Undesired Births, Contraception, and Abortion Before and After the Cairo Consensus: Trends in Conditional Undesired Birth Rates and the Impact of Contraception and Abortion.

The Programme of Action adopted after the International Conference on Population and Development (ICPD), and later the Beijing Declaration, affirmed commitments to the human right to decide on the number and spacing of one's children and have the information and means to do so. In this study, we estimate trends related to this component of reproductive agency-undesired births per thousand women who want to avoid pregnancy, the conditional undesired birth rate-with annual rates for five-year periods from 1975 to 2024. Worldwide, 36 million undesired births occurred annually in 2020-2024 compared to 45 million annually in 1990-1994, corresponding to a decrease in rate from 61 to 32. Had it not been for increases in contraceptive use since 1990-1994, the global average rate in 2020-2024 would have been 36 percent higher than it actually was. Had it not been for increasing proportions of pregnancies aborted, the rate would have been 58 percent higher. Comparing regional averages, excepting Sub-Saharan Africa and Oceania, the pace of decline in conditional undesired birth rates slowed by the 2000s; hence, the global average rate decreased by 22 percent in the latter half of the post-ICPD period after declining by 31 percent and 33 percent during the 15-year periods immediately before and after ICPD.