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Delaying, Spacing and Limiting Pregnancies
Delaying early pregnancies, spacing births and limiting total pregnancies are all ways to significantly reduce fistula as well as other maternal and infant injuries and deaths.
Teenage pregnancies are risky, and the younger the girl, the higher the risk. Girls under 15 are five times more likely to die in childbirth than women in their twenties. Many of those who survive days of obstructed labour end up with fistula. Thus, delaying a girl's first pregnancy is a critical strategy for reducing fistula and maternal death as well as an important public health issue.
The dangers associated with early pregnancy are the reason the Campaign also advocates for alternatives to child marriage. Young married girls are often pressured to get pregnant soon after marriage and may face a variety of barriers to accessing contraceptive services. In spite of laws against early marriage, 82 million girls in developing countries will be married before they turn 18. About half of all teenage girls will have their first child by the time they turn 18.
Married at 12, Almaz's tiny and fragile body was not ready for the strain of pregnancy and childbirth. After two days of labour pains, she was told to keep pushing. By the sixth day, her child was finally born, but it was dead.
Too many pregnancies, or closely spaced births, are also detrimental to women's reproductive health and can result in complicated pregnancies, fistula, other injuries or death. Meeting the existing demand for family planning services would reduce maternal deaths and injuries by at least 20 per cent. However, in many of the countries where fistula is common, use of contraceptives is very low. For example, fewer than 5 per cent of women use modern contraceptive methods in Eritrea, Niger and Rwanda. At least 120 million women [see publication Adding it Up] would use family planning methods if they had access to information and services about contraception or the support of their husbands and communities.
Gooday's story
Gooday, who lives in a slum in northern India, almost died delivering her eighth child. She was rushed to the hospital unconscious, after three days of obstructed labour. She finally delivered a baby girl, but is terrified of another pregnancy and childbirth, and wants to be sterilized. Her husband and mother-in-law have overruled her. Several of Gooday's children have already died, and the family wants a second son.
—As reported on PBS' NOVA, "World in the Balance"
What UNFPA is doing
Ensuring universal access to a full range of safe and reliable family planning methods by the year 2015 is part of UNFPA's mandate. UNFPA works toward this goal by supporting clinics and outreach services, training community health workers and other health providers, procuring contraceptive supplies and advocating for couples to have the information and services they need to freely plan their families.
