods and providers who are trained to work with young people.
- If the 3.4 million adolescent women with unmet need were to use the same mix of modern methods as current users and receive improved services, total costs for current and new users would be $196 million annually, an increase of $77 million annually.
- The expanded and improved services for all 9.4 million women who need them would cost $21 per user annually. Put differently, the cost per capita in Latin America and the Caribbean would be 20 cents.
Benefits of Meeting All Contraceptive Needs
- Increased use of modern contraceptives by adolescents wanting to avoid pregnancy would prevent unintended pregnancies, save lives and improve health.
- If all adolescent women who need modern contraceptives were to use them, total pregnancies would drop from 3.6 million per year to 2.4 million per year. Unintended pregnancies would drop by 1.2 million per year (43%), resulting in
— 400,000 fewer unplanned births, a decline of 44%;
— 600,000 fewer abortions, (a decline of 43%), nearly all of which would have been unsafe; and
— 200,000 fewer miscarriages of unintended pregnancies, a decline of 43%.
- Maternal deaths—those due to complications of pregnancy and childbearing—among women aged 15–19 would drop from the current level of 600 per year to 400.
- Meeting adolescent women’s contraceptive needs requires working on several fronts: ending child marriage, preventing sexual abuse and coercion, increasing girls’ education, empowering girls and women, and providing high-quality contraceptive services.
- Boosting girls’ education increases their ability to make autonomous decisions. Studies show that adolescents who are in school are less likely than those not in school to have sex and more likely to use contraceptives when they do have sex.
- Engaging young men in sexual and reproductive health programs can help bring about more gender-equitable attitudes.
- Adolescents need access to age-appropriate sexual and reproductive health information before they are sexually active. Policies and programs should be in place that address the needs of this age-group, including the provision of comprehensive sexuality education.
- The most effective approaches to providing sexual and reproductive health services to youth include a combination of health worker training; facility improvements geared toward welcoming adolescents and protecting their privacy; and information dissemination through schools, communities and the media.
- Contraceptive services must be provided in a way that protects young women’s rights to voluntary, informed and confidential contraceptive choice.
- The counseling provided with contraceptive methods must be strengthened. All young women need correct information about their risk of becoming pregnant, choices of contraceptive methods and possible side effects, and support in switching methods when desired.
The information in this fact sheet is drawn from Darroch JE et al., Adding It Up: Costs and Benefits of Meeting the Contraceptive Needs of Adolescents, New York: Guttmacher Institute, 2016, https://www.guttmacher.org/fact-sheet/adding-it-meeting-contraceptive-ne....
This report was made possible by grants from the Bill & Melinda Gates Foundation, Children’s Investment Fund Foundation, the Swedish International Development Cooperation Agency and the UK Government. The views expressed are those of the authors and do not necessarily reflect the positions and policies of the donors.