Women spend up to three-quarters of their childbearing lives trying to avoid getting pregnant, according to a report published yesterday.
Yet world-wide there are still 20 million unsafe or backstreet abortions per year, 70,000 of which result in death.
The report, Hopes and Realities: Closing the Gap Between Women's Aspirations and Their Reproductive Experiences, examined the wishes of women in 42 countries in terms of childbearing and what they are actually able to achieve.
The size of families has implications in terms of women's ability to play an equal part in the labour market, and for population control world- wide. Better educational opportunities and the desire to escape poverty means that women want fewer children than before.
The report found that in the last 25 years the average family size has dropped from six to three children in many countries.
"That's just one generation," said Susheela Singh, author of the report and associate director of the New York-based Alan Guttmacher Institute which issued the survey of 360,000 women. But having to spend as much as 20 years practising birth control reflects "how much effort a woman needs to make to achieve a small family", she said.
Up to 60 per cent of women world-wide are still finding it difficult to have the number of children they want, when they want them. Ms Singh said it was worrying to see the huge numbers who said they did not want to be pregnant or that a pregnancy was mistimed.
According to United Nations figures, the number of births each year would fall from 139 million world-wide to 122 million if women could plan their pregnancies.
"If all the women who actually were able to enact what they want, the growth rate in world population would be reduced by 20 per cent," Pat Murray, a spokeswoman for the charity Population Concern, said. "So as well as being in the interests of individual women, it actually affects the wider countries. It's an absolutely pivotal issue."
One of the greatest challenges, according to the report, is that of provision of birth control to women in developing countries. The study found that one in six women still lacked access to adequate birth control methods and that the levels of men using birth control was low.
"The biggest obstacles to women's success in this field are the religious lobbies who are still essentially in business of opposing women having self-determination over their bodies," Ms Murray said.
In the United Kingdom, 70 per cent of women aged 16-49 use some form of contraception. In African countries such as Namibia and Niger it is 5 per cent. One in four of the 190 million pregnancies world-wide each year end in abortion.
The key factor, according to Ms Murray, is education. The report said that girls with little schooling are at least twice as likely to have a child before 20 as their better educated peers.
Ms Murray said the report expressed the "universal need" for women to have a say in this aspect of their lives. "This is critical in determining effective choices in any other parts of their lives. How do you have proper choices if you can't take care of that one?" she asked.Reuse content