Better contraception could save 100,000 lives

More than 100,000 women could be saved from dying prematurely every year by simply improving access to family planning information and contraception, new research reveals.

Too many children, too close together substantially increases the risk of maternal deaths, premature births and infant mortality, yet millions of girls and women have no control over their pregnancies. Only one in five sexually active women in sub Saharan Africa use contraception compared to 75 per cent in developed countries.

Family planning has been neglected for decades, but has a crucial role to play if the Millennium Development Goals for maternal health, eradication of poverty, education and gender equality are to be achieved, according to a ground-breaking series of articles published by The Lancet. It is the single easiest way to prevent maternal deaths and improve the life-chances and long-term potential of children.

The importance of giving women the right to choose how many and when to have children will be recognised on Wednesday when the Prime Minister David Cameron and Belinda Gates are expected to announce substantial new funds for family planning programmes , placing it at the centre of future development policies. The announcement will be made on World Population Day during an international summit on family planning being hosted by the Department for International Development.

Universal access to vaccinations against killer childhood diseases is universally accepted as part of the Holy Grail of global efforts to slash infant mortality rates. It has justifiably therefore, dominated the attention of health experts, scientists, governments and philanthropists over the past two decades.

Family planning on the other hand, has been considered too simple, unsexy and controversial - given past human rights abuses stemming from population control measures - and so has been scandalously neglected in comparison.

These are the thoughts of an eminent group of scientists, researchers and reproductive health experts gathering in London for the summit, who hope to make the case for the “rebirth of family planning”.

Professor John Cleland, from the London School of Hygiene and Tropical Medicine, said the link between the survival of women, infants and children has not been properly recognised.

“Thousands of women die unnecessarily from pregnancies that they did not want to have, and that is a scandal.

“The spacing between pregnancies is crucially important: children born within two years of an elder sibling are 60 per cent more likely to die before their first birthday infancy that those born two or three years later… The risk of the older child dying increases by 40 per cent, so for older and younger siblings there is a double jeopardy.”

He added: “Family planning programmes need to make contraception a hum drum, everyday part of life rather than something that is feared.”

Increasing contraceptive use in developing countries has already cut maternal deaths by 40 per cent over the past two decade. But there is plenty of room for improvement.

In 2008, 342,000 women died from pregnancy and child birth complications; without contraception the number of deaths would have been almost double, according to the research by Dr Saifuddin Ahmed, from the Bloomberg School of Public Health at John Hopkins University in Baltimore.

Dealing with unmet need, that is providing information and contraception to those women who want it, would cut deaths by almost 30 per cent. It could single-handedly eliminate the 50,000 deaths from unsafe abortion ever year.

“Vaccinations save children’s lives; contraception saves women’s lives,” said Dr Ahmed.

Strong government leadership has been proven to minimise the impact of religious opposition to contraception, according to Dr Alex Ezeh, from the African Population and Health Research Centre in Nairobi.

The series of research papers also includes evidence of potential economic and environmental benefits of meeting contraction needs.

Each 1 per cent rise of carbon dioxide emissions is associated with a per cent increase in population size, according to Dr Leiwen Jiang, from the National Center for Atmospheric Research in Colorado. This means CO2 emissions could increase by a staggering 60 per cent if the united Nation’s highest population growth estimates prove to be correct.

Dr Richard Horton, editor of the Lancet said past abuses had to be acknowledged. “This is not about population control, it is about increasing choices for women through better information and services around family planning.

“There is an extraordinary degree of consensus around this message across the scientific, advocacy and political communities. We are on the cusp of a new social movement for family planning… there is an opportunity to learn from the mistakes of the past and put us on a sustainable path and improve the lives of women and children.”