Mother and daughter, Liza and Agnes, living in a small seaside community of St Bernard in the Philippines, recalled the day Super Typhoon Rai made landfall. When I visited them, they told me that when the typhoon hit, the wind sounded like a thousand horses thundering through the community and ripping houses and families violently apart, destroying thousands of lives, and disrupting access to critical health services.
Liza and Agnes and millions of girls who found themselves pregnant while in the maelstrom of crises, from natural disasters to pandemics, and conflicts -- are the real victims. Evidence shows us that in humanitarian settings, more than 50% of all maternal deaths and up to 70% of gender-based violence occur.
This is particularly apparent in Asia and the Pacific, the world's most disaster-prone region, where women and girls are at high risk and extremely vulnerable when they lose access to information and services on sex and health, including contraception.
This is one of the world's most devastating crises and it is right in front of our eyes. Yet somehow it remains unseen. In today's modern age of space travel, many women and girls still do not have the basic human right to bodily autonomy -- the ability to choose whether, when and with whom to become pregnant. At the peak of mankind's technological evolution, half of all pregnancies are unplanned, and many of them unwanted. How is this possible in the age of modern and effective contraception?
Unintended pregnancies are not just happening in humanitarian settings. Women and girls in many communities across Asia-Pacific are still curtailed from responsively and freely deciding and spacing pregnancies. Across six South Asian countries, an average of 22.7% of women with three or more children have for instance experienced an unintended pregnancy.
What we don't tend to realise is that this lack of individual choices cascades into monumental global costs. There are steep consequences associated with unintended pregnancy -- costs to an individual's health, education and future, impact on whole health systems, workforces and societies. The amount of girls who delay or discontinue their education and workforce participation due to unintended pregnancies is vast, with lifetime and intergenerational impacts on earnings and health.
At a granular level, costs on individuals are staggering. There are social, mental and physical health consequences including recourse to unsafe abortion and increased vulnerability to poverty. The toll of these pregnancies is -- and has long been -- unseen. Though we can estimate health care costs and monitor school drop-out rates, these only scratch the surface.
Additionally, unintended pregnancy is a driver of child marriage. Cultural beliefs in the region that pride, family and honour push many young girls into marriage, disrupting their education and their ambition to reach their full potential.
Over the last 20 years, the Asia and the Pacific region has seen impressive improvements in sexual and reproductive health. However, there are still 140 million women in the region with an unmet need for family planning.
Over 60% of unintended pregnancies end in abortion and an estimated 45% of all abortions are unsafe, accounting for 5–13% of all maternal deaths recorded, according to the UNFPA's flagship State of World Population 2022 report.
This is also having a major impact on countries' ability to reach the Sustainable Development Goals by the 2030 target date.
The solution to so many of the world's biggest challenges is right in front of us -- the realisation of gender equality and the full rights and potential of women and girls. This can be done through listening, investing, building and advancing efforts from all spectrums to shift society's priorities by allowing women and girls to achieve their bodily autonomy.
UNFPA, the United Nations sexual health and reproductive agency, calls on policymakers, community leaders and everyone to work collectively to change society's priorities by expanding choices and resources for women and girls. To finally exercise real, informed choices over their health, bodies, and futures, we can unleash a powerful, reinforcing cycle of gains.
With a united call for action, our collective efforts will bring us closer to our professed shared vision for humanity -- a world in which every pregnancy is wanted, and every person enjoys the full realisation of their rights and potential.
Bjorn Andersson is the Director of the Asia Pacific Regional Office of the United Nations Population Fund, the UN sexual and reproductive health agency.
