Family Planning Saves Lives, But Millions Can’t Access It


by Carolyn Miles, President & CEO of Save the Children. Miles traveled to Uganda in February.

Around the world, an estimated 222 million women who don’t want to get pregnant cannot access contraception. I was surprised to learn Namutebi was one of them.

On the way to the Ugandan hospital where I met Namutebi, I saw several clinics advertising family planning services. The services were free and there for the asking.  But despite her deep desire to control her family size, Namutebi told me she didn’t go to the clinics.  Her husband didn’t want her to use contraceptives, she said.  It just wasn’t a decision she could make.

Namutebi was in her early 20s, but she had just given birth to her fifth child.  She was lucky, really, because she escaped serious complications for her baby or herself—even though she was unable to plan and space her pregnancies at least two years apart as medically recommended. In fact, empowering women to delay conception for three years after giving birth could save up to 1.8 million children’s lives each year, as explained in Save the Children’s new report, Every Woman’s Right: How family planning saves children’s lives.

But Namutebi hardly felt like celebrating.  She told me she felt worried.  How would she and her husband provide for their growing family?  Would there be enough money for food?  For school fees?  And what if she kept having babies?  She probably would, she knew.  The average Ugandan woman has seven children, a figure that has barely budged for several decades.

In Namutebi’s community and others around the world, large family size is equated with status and even a perception of wealth.  In some Ugandan tribes, for example, a man may receive cows for every daughter he marries off.   He’ll need these when it comes time for his sons to marry.  The whole thing can end in a wash, but the pressures remain.  Women like Namutebi and their children often pay the price, sometimes with their lives.

In many places where men have the upper hand, husbands may insist their wives keep having children and become angry or even abusive if women choose to use contraception. It makes sense, then, that when we talk about making family planning more accessible for women, we include men in the conversation. The Ugandan government has started to do that now with a campaign aimed at engaging men around the benefits of having smaller families.

Save the Children also includes men in our global efforts by helping train male “motivators” to talk to their peers with messages on the importance of healthy timing and spacing of births.  At the same time, we must ensure that women themselves can access family planning methods that are acceptable to them.  That’s one of the many reasons Save the Children puts great emphasis on training frontline health workers to reach out directly to mothers in their own communities.  These health workers are a critical link to lifesaving maternal, newborn and child health services—including family planning—for women who cannot access hospitals or sometimes even a clinic.

This week, world leaders are congregating in London for a family planning summit hosted by the British government and the Bill & Melinda Gates Foundation.  The summit will be a great opportunity to address the barriers to improved access and use of contraception, and we hope to see commitments that will boost supplies, improve delivery and focus on the critical role of frontline health workers.   This comes on the heels of a global “Child Survival Call to Action” hosted by the U.S., Indian and Ethiopian governments in Washington last month. Save the Children is calling on policymakers to endorse that forum’s goal of ending preventable child deaths within a generation.

The United States has helped lead the way to cutting child deaths by nearly half in the last 20 years.  We need to keep investing in girls’ education and health and nutrition programs that we know save children’s lives. Family planning is a key part of the solution.

To learn more, visit

Related reading:

Hillary Clinton Defends Reproductive Rights In Rio

Publicly Funded Family Planning Clinics Bring Wide Benefits

Melinda Gates Announces Commitment to Family Planning

Photo credit: Save the Children. After suffering anemia while pregnant with her son, community health workers counseled Sobia on the importance of birth spacing.  She delayed her next pregnancy and then gave birth to a healthy baby girl.


Annmari Lundin
Annmari Lundin5 years ago

7 billions and counting...Do we need more?

Robert Pavlick
Robert Pavlick5 years ago

Rosemary G says to Nancy: "You are on religion drugs which prevent you from seeing what is really going on.."

Rosemary, what do you really know about Nancy to try to make her look foolish? One doesn't have to be religious to value life. I am an Agnostic and would never drown a puppy or kitten, much less snuff an infant.

I DO acknowledge that there are extreme cases and exceptions like rape, incest, etc. But even then, if one gets immediate medical attention, pregnancy need not occur. But compared to the numbers of abortions that take place, those extreme cases are few and far between.

