Many Women in Developing Countries Don’t Use Contraception. Why?

More than 225 million women in the developing world live with an unmet need for contraceptives. A new report by the Guttmacher Institute has some answers as to why, and they might surprise you.

The Demographic and Health Survey asked women in 52 countries to specify all of the reasons for not using either a traditional or modern method of contraception.

More than 25% of them said they did not use birth control because they fear side effects such as infertility or depression. Followed closely behind that, 24% of married women said that they did not use contraception because they are not sexually active or rarely engage in sex. Another 23% of the surveyed women said that they, their partner, or someone close to them opposed contraception. And 20% report that they breastfeed or haven’t resumed menstruation after a birth.

Unmarried women with unmet need had different reasons for not using contraception. 78% of them said that they didn’t use birth control because they rarely have sex or because they are not married. In countries where contraception is taboo, unmarried woman are less likely to seek it due to fears of marginalization. Nearly 20% of unmarried women with an unmet need for family planning were afraid of side effects.

How can we end misconceptions about contraception?

Is it important for women who rarely have sex to use contraception? Yes. Does contraception lead to long term health problems such as infertility? No. Should unmarried women face humiliation or marginalization or feel shame and fear for using contraception? Absolutely not. Now that we know why a large number of women in the developing world are not using contraception, we must find ways to increase their social and emotional access, in addition to continuing to strive to increase physical access.

Awareness is key. If women and girls are not aware of the actual potential side effects of certain contraception, such as depression or acne in some women, they are more likely to believe rumors. This awareness must include comprehensive sex education. Girls and women should have the opportunities to learn about contraception in safe and judgment-free zones to learn that infrequent sex, having recent birth or not having a partner do not necessarily prevent pregnancy. Communities need opportunities to learn about the various reasons for usage of contraception.

Women may use birth control for reasons other than avoiding pregnancy. Other health benefits for women who use certain types of contraception include decreased chances of ovarian cancer, uterine cancer, and anemia, as well as alleviated menstrual cramps and acne. Certain birth control methods, such as the oral contraceptives, can regulate or even lighten a woman’s menstrual flow or help deal with ovarian cysts. Awareness of the diverse uses of contraception can help fight the stigma that exists against it in some communities.

Access and affordability matter. If women are not able to try the various methods of modern contraception available to them, they are less likely to find methods that work for them without side effects. If women can’t access sound information about contraception and its impact on their health, misconceptions will continue. Engaging men and raising their awareness about contraception can also help remove some of the obstacles in the way of women’s access.

Contraception can save lives. It can lead to fewer unsafe and illegal abortions and decrease maternal and infant mortality. It can also ensure that girls have the opportunity to finish their education instead of dropping out of school due to pregnancy. And, most importantly, it can give women and girls the chance to make decisions about their own bodies. This is why we must continue our fight for increased access to supplies, services, and education, so that every woman has options.