Trends in unwanted childbearing in the developing world.

This study analyzes trends in unwanted fertility in 20 developing countries, based on data from the World Fertility Surveys and the Demographic and Health Surveys. Although wanted childbearing almost invariably declines as countries move through the fertility transition, the trend in unwanted fertility was found to have an inverted U shape. During the first half of the transition, unwanted fertility tends to rise, and it does not decline until near the end of the transition. This pattern is attributed to the combined effects of an increase in the duration of exposure to the risk of unwanted pregnancy and a rise in contraceptive use as desired family size declines. The substantial variation in unwanted fertility among countries at the same transition stage is caused by variation in the degree of implementation of preferences, the effectiveness of contraceptive use, the rate of induced abortion, and other proximate determinants, such as age at marriage, duration of breastfeeding, and frequency of sexual relations. The principal policy implication from this analysis is that vigorous efforts to reduce unwanted pregnancies through family planning programs and other measures are needed early in the fertility transition because, in their absence, unwanted fertility and abortion rates are likely to rise to high levels.