The Human Drama of Abortion: A Global Search for Consensus

5. Why Women Get Pregnant When They Do Not Want To

45 5 Why Women Get Pregnant When They Do Not Want To The most common reason given for why women have unintended and unwanted pregnancies is that they lack information about and/or access to contraceptive methods (Henshaw, Singh, and Haas, 1999). This is undoubtedly true both for unmarried women and for married women who already have the children they want. This was the case with Rosa the peasant and Maria, the middle class woman, in the stories told in Chapter 1. Both became pregnant against their will because they lacked accurate information about how to prevent pregnancy or were unable to overcome the economic, cultural, or physical obstacles to the use of contraception. However, it is appropriate to recognize other circumstances that often fail to be taken into consideration in discussions on why women abort. Another important cause of unwanted pregnancy, even in women who are educated and financially independent, is the woman’s inability to exercise control over when and under what circumstances she will have sexual relations, as in the case of Blanca and Cristina, the two physicians in the stories in Chapter 1. Sometimes, women get pregnant because they want to have a child, but then their situation changes. A woman may experience negative pressure from a social group, her partner may threaten to abandon her or may simply disappear, her employer may force her to decide between her job and having the baby, her school may not accept pregnant students, or her family may not provide her with the support she expected (see the story of Luisa in Chapter 1). Clearly, the circumstances that lead a woman to find herself confronted with a pregnancy she cannot allow to continue are not limited to lack of access to or knowledge of contraception. If we are serious in our intention to reduce the number of abortions worldwide, we must con- 46 The Human Drama of Abortion sider each of the circumstances that can lead to unplanned or unwanted pregnancy. Each of the circumstances leading to abortion merits a more detailed discussion to fully understand its significance and to be able to resolve the problems that lead women to place themselves at risk and undergo the hardships of pregnancy termination. Lack of Knowledge about Contraceptive Methods There is vast information, derived mostly from the Demographic and Health Surveys (DHS 2002) population-based studies, that use a single set of research criteria and are carried out globally, permitting comparison among countries. According to these surveys, a high proportion of women worldwide state that they have knowledge of at least one “modern ,” highly effective contraceptive method. The definition of modern includes hormonal methods, intrauterine devices, barrier methods (such as the diaphragm and the male or female condom), and male or female surgical sterilization. The percentage of women who declared that they knew of at least one of these methods varied from under 50 percent in Chad; to between 60 and 70 percent in Mozambique, Mali, Guinea, and Madagascar; to close to 98 percent in Kenya, Zambia, Nepal, and the Philippines (DHS, 2002). The proportion of women who declared that they knew at least one modern contraceptive method reached virtually 100 percent not only in developed countries but also in some less developed countries such as Bangladesh, the Dominican Republic, and Brazil. These studies also show significant differences within each country, according to the place of residence (urban or rural) and socioeconomic status. The number of years of schooling is the main factor that determines contraceptive knowledge. As a result, in virtually every less developed country, 98 percent or more of women who have a secondary education or higher declared that they were aware of at least one modern contraceptive method; this was true for only about 50 percent of women with no education in Cameroon, Madagascar, Mozambique, the Philippines , and Bolivia. If we move from the knowledge of at least one method to information on specific contraceptives, the differences by educational level are even more dramatic. In Brazil, virtually all women at every level of society know at least one modern method. This high level of knowledge is attributed to almost universal exposure to television, with its direct Why Women Get Pregnant When They Do Not Want To 47 and subliminal messages (Faria and Potter, 1999). Condoms have been the subject of mass media campaigns, as have the two most popular methods: female sterilization and pills. Nevertheless, the...