Bill & Melinda Gates Foundation

Imagine a World... Without Contraception

June 25, 2012

This is the first post in the "Imagine a world …" series from Marie Stopes International.

To many of us, sitting reading this in the United Kingdom, United States, or other more developed countries, it seems quite easy.

It’s true that women in the U.K. don’t always know all the pros and cons of different contraceptives and why an implant might suit them better then the pill.

It’s true that we still hear stories of women who don’t live in a major city taking several buses to get a contraceptive injection.

But fundamentally, we know that contraception exists and that it can be used to stop us having babies when we don’t want to – in an ideal world thanks to gold standard sex education in school, more usually from snippets picked up in the playground, from our parents, or from the internet.

We can also access contraception – in the U.K. mostly from our general practitioner (GP) but sometimes from a specialist sexual and reproductive health clinic if you don’t feel like discussing your contraception with someone you might bump into in your local shop.

At the very least, we can stop ourselves becoming pregnant when we don’t want to be by visiting a pharmacy, who stock an ever-expanding range of condoms as well as emergency contraception should we need it. The places we get our chosen contraceptive method from are usually nearby, open regularly, and have plenty of supplies available when we visit.

For the most part, only people who really need or want something care much about it being available, and that’s why it can be hard to make people in the developed world tune in to the huge unmet need for contraception globally – 222 million people who want to use contraception can’t get it, at the last count.

Our reproductive biology means that the vast majority of people using contraception in the U.K. and U.S. are less than 50 years old, so we simply can’t remember what life was like before it was available. For as long as we’ve been having sex, the pill – 50 years old last year – has been there for women, quietly revolutionising our lives, careers, and families.

So we take contraception for granted, and we take it for granted that every woman around the world is lucky enough to do the same. To stop us taking it for granted for a moment, let’s think about what our lives might look like if our regular, reliable contraception suddenly became unavailable tomorrow morning, and we lived in a country – as so many women do – where abortion is not safe or legal.

Every single time we had sex, there’d be a chance that we’d become pregnant. It’d be the same for our friends, and, for some of us, the same for our parents, many of whom would feel that their families of two, three, or four children are already complete. It would affect our decisions about our relationships and our decisions about our education and careers as we would not be able, together with our partners, to control and plan our reproduction.

The London Summit of Family Planning on July 11th is our chance to tell the world that this is exactly the situation that 222 million women find themselves in day in, day out. It’s perhaps the world’s best opportunity to agree together what we’re going to do to rectify the situation.

Over the coming weeks, our Imagine a world … series of blogs will take you to Ghana, where our country director, Faustina Fynn Nyame, imagines a world where women are equal: a world where our work providing family planning to young people means the poorest girls from the north will no longer travel to the south to work as porters for wealthy families, become pregnant by their employer then be “discarded.”

Then Colette Ndoye, a midwife who works for us in Senegal, will help you imagine what life is like if you don’t know contraception even exists, much less how it works or where to get it.

Finally, Mukanga Sindazi, from our Zambia programme, imagines a world where contraception is available even in remote areas. If we could clone Mukanga many times over perhaps this would become reality: he and his outreach team deliver counselling and voluntary family planning to women who live in areas so remote that even after Mukanga has travelled for a whole day to set up his mobile clinic in their nearest village, the women still need to walk two hours there.

We hope you enjoy imagining with us over the next few weeks, and we look forward with you to the London Summit of Family Planning. We hope great things come out of it, which make a substantial dent in the great unmet need for contraception.

 
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