Scientific Society Symposium

How to reduce unintended pregnancies and abortions

David Serfaty (FR)


HOW TO REDUCE UNINTENDED PREGNANCIES AND ABORTION ? D.SERFATY « …Of the 208 millions pregnancies worldwide, 86 million were unintended resulting in approximately 33 million unplanned births and 41 million abortions… » [Sing et al. 2010] « … Forty-five percent of pregnancies are not planned in the US and the UK… » [Millar et al, 2017] How to reduce these unintended pregnancies ? Long-acting reversible contraception (LARC) such as implants and IUDs is the most effective contraceptive method as it does not require compliance. It’s time : - to increase LARC access to adolescents and young women, - to increase access to immediate postpartum LARCs particularly in adolescents mothers (one on six teen births in 2015 was a repeat birth in the US) - and to increase access to immediate postabortum LARC (almost one half of all abortions performed in the US are repeat abortions) To increase access to emergency contraception (not only emergency contraceptive pills containing levonorgestrel or ulipristal acetate but also copper intrauterine devices) (two-thirds of women who choose IUD placement at the emergency contraception clinical encounter continue use at 1 year) and perhaps in the future to increase access to pericoital contraception, may contribute to reduce the number of unplanned pregnancies. The role of men to avoide unintended pregnancies and abortions is also of paramount importance. But technology by itself is not enough and one size does not fit all … Finally the role of a counselling well adapted to contraception users is also of prime importance. CONCLUSION "If there is a consensus to wish that the number of abortions declines, and to favour effective and safe contraception, it must be admitted that abortions could never be totally eliminated because women and men are human beings, so fallible and because the best methods of contraception can also be fallible." (D.Serfaty, Council of Europe, 27-29 Novemer 1997)