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.
The ICPD Programme of Action and the Sustainable Development Goals both underscore the essential role of sexual and reproductive health and reproductive rights in development. Despite significant progress on many aspects of sexual and reproductive health and rights (SRHR), challenges remain, and they are exacerbated by rising anti-rights movements in many countries. At a time when SRHR is under threat, it is important to surface evidence that speaks to its critical role in development and its inextricable connections to multiple global goals. In this commentary, we argue that investing in SRHR is strategic because it yields substantial benefits to individuals, economies, societies, the environment, and peace and security, and thus contributes to progress on related goals. We encourage SRHR advocates to leverage the broad array of arguments to bolster decision-makers' and other stakeholders' support of SRHR, alongside the well-established arguments grounded in cost-effectiveness, and returns on health and human rights. With the world falling short of achieving the Sustainable Development Goals and conservative forces threatening to undo the progress that has been made, urgent and collective action on multiple fronts is needed. By recognizing that many development priorities are interconnected, we can accelerate progress through cross-movement advocacy and mobilization.
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