Journal Article

From fertility preferences to reproductive outcomes in the developing world

Achieving a close correspondence between fertility desires and realized fertility is a widely shared public policy goal. This article examines the current relationship between 
desired family size and reproductive outcomes in developing countries. Since the implementation of fertility preferences through contraception (including abstinence) is imperfect, these outcomes include unplanned births and induced abortions. The data on reproductive preferences and outcomes are taken from Demographic and Health Surveys in 53 developing countries. Abortion estimates come from reports of the Guttmacher Institute. The main finding is that levels of unplanned pregnancies vary widely by transition stage as measured by desired family size. The highest unplanned pregnancy rates (more than two pregnancies during a woman’s lifetime) are observed in countries with a desired family size below three children per woman. In these countries more than half of all pregnancies are unplanned. About half of these unplanned pregnancies end in abortion and the other half in unplanned births. These findings demonstrate the difficulty many women have in controlling their fertility to the desired level by practicing contraception even in countries with high levels of contraceptive prevalence.

Published in a peer-reviewed journal of the Population Council.