Ensuring that adolescent women are able to choose whether and when to have children is crucial to their sexual and reproductive health, yet new data published today by the Guttmacher Institute show that contraceptive services in developing regions fall short of meeting adolescents’ needs. The new data, published in a series of fact sheets, indicate that as of 2017, an estimated 36 million young women aged 15–19 in developing regions are married or sexually active and want to avoid becoming pregnant in the next two years. Yet the majority of this group—20 million adolescents—are not using a modern contraceptive method and thus have an unmet need for modern contraception. Most adolescent women with unmet need are using no contraceptive method (85%), while the remaining 15% are using traditional methods, such as withdrawal or periodic abstinence, which are less effective than modern methods.

Each year, roughly half of the 9.6 million pregnancies among adolescent women aged 15–19 in developing regions are unintended, and about half of these unintended pregnancies end in abortion. For a variety of reasons, including legal restrictions and stigma, more than half of abortions obtained by adolescents in developing regions are unsafe.

“Investing in sexual and reproductive health services for adolescent women is critical,” says Ann Biddlecom, director of international research at the Guttmacher Institute and coinvestigator of the new estimates. “When adolescent and young women are able to avoid unintended pregnancy, they are able to lead healthier lives and have greater educational and economic opportunities.”

According to the researchers, the annual cost of providing high-quality contraceptive services in developing regions to all adolescent women aged 15–19 who are married or sexually active and who want to avoid having a child for at least two years—including both current and new contraceptive users—would be $889 million, or $25 per user. Although this is a significant investment, it is important to note that about one-third of this cost is already being spent to provide modern contraceptives to current adolescent users.

Moreover, the full investment will yield enormous returns. Meeting the need for modern contraception among adolescents in developing regions would improve young women’s health and well-being by resulting in

  • Six million fewer unintended pregnancies (a 63% decline from 2017 levels)
  • 2.4 million fewer unplanned births (a 64% decline)
  • 2.9 million fewer abortions (a 62% decline), of which 1.9 million would have been unsafe (a 65% decline)

The authors emphasize that investments in the full range of sexual and reproductive health care for adolescent women—including comprehensive contraceptive services that involve medically accurate counseling and information—are critical to improving adolescent women’s health and well-being. Investing now is vital to prepare for expected increases in the contraceptive needs of adolescents in developing regions.

Policies and programs must be implemented and monitored to fully meet adolescent women’s needs and ensure their right to make voluntary and informed choices regarding contraception. Such policies and practices must prioritize making high-quality contraceptive services available and accessible to adolescents, including by training health workers in youth-friendly provision (including counseling) and providing a wide range of contraceptive options. Age-appropriate comprehensive sexuality education also must be put into practice to provide adolescents with medically accurate information that they can use to prevent unintended pregnancy and make healthy choices throughout their lives.