The use of modern contraceptive methods, including voluntary sterilization, to avoid unplanned childbearing has increased rapidly over the past 30 years, especially in countries with strong family planning programmes. Almost all of the increase reflects greater use by women; fewer than 5% of couples in the majority of developing countries rely on male methods (the condom, withdrawal or vasectomy).

Over the past 30 years. Almost all of this increase reflects greater use by women rather than by their partners. Worldwide, an estimated 228 million women who want to delay or cease childbearing—roughly one in six women of reproductive age—are in need of effective contraceptive methods. A gap frequently exists between the number of children women say they want and the number they have; many women have births before they and their partners feel ready for a child

Substantial proportions of women in every country—more than 50% in some—say their last birth was unwanted or mistimed. More than 50 million of the 190 million pregnancies worldwide each year end in abortions; many of these procedures are clandestine, performed under unsafe conditions.

Differing patterns of contraceptive use may not reflect women’s personal preferences as much as political and economic decisions made by governments to emphasize certain methods, the attitudes of medical professionals, cost, the limited range of methods offered in some countries or an uneven availability of contraceptive supplies. In fact, high quality family planning services are often not available: One evaluation of family planning programmes in 88 developing countries concludes that family planning services are routinely made available to women at reasonable cost in only 14 countries, and that many family planning programmes fail to offer a wide selection of methods, lack high standards of medical practice, are insensitive to cultural conditions, do not offer sufficient information about proper use or possible side effects and neglect women’s other reproductive health needs.

Worldwide, an estimated 228 million women who want to delay their next birth or cease childbearing are in need of an effective contraceptive method. In many developing countries, at least a third of women need contraceptive services. Some of these women do not know about modern methods, are unable to obtain or afford them, or distrust or dislike the methods that are available. Some are single women and teenagers who are barred by policy or practice from obtaining contraceptive services. Other women may not be using a method because they are ambivalent about whether they want a child or are unsure about their ability to become pregnant; still others live with a partner who does not approve of contraception or who wants them to become pregnant.

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