Contraceptive methods access: an ongoing debt in several nations

According to the most recent research on access to and use of contraceptives methods in 23 countries in Latin America and the Caribbean, published in Lancet Global, women with higher incomes have a higher frequency of permanent contraception use and long-acting reversible methods, while access is deficient in poor countries.

The Woman Post | Ayda María Martínez Ipuz

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The research, based on 212,573 sexually active women aged 15 to 49, which represents 91% of women of reproductive age in the region, shows that "Health inequities are related to social determinants, and Latin America and the Caribbean are still characterized by wide social and income inequalities, despite great progress."

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According to the study, Haiti has the lowest prevalence of modern contraceptive use (31.3%), followed by Bolivia (34.6%); whereas Brazil, Colombia, Costa Rica, Cuba, and Paraguay have a prevalence of use of 70%. The use of long-acting reversible contraceptives was below 10% in 17 of the countries (only Cuba, Colombia, Mexico, Ecuador, Paraguay, and Trinidad and Tobago have a percentage higher than 10% in this type of method). In this regard, women with higher incomes have a higher frequency of permanent contraception use and long-acting reversible methods.

On World Population Day, the issue of access to contraceptive methods for both women and men remains in focus, despite reaching zero population growth rates in several regions of the world, with over 50% of the population surpassing the age of 60.

The truth is that in developing regions of the world, birth rates remain high, and the rights of women to freely decide when to become pregnant, how many children to have, and their spacing are still violated by discriminatory policies that deny guarantees of sexual and reproductive health.

Providing women and girls with access to safe contraceptive methods is part of the states' responsibility to ensure the highest possible level of physical and mental health for all, emphasized a UN human rights working group during a statement by experts on World Contraception Day last September.

The truth is that current reviews of the exercise of family rights to freely choose the formation of their family have identified setbacks in some countries that affect the right to sexual and reproductive health, including the right to abortion.

"Human rights laws stipulate that women should be free to decide when to become pregnant, how many children to have, and how to space pregnancies. The full enjoyment of sexual and reproductive health guarantees is essential for women and girls to exercise all other human rights and to achieve gender equality," said the UN experts in the declaration.

You can also read Contraceptive Methods: A Shared Responsability? 

Prioritizing sexual and reproductive health

Prioritizing the rights to sexual and reproductive health and adopting legislation, policies, and decisions that ensure women and girls the full exercise of their right to access sexual and reproductive health and healthcare services, including safe abortion, is one of the areas with a high debt, which is reflected in deficient healthcare services for both women and girls and their babies.

In addition to this, there are fears of intimidation, stigma, or penalization, as is the case in many countries with legislation and religious practices that affect women's freedom of choice.

According to the experts, legal restrictions on contraceptives methods for ideological reasons and the disruption of sexual and reproductive health services, which have not yet been restored in hundreds of countries following the covid-19 emergency, remain higher among historically discriminated female population groups, such as girls, black and Afro-descendant women, indigenous people, migrants, refugees, and displaced persons, among other collectives.

According to the World Health Organization, up to 39,000 women die each year due to lack of access to safe abortion services, emphasizing the importance of preventing unwanted pregnancies through access to contraceptive methods, safe abortion services, and quality post-abortion care.

Religion and culture should not be a pretext for discrimination

"Women and girls should not be instrumentalized to serve fundamentalist ideologies and populist agendas. Religion and culture should not be misused to further discriminate against and oppress them in a global context of severe reactions against gender equality," insists the UN.

Therefore, states must respect the capacity of women and girls to make autonomous decisions and not limit access to contraceptives to obtaining authorization from husbands, partners, or parents.

Likewise, sexual and reproductive health strategies must take into account the needs of lesbian and bisexual women, transgender men, and all gender-diverse individuals for whom they are relevant.

In this way, the call to states is to work towards dismantling all practical barriers rooted in the lack of official regulations, such as conscientious objection and the imposition of a marital consent requirement, even when not required by law. This implies the constitutional recognition of sexual and reproductive rights by the Constitutions of nations.

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