According to Dr. Dorothy Shaw, a woman planning to have one or two children will spend less than 5 years trying to get pregnant, being pregnant or breastfeeding, and more than thirty years trying to avoid pregnancy. There is an immense need for access to high quality knowledge, methods and services to prevent unintended pregnancies.
However, Canadian epidemiological data on sexual health is limited, and access to contraception and abortion services is disproportionately limited for those women among marginalized and vulnerable populations. Collection of the basic indicators of unmet need for contraception, and research to understand optimal delivery of high quality health services, are required to inform health policies and health system decisions that would improve the ability for all Canadian families to plan and space their pregnancies.
Vulnerable populations include youth, First Nations, new immigrants, those of low socioeconomic status, and residents of rural or remote communities. Because of their economic, logistic, cultural, and social barriers, access to high-quality contraception and abortion services are limited. For example, family planning education or contraception resources may be lacking in a rural community because there are not enough physicians in the area. Despite their need for these services, their access is sub-par compared to the rest of the population.
Hence, it is not surprising that vulnerable populations are overrepresented among women who have unintended pregnancies and seek abortion. Many in the vulnerable population already deal with the burdens of low socioeconomic status. Thus, unintended pregnancies create an addition layer of burden on their lives. Unintended teen pregnancies impede women from pursuing their career goals. They are less likely to pursue post-secondary education or graduate secondary school. For families, unintended pregnancies can lead to financial strain. This means less time and money is spent on each child currently in the family. Ensuring equal access to family-planning services, mean that more mothers, children, and families have better opportunities in life!
Investing in high quality family-planning healthcare services is cost-effective. According to a study by the Guttmacher Instititute, every dollar invested into family-planning saves nearly four dollars spent in treating complications arising from unintended pregnancies. Similarly, Dr. Norman’s research in Canada shows that providing free long-acting reversible contraception (LARC)—such as intrauterine devices—for post-abortion patients reduces healthcare costs. LARCs are user compliance-free, and have the lowest fail-rates in comparison to other contraception methods.
However, most women are either unable to afford the up-front cost or are unaware of the safety and effectiveness of these methods of contraception. Education on the options available and free provision of contraception, can lead to healthcare cost reductions. Investing in high-quality family-planning healthcare also has overarching societal benefits. By preventing unintended pregnancies, women and families spend more time completing their education, engaged in careers and caring for each child. Optimizing the time between pregnancies reduce infant mortality.
Moreover, unintended pregnancies are associated with a large number of risk factors. For example, in association with unwanted pregnancies, there is greater maternal mortality, greater infant mortality in the first year of life, and women are more likely to be abused in their relationship. Therefore, not investing in family-planning is expensive—preventing unwanted pregnancies reduce costs and saves lives.