UNITED NATIONS, New York/JUBA, South Sudan – Globally, an estimated half of all pregnancies are unintended, a recent UNFPA report highlights. But during a humanitarian crisis, the conditions that erode women’s ability to exercise bodily autonomy and reproductive choice increase catastrophically, multiplying the risks of unintended pregnancy.
Contraceptive services and sexual and reproductive health information are much harder to come by in crisis settings, leaving women less able to control their fertility. Additionally, the stresses of conflict are known to heighten women’s vulnerability to gender-based violence – including sexual violence and various forms of intimate partner violence. Sexual violence leads to pregnancies at rates similar to or greater than consensual sex, while survivors of intimate partner violence are twice as likely to report experiencing an unintended pregnancy compared to women who have not experienced violence.
These facts show how easily the most fundamental rights of women and girls are pushed to the backburner, especially during times of crisis.
Finally, coercion and exploitation tend to thrive in humanitarian settings, as desperation can lead individuals to engage in sex work for survival or fall victim to traffickers.
These facts show “how easily the most fundamental rights of women and girls are pushed to the backburner, especially during times of crisis – precisely when they are at greatest risk of being sidelined,” said Dr. Natalia Kanem, UNFPA’s Executive Director.
Pregnant in a crisis
In Afghanistan, UNFPA estimates that conflict, health system disruptions and barriers to women’s ability to exercise reproductive decision-making will lead to 1 million more unintended pregnancies each year between 2021 and 2025.
Unintended pregnancies, in general, are linked to greater health risks to women, including higher maternal death rates as well as worse health and economic outcomes for families and communities.
Unintended pregnancies in humanitarian and fragile settings come with many added risks, including scarce access to life-saving health services. In 2015, UNFPA estimated that more than 60 per cent of all maternal deaths occurred in such conditions. Humanitarian crises have only proliferated since those estimates, and the world now faces record numbers of people forcibly displaced by war, persecution, pandemics and other large-scale disasters.
On-the-ground health and aid workers highlight the particularly grave consequences of pregnancies that result from sexual violence. These “unintended pregnancies have social and psychological effects on women and girls,” said Dr. Wato Chuol, who works with International Medical Corps, a UNFPA partner, to provide health care to displaced people in Juba, South Sudan.
The consequences of these situations spill over generations. Not only are women and girls forced to grapple with pregnancies they did not choose, under circumstances they did not choose, but the children born from these situations can also face extraordinary hardships.
“We delivered a lady who refused to touch her newborn at our health facility,” Dr. Chuol said. “The midwife and I were surprised that she seemed unhappy about seeing the newborn. Later on, we discovered that her pregnancy resulted from sexual assault. In the end she eventually left the baby at the facility.”
Resorting to unsafe abortion – one of the world’s leading contributors to maternal death – is another dangerous fallout. “In the last two years, I have witnessed an increased number of women who attempted abortion,” said Dr. Chuol.
A girl educated today has a greater chance of becoming a productive woman tomorrow.
Elevate the status of women
Dr. Chuol say the best protection for women and girls is elevating their status with gender equality, education and opportunity – even in the darkest humanitarian emergencies.
UNFPA is calling for sexual and reproductive health information and services to be considered a non-negotiable part of every humanitarian response. Alongside sexual and reproductive health care, survivors need protection from gender-based violence, safe spaces, psychosocial support and referrals to legal and justice systems, all embedded within broader humanitarian efforts.
“A girl educated today has a greater chance of becoming a productive woman tomorrow… With free and informed choices, girls and women can thrive,” Dr. Chuol said.
