With tensions extremely high in the United States around the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, it is easy to forget that unintended pregnancy and the concurrent demand for healthy, safe, and non-judgmental abortion is part of healthcare systems globally.
Experts estimate that, around the world, there were 121 million unintended pregnancies each year between 2015 and 2019. Of these unintended pregnancies, 61% ended in abortion, which means there are about 73 million abortions per year.
Unintended pregnancy and the termination of those pregnancies are as old as the human species itself. Moreover, they will continue in perpetuity. This is a self-evident fact – we will never live in a word where abortion does not exist. Yet we still see challenges to abortion, a medical procedure that is a huge part of everyday life and an essential human right.
Unfortunately, in large swaths of the world abortion is not safe, legal, or destigmatized. In fact, in many regions where Population Media Center works, abortion is restricted to situations where it is deemed necessary to save the woman’s life or address a severe danger to her health.
To repeat the obvious, even where laws and penal codes are construed to create barriers to abortion, abortion happens on a daily basis. Just as it always has — and always will.
The bitter irony about restrictive abortion laws is that they correlate with relatively high rates of abortion.
The Guttmacher Institute notes that “In analyses that exclude China and India, whose large populations skew the data, the abortion rate is actually higher in countries that restrict abortion access than in those that do not. In countries that restrict abortion, the percentage of unintended pregnancies ending in abortion has increased during the past 30 years, from 36% in 1990–1994 to 50% in 2015–2019.”
One example of how PMC strives to help women and girls, especially around the realities of unintended pregnancy and the concomitant, natural demand for abortion, was a 120-episode radio show, Jolokoto ("Mirror of Life"). We developed, produced, and aired this program in Southwest Nigeria from July 2019 through August 2020.
For this project, PMC partnered with five major networks of sexual and reproductive health (SRH) clinics in Nigeria, all supported by the Susan T. Buffett Foundation (STBF), Marie Stopes International (MSI), Population Services International (PSI), DKT, Ipas, and the Planned Parenthood Federation of Nigeria (PPFN). Services provided by government-run reproductive health clinics (the “Green Dot” clinics) were also promoted through PMC’s radio show and social media activities. The core project beneficiaries were adolescents aged 15-19 in the two southwestern states of Oyo and Ogun.
Our goals for this program included:
- Increase voluntary, modern contraceptive use among youth;
- Reduce unintended pregnancy among adolescent girls of age 15-19;
- Increase family planning/long acting reversible contraception (LARC) use;
- Increase sales of misoprostol and combination-pack products;
- Increase access to safe abortion/post-abortion care (PAC) services, products and long-term and permanent methods (LTPM), based on number of services delivered in safe clinics; and,
- Create a socially supportive environment for clients, especially youth, to access sexual and reproductive health services.
After Jolokoto’s broadcast, PMC conducted a cross-sectional endline survey to assess the program’s impact. In terms of helping to prevent unintended pregnancy and reduce the need for abortion services, several influential measures can be seen. When compared to baseline research conducted by PMC, the percentage of 15- to 25-year-olds living in rural areas of the two states who knew of reproductive health clinics where they could obtain contraceptives such as inter-uterine devices (IUDs), implants, or injectables to prevent pregnancy increased from 29% to 57%. In peri-urban areas this knowledge increased from 32% at baseline to over 60% at endline.
Listeners to Jolokoto were also significantly more likely to have discussed family planning frequently or sometimes with a spouse or partner in three months prior to the survey than non-listeners — over twice as likely, in fact. Importantly, our drama motivated thousands of calls to contraceptive “hotlines” and other counseling services operated by the sexual and reproductive health clinics in the broadcast zone.
We are saddened that given all our work around the world, we now must join in explaining the basic health, social, economic, and other reasons 1 in 4 women and girls in the United States will need an abortion at some point in their life. We now have to fight this fight again, reiterating that outlawing abortion does not eliminate abortion, it only reduces safe abortions. To truly decrease demand for abortion, we must provide accurate information and access to contraception and family planning services. We should not have to inform lawmakers and whole communities alike that abortion advances basic human rights and saves lives.
Yet here we are, working in multiple regions around the world to move forward on reproductive rights while having to help mobilize right here in the United States, where abortion is supposed to be law of the land.
To be clear, we will not stop until anyone who can become pregnant has the right to choose, the right to safety, and the right to privacy. At Population Media Center, we envision a world where people’s bodies, decisions, and futures are respected. We will not stop until we get there.