Chapter 2. Sexual intercourse and Reproductive intentions: A delicate balance. (Unplanned Pregnancy).

Although women in much of the world commonly have sexual intercourse at very early ages and before or outside marriage, childbearing is often considered undesirable in these circumstances. Moreover, married couples almost everywhere increasingly want small families. Yet, for many reasons--inadequate access to contraceptive services, the poor quality of existing services, fear or distrust of methods, or conflict between partners about childbearing goals--many women who do not wish to become pregnant are not using an effective contraceptive, are not using a method correctly or are nor using any method. And all contraceptive methods, even when used regularly and correctly, sometimes fail. Consequently, unplanned pregnancies occur in every society, and some proportion of women faced with an unplanned pregnancy decide to have an abortion. The reasons they give--primarily health, economic and relationship problems--are similar around the world.

At its most basic level, unplanned pregnancy results from a failure of the complex, often tricky, balancing act engaged in by most women (and men) to reconcile two aspects of their lives: sexual intercourse and the wish--or reluctance--to have children. Contraceptive use can mediate the tension between the two, but contraception is not always available, and all methods can fail.

However, people's attempts to reconcile sexual intercourse and the desire for children do not take place in a vacuum. The degree of control that a woman has over whether she has sexual intercourse and over when and how many children she has is often affected by her age, cultural and religious background, and social and economic position in society.

In addition to persistent and long-standing social and economic disparities between women and men, and between and within countries, and a highly inequitable distribution of the world's resources, some newer and perhaps even more destabilizing social forces have entered the picture. Civil wars, the resurgence of suppressed ethnic rivalries, organized genocide, famine, the virtual collapse of civil societies and the devastation wrought by AIDS in some countries--all are likely to disrupt and undermine the ability of men and women to control their own and their family's lives, including their reproductive lives.

The reproductive consequences of sexual intercourse are more lasting and often far more serious for women than for men. In this section, therefore, we look at sexual intercourse, the desire for children and contraceptive use among women only (see box on page 12), to see what these measures can tell us about the probability--some might argue, the inevitability--that a certain level of unplanned pregnancy will always exist.

Pregnancies Resulting from Some Sexual Unions Are Likely to Be Unwanted

The physical expression of sexuality is fundamental and universal. What differs is how cultures, religions and societies construe and influence both the setting in which sexual intercourse between men and women occurs and the types of relationships in which pregnancy is encouraged or discouraged.