Statement by UNFPA Executive Director Dr. Natalia Kanem at the launch of the State of World Population Report 2022

Distinguished members of the press,

Dear colleagues and friends,

Mamusu from Sierra Leone was pregnant at age 14. Rahmadina in the Philippines was pregnant and married before she finished her first year of high school. Mukul in India was a married professional using contraception; she was shocked to discover she was five months pregnant less than a year after delivering her first child. And Yajaira [Ya-hai-ra] from El Salvador slept with her boyfriend just once; she had not received any sexuality education.

The State of World Population report 2022 shows that where data are available, nearly a quarter of all women are unable to say no to sex and unable to make decisions about their own health care.

Is it any wonder then that nearly half of all pregnancies in the world are unintended – nearly half – amounting to 121 million pregnancies every year? For the women affected, the most life-altering reproductive choice – whether or not to become pregnant – is no choice at all.

The 2030 Sustainable Development Goals recognize women’s bodily autonomy and gender equality, and the importance of women's ability to make informed decisions about sexual relations, contraception and reproductive health care. When an estimated half of all pregnancies are not by choice, it gives us an alarming picture of the state of neglect of women’s reproductive freedom.

Yet this crisis is largely invisible, in part because it is so very common. It’s happening everywhere, including right here in the heart of Europe. Nearly everyone knows someone who has experienced an unintended pregnancy.

Of course, just because they’re unintended doesn’t mean they are unwelcome: Many unintended pregnancies are met with joy. Many unplanned babies are deeply loved. Yet while celebrating fortunate outcomes, we must also acknowledge the denial of choice that gave rise to the pregnancies to begin with.

And it would be wrong to ignore the unwelcome outcomes. Unwilling pregnancies leave women and girls struggling to deal with a situation they did not affirmatively choose, at a time they did not choose, under conditions they did not choose – or even with a partner they did not choose. You may be surprised to know that an estimated 60 per cent of unintended pregnancies are decidedly unwanted and end up in abortion, far too often unsafe abortion – a major driver of maternal deaths.

So why talk about this now? Why discuss pregnancy and women’s sexual and reproductive rights? The question is understandable… and deeply regrettable. It shows how easily the most fundamental rights of women and girls are pushed to the backburner, especially during times of crisis – precisely when they are at greatest risk of being sidelined. Our report shows how these rights are undermined in times of peace, and under assault in times of conflict and instability.

Yes, there are other issues competing for the headlines: horrors of conflict, COVID-19, climate change, vast displacements, racial injustice. None of these are standalone issues, and neither is unintended pregnancy. Our world is interconnected, and so are our catastrophes. Including the personal catastrophe of giving birth to a child without hope.

We saw this when pandemic “lockdowns” disrupted sexual and reproductive health services and contraceptive access and led, in some places, to increases in unintended pregnancies. We see it in humanitarian settings where women and girls face escalating risk of sexual violence. And we see it when women’s and girls’ bodies are not considered their own, which has impacts across societies. Unintended pregnancies are personal issues for the women affected, health issues for women, families and societies, and human rights issues for countries and the world.

For far too long, humanity has accepted this denial of women’s autonomy as normal. Whole systems – law, custom, traditions, family rules – continue to assign men control over women’s bodies and fertility. It was not until 1968 that the international community recognized the right of all people to freely choose the number and spacing of their children. And it was only in 1993 that marital rape was recognized as a violation of human rights.

Since then, we have seen world leaders sign on to shared human rights principles and popular support for gender equality. There is also arguably better understanding that, in our interconnected world, the fates of the few impact the futures of the many. The marginalization of a few can spread misfortune across borders and generations. This is why the world committed to the Sustainable Development Goals.

As I’ve already said unintended pregnancy leads to maternal deaths. Our report reveals that rates of unintended pregnancy strongly correlate with gender inequality, with lower socioeconomic development, and with more restrictions on sexual and reproductive rights. It shows the steep costs associated with unintended pregnancy: worsened health, lost education, lost income and increased family hardships. Unintended pregnancy costs billions of dollars in increased health system expenditures, and worse outcomes for future generations.

Let us not forget to stand up for the adolescent girl who, through ignorance about her body or lack of choice – or both – is condemned to a life of poverty when unintended pregnancy ends her education – her lifeline to a brighter future. Let us remember that the devastating ripple effects of crushing poverty don’t stop at that girl’s doorstep, nor at her country’s border. We are all poorer for it. Global development threatened, because of it.

Over 250 million women desire to avoid pregnancy yet are not using a safe, modern method of contraception. Our systems, societies, leaders, governments and media are failing to recognize this as a crisis, one that has ramifications on the rights and welfare of people all across the world. Open your eyes; see the unseen. This is a wake-up call.

Our report calls for a collective change in mindset to see the unseen, to acknowledge the unrealized value of women and girls, to ensure universal health coverage, end gender-based violence, and uphold sexual and reproductive rights, especially in crisis and humanitarian contexts.

To solve the problem of unintended pregnancy, we are calling on policymakers and community leaders to change priorities, to expand choices and resources for women and girls. Raise up the value of women and girls, listen to their voices, invest in the contraceptive services and information that they say they want and need – services that are stigma-free and supportive of bodily autonomy. Don’t just promise gender equality – model it in your actions.

We know these actions can produce real change. We see it in the lives of the girls I just mentioned. Mamusu, in Sierra Leone, is receiving the support she did not have as a girl, from a mentor with a local NGO, and she has been able to resume her education. She wants to become a nurse. Rahmadina is determined to give her daughter options that she did not have herself. And Yajaira is raising two boys to reject gender-unequal norms and speak openly about issues like contraception.

Yet the burden of addressing this crisis should not fall on the shoulders of the women who experience unintended pregnancy. That’s a responsibility that belongs to me, to you, to all of us. It is up to all of us to act.

We see action when governments commit to a dedicated budget line for family planning.

We see action when crisis responders take into account the sexual, reproductive and menstrual health and hygiene needs of women and girls stricken by disaster. These are essential, life-saving services.

We see it when faith partners promote access to comprehensive sexuality education. I urge more religious leaders to challenge the notion that there is somehow a conflict between faith and human rights, women’s rights. 

Only when each of us has the power to make this fundamental decision about our health, bodies and futures will we be able to secure a more just, equitable and prosperous world.