Let's be honest here and admit that most abortions are due to sloppy planning or no attempt at family planning whatsoever on the part of the MAN, but also the woman who allows it. And not only are we talking about avoiding pregnancy, but we want to avoid deadly STD's too don't we? If a woman chooses to have multiple partners and allows them to use no protection, she's running the risk of having a baby born with HIV and getting HIV herself. She might be able to abort the child, but she can't abort HIV. If you think condoms are expensive wait until you see how much HIV medications cost; not to mention the side effects and ultimate organ damage.

We're not talking about Islam here or the Middle East where abortions are simply not an option. We are talking about here in the good old USA.

Rosemary G.
Rosemary G5 years ago

Nancy and if you are still not convinced of my argument, please, educate yourself with a book other than the Bible and read : " The Population Bomb" by Paul Ehrlich in 1968.
We have a clause in the Constitution of Separation of Church and State and it should remain that way, otherwise we will have a Theocracy and not a Democracy and we are frightfully going in that direction.
Any religious entity that meddles with politics should be stripped immediately of its non profit and tax exempt status.

Rosemary G.
Rosemary G5 years ago

Nancy, I don't know where you get your information but since life is so sacred to you, why don't you condemn wars and the killing and raping of millions of innocent babies and adults?
Your belief system is flawed and hypocritical You are on religion drugs which prevent you from seeing what is really going on..You are as remote from the realities of life as that hypocritical wanking idiot called Romney..Get your bum off the so-called reality TV and go and see what really is going on in this World..and you don't have to go too far! By the way, I feel sorry for your kids who would not get the opportunity to think with the brain they were born and forced to think with a book written by murderous and misogynist Neanderthals inspired by an invisible man made entity.

Rosemary G.
Rosemary G5 years ago

Nancy, your argument is based on a belief system,not facts and only makes sense if you are prepared to take care of all the unplanned, unwanted children. In the meantime, stay out of other women's lives and take care of your own without any help from the taxpayers.

Carolyn M.
Carolyn Miles5 years ago

Thanks so much to the Care2 community for engaging around making lifesaving family planning more accessible for women around the world! Some really thoughtful comments here and Save the Children very much agrees with those who have pointed out that women’s empowerment and education are an important part of the solution. As those efforts continue, we also want women and their families to have options even under circumstances that are not ideal. While there is no question that abstinence – if practiced consistently – is 100 percent effective in preventing pregnancies, this is simply not a realistic option in many parts of the developing world, particularly for married women, who lack key decision making power when it comes to their bodies. To that end, we work to ensure women have access to effective and acceptable contraceptive methods such as injectables that can be used discreetly and only require four shots a year. By training community health workers to safely deliver this method, we’ve given more women access without their having to travel far from home. That’s critical for women who don’t have support from their husbands. But efforts to build that support are really critical, so we will continue to work to engage men as champions on this issue. It’s to everybody’s benefit when husbands come to understand the benefits of birth spacing for the health of their own children and wives.

Leia P.
Leia P.5 years ago

sorely needed

Nancy M.
Nancy M.5 years ago

I care about both. The sanctity of human life needs to be protected. The direct attack upon an innocent human person is never morally acceptable, in any stage or in any condition. Other direct threats to the sanctity of human life besides abortion include euthanasia, human cloning, and the destruction of human embryos for research.

Heather G.
Heather G5 years ago

Nancy, there are millions of already born babies and children around the world who are literally starving to death and you're worried that the egg of someone who doesn't even want to be pregnant won't find it's way to a uterus?!?

Nancy M.
Nancy M.5 years ago

Failed contraception TAKES LIVES from the wombs of mothers who get a surgical abortion as a result of getting pregnant. You need not look further than the US to see the co-relation between increased access to contraception has increased th number of surgical abortions.

Moreover, there are two ways the Pill acts as an abortifacient:

One way the Pill causes early abortions is that it interfers with the flexing motions and the cilia movement of the fallopian tubes. These changes slow the transportation of newly conceived child from the fallopian tubes to the womb. Unfortunately, many small babies starve to death in the fallopian tubes because chemicals caused changes that prevented them from reaching the womb in time to be nourished.
Another way the Pill causes early abortions: If your tiny baby survives the ride down the fallopian tube to your womb, the Pill will almost always cause the endometrium (the lining of your uterus) to reject your child. Chemical reactions often cause the lining of your womb to become thin, shriveled and unable to support implantation of your newly conceived child.

This means that in almost every case, your new child will not be able to attach to the wall of your womb where he or she would normally live, grow and receive nourishment for 9 months. This means your tiny baby will starve to death and his or her remains will be passed along in your next bleeding cycle.