SWOP Report 2018

           

The power of Choice

Reproductive rights and
the demographic transition

Can people in the world today have the number of children they choose, when they choose?

Photo Photo © Michele Crowe/www.theuniversalfamilies.com

There are still millions of people who are having more–or fewer–children than they would like.

Photo Photo © Mads Nissen/Politiken/Panos Pictures

The extent to which individuals are able to exercise their reproductive rights determines the number of children they choose to have.

Photo Photo © Michele Crowe/www.theuniversalfamilies.com

These choices, or lack thereof, are mirrored directly in fertility rates across the globe.

Photo Photo © Eriko Koga/Getty Images

Never before in human history have there been such extreme differences in fertility rates among groups of countries.

1800 1850 1900 1950 2000 2018
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Higher fertility Lower fertility
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Challenges to Choice

High Fertility

 

High fertility translates into faster population growth, with a disproportionate share of the population aged 15 or younger. High fertility rates pose challenges for governments struggling to meet the demand for education and health services, and to sustain development gains.

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© Mark Tuschman
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© UNFPA/Ollivier Girard
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An estimated 60 per cent of the population in sub-Saharan Africa is below the age of 25.

 

In high-fertility countries, economic, social, institutional and geographic barriers may prevent women from accessing quality family planning information and supplies. Barriers may be particularly insurmountable for young people. Together, these barriers stop millions of people from exercising their reproductive rights.

Photo Photo © Giacomo Pirozzi
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© UNFPA/Ollivier Girard

In sub-Saharan Africa, an estimated 21 per cent of women want to avoid a pregnancy but are not using a modern contraceptive method.

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© UNFPA/Robbie Lawrence
 

Women with at least a secondary education prefer to have fewer children compared to women with little or no education. Educated women are also in a better position to break the barriers to decent, paid employment later in life.

Photo Photo © UNFPA/NOOR/Bénédicte Kurzen
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Challenges to Choice

Middle Fertility

 

The countries where a woman has an average of three to four children are geographically and economically diverse and have followed different paths at different paces as their fertility rates declined.

Photo Photo © Chris Stowers/Panos Pictures
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© 2012 Meagan Harrison, courtesy of Photoshare

Today, 12.5 per cent of women in Egypt have an unmet need for modern methods of contraception. The rate is even higher in rural parts of the country.

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© UNFPA/NOOR/Sanne De Wilde
 

A total fertility rate of three or four may mask large differences within countries, with wealthier people in urban areas having access to contraception, while rural, ethnic minorities have limited access to family planning programmes. Adolescents in some of these countries also have limited access to contraception information and services, resulting in comparatively higher rates of teenage pregnancy.

Photo Photo © UNFPA/Roger Anis
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© Joshua Cogan/PAHO
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© Paul Smith/Panos Pictures

Percentage of women who have an unmet need for contraception

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15 countries in 5 regions

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© Mark Tuschman
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© Robert Wallis/Panos Pictures
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© PAHO

In the 12 Latin American and Caribbean countries covered in this chapter, fertility rates among adolescents aged 15–19 and young people aged 20–24 are higher than rates for these age groups in other parts of the world with similar total fertility rates.

 

In some countries where fertility has been steadily declining, economic shocks, wars and other crises can cause fertility rates to dip suddenly as couples choose to delay having children and then rebound after the crisis, when stability and security return.

Photo Photo © Joshua Cogan/PAHO
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Challenges to Choice

Low Fertility

 

Countries where fertility rates have been low for many years are generally more developed. Basic reproductive and other rights are mostly met. Challenges facing these countries typically include an increasing share of older people in their populations and higher associated health-care costs, as well as a shrinking labour force.

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© Frank Schoepgens/Getty Images
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© Thanasis Zovoilis/Getty Images
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© Maskot/Getty Images
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The percentage of governments in more developed countries that consider fertility to be too low and are pursuing policies to increase it

 

Current fertility rates of these countries indicate that women have become more effective in preventing pregnancies and spacing births. Where education and career are high priorities, marriage and childbearing may take a back seat. Women who opt to delay pregnancy until their late 30s or 40s are at greater risk of infertility and complications during pregnancy.

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© JGI/Jamie Gril/Getty Images

Among married couples in Japan, men contribute an average of 3.4 hours per week to household duties, whereas women contribute an average of 27.4 hours.

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© iconics/a.collectionRF/Getty Images
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© Emma Inncocenti/Getty Images
 

Long-standing gaps in support for balancing work and family life can inhibit women from having the number of children they want to have. Challenges that women in low-fertility countries face in exercising their reproductive rights include economic hardship, a lack of affordable housing, high childcare costs, and uncertain labour markets.

Photo Photo © Michele Crowe/www.theuniversalfamilies.com

Fertility Matters

 

Amid today’s wide gaps between high and low fertility rates, both within and across countries, fertility issues and drivers vary hugely.

Much progress has been made in upholding reproductive rights. Yet today, no country can claim that all population groups enjoy these rights at all times. Almost everywhere, social, institutional and economic circumstances still deny some people the means to freely and responsibly have the number of children they want or have them when they want.

Each country needs to define the mix of services and resources it requires to uphold reproductive rights for all citizens, but there are some actions that apply to every country, regardless of fertility rate.

  • © UNFPA/Ollivier Girard

    Develop and invest in family planning programmes that aim to achieve zero unmet need for family planning services no later than 2030 to help attain the Sustainable Development Goals.

  • © UNFPA/NOOR/Sanne De Wilde

    Make reproductive health services integral to primary health care, equal to vaccination and other essentials for sound health.

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    Consider conducting regular national reproductive rights “check-ups” to assess whether laws, policies, budgets, services, awareness campaigns and other activities are aligned with reproductive rights, as defined by the International Conference on Population and Development.

  • © Eriko Koga/Getty Images

    Gender equality should be enshrined in all national policies and practices, and should be a central operating principle of all health-care systems.

  • © UNFPA/Roger Anis

    Dismantle social, economic, institutional and geographic obstacles that prevent people from deciding the number and timing of pregnancies.

  • © 2016 UNFPA/Arvind Jodha, courtesy of Photoshare

    Define the mix of services and resources required to uphold reproductive rights for all, ensuring that no one is left behind.

  • © Simon Straetker/Ascent Xmedia/Getty Images

    Review demographic policies to ensure they enhance reproductive rights and empower individuals to realize their own fertility goals.

 

Data

State of World Population 2018

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© Milo Aikawa/Getty Images