More than 1 billion women reported a desire to use some type of modern contraceptive in 2020—yet much of that demand remains unmet. As one result, researchers estimate that more than 100 million unintended pregnancies still occur every year.^{2, 11}

Why?

Obstacles to family planning fall into two main categories: demand-side obstacles and supply-side obstacles.

Demand-side obstacles to family planning include the following:

• Fear of unwanted side effects from contraceptive option(s)
• Misconceptions or lack of knowledge about family planning or contraception
• Opposition from partners, family, and/or community (e.g., community-level acceptability of contraceptives, youth challenges, stigma.

Supply-side obstacles to family planning include the following:

• Lack of sufficient, sustainable financing for family planning commodities and services, particularly domestic resources in places where family planning financing remains highly donor dependent
• Laws and policies limiting access to family planning services
• Poor quality of care, including limited and inconsistent access to contraceptive methods and points of service or provider biases.^{12, 13}

Reasons for nonuse of contraceptive methods among women with demand for contraception not satisfied in 47 LMICs

Moreira, L.R. et al. Reasons for nonuse of contraceptive methods by women with demand for contraception not satisfied: an assessment of low and middle-income countries using demographic and health surveys. Reprod Health 16, 148 (2019)

These obstacles vary from place to place, and even from person to person. Consequently, access to family planning and sexual and reproductive rights remains inequitable across and within countries. Some groups—such as adolescents, people living in rural areas, people living in poverty, people with disabilities, and people who face discrimination because of their race, ethnicity, caste, gender identity, sexual orientation, or religion—face particular challenges when they try to access family planning services.¹⁴

According to the High Impact Practices in family planning (HIPs) partnership:

Every person in the world is born with the right to control their reproductive future, whatever that means to them. We need to eliminate these obstacles to family planning for everyone, everywhere, to make that right a reality.

The FP2030 initiative and the SDG targets and indicators focused on family planning have set expansive global goals.^15,16

FP2030 “strives to create a future where women and girls everywhere have the freedom and ability to lead healthy lives, make their own informed decisions about using contraception and having children, and participate as equals in society and its development.¹⁷ That means “voluntary modern contraceptive use by everyone who wants it, achieved through individuals’ informed choice and agency, responsive and sustainable systems providing a range of contraceptives, and a supportive policy environment.¹⁸

The UN’s Sustainable Development Goal (SDG) target on family planning (3.7) reads: “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs."¹⁵ The organization will measure progress toward this goal using two indicators: the proportion of women of reproductive age who have their need for family planning satisfied with modern methods (demand satisfied), and the adolescent birth rate (ages 10–14 and 15–19) per 1000 women in that age group.

To meet these goals, we need to act urgently. Our partners are leading research on family planning Exemplar countries to understand which demand- and supply-side policies and interventions drive success—including the proven, promising, and emerging Family Planning High Impact Practices (HIPs).¹⁹ This research will also explore successful approaches to enhancing family planning equity and reaching vulnerable groups, including adolescents.

Universal access to reproductive health services will not just prevent unintended pregnancies; it will also improve maternal and child health and well-being across the board and ensure that women and their partners have the tools they need to decide for themselves what their reproductive futures will be.