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CONTRACEPTION AND HEALTH

Monday, 6th of August 2012

• CONTRACEPTION AND HEALTH

The Lancet,  Volume 380, Issue 9837, Pages 149 - 156, 14 July 2012

Published Online: 10 July 2012

Full text is at

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60609-6/fulltext

Original Text

Prof John Cleland MA a , Agustin Conde-Agudelo MD b, Prof Herbert Peterson MD c d, John Ross PhD e, Prof Amy Tsui PhD f

Increasing contraceptive use in developing countries has cut the number of maternal deaths by 40% over the past 20 years, merely by reducing the number of unintended pregnancies. By preventing high-risk pregnancies, especially in women of high parities, and those that would have ended in unsafe abortion, increased contraceptive use has reduced the maternal mortality ratio—the risk of maternal death per 100 000 livebirths—by about 26% in little more than a decade. A further 30% of maternal deaths could be avoided by fulfilment of unmet need for contraception. The benefits of modern contraceptives to women's health, including non-contraceptive benefits of specific methods, outweigh the risks. Contraception can also improve perinatal outcomes and child survival, mainly by lengthening interpregnancy intervals. In developing countries, the risk of prematurity and low birthweight doubles when conception occurs within 6 months of a previous birth, and children born within 2 years of an elder sibling are 60% more likely to die in infancy than are those born more than 2 years after their sibling.

a London School of Hygiene and Tropical Medicine, London, UK

b Perinatology Research Branch, Hutzel Women's Hospital, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI, USA

c Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau, Chapel Hill, NC, USA

d Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Rosenau, Chapel Hill, NC, USA

e Futures Group, Washington, DC, USA

f Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Correspondence to: Prof J Cleland, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK