More women than ever are using contraception, giving hope for a global slowdown in population growth. But despite improvements in family planning services, particularly in low-income countries, the UN estimates 225 million women and girls who would like to delay or avoid pregnancy do not have access to a modern form of contraception.



Following the publication of our interactive on contraception rates around the world, which used UN figures, we asked readers to share their experiences of accessing family planning services. There were many positive responses from women in countries including the UK, Sweden, Australia, Jamaica, Spain and Argentina, who said they experienced little or no problems accessing contraception.

Others – including in Zimbabwe, Japan and Ireland – described the barriers they faced, including cultural or religious opposition to contraception, supply shortages and frustrations in having their views heard by medical professionals. Below are four of the most common responses from readers, some of whom wish to remain anonymous.

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‘The family planning services aren’t there’

In Kenya, national health surveys show more than 60% of young women and girls who have had sex have not used contraception. One reader, Raymond Obare, who works on a project providing contraception to young people in Nairobi, said women face a multitude of barriers. “In Kenya, family planning services in government hospitals are limited and inconsistent,” Obare said. “Unintended pregnancy is a big challenge to girls and young women, resulting in high unsafe abortion rates and school drop-outs.”

A reader from Ghana, aged 23, said people in rural areas face the biggest challenges in accessing long-term contraception. “If you are in a city it is easy to get contraception from a walk-in clinic or the hospital, but women outside of the city can’t because they sometimes have to travel a long way to the clinic, or if you can get the pill close by you might not want to in case family members see you,” she said. “Also people talk about side effects so some girls don’t want to use the pill because they’re afraid. Then they are faced with relying on condoms and making sure men put them on.”

‘I was denied contraception on religious grounds’

One reader from Jamaica, aged 35, said she was unable to access emergency contraception while in the US. “I remember being in Florida, and being denied the morning-after pill, because the doctor felt it went against her religious beliefs,” she said. A reader from the UK, aged 24, said she had to change clinics after the first nurse said she knew her Catholic parents and hinted she would tell them she was using contraceptives.

In many countries it is difficult for single women to get full access to family planning services. “It’s fine for married women, but if you’re unmarried it’s difficult,” said a reader from the Philippines. “It’s expected that you will not have sex until you are married, so if you want to go on the pill when you just have a boyfriend, you have to find the right place to ask.”

‘My method of choice is unavailable’

Of those women who live in countries where some forms of contraception are readily available, the majority said their biggest issue was accessing their method of choice. Rachael Ingram, 19, from the UK, said fitting into clinics’ schedules was difficult. “There are many clinics around my area to get contraception, however most of them only offer certain types of contraception on certain days of the week, and as a woman working full-time it just isn’t viable to go to the clinic or doctor on for example a Wednesday morning just to get a specific form of contraception that I want,” she said.

A particular concern from readers was the difficulty in finding medical staff who could fit and remove IUDs. One Australian woman, aged 25, said she faced a $300 bill at a private clinic after facing a six-month wait at a public hospital and no local GPs with the required specialised training to fit her IUD. “Most doctors will just prescribe the pill. IUDs are hard to access even though they’re well-regarded and effective,” she said.

‘Not all doctors are willing to listen to what I want’

Some readers said they were childless by choice, but were unable to access long-term or permanent methods of contraception. “I feel like even the term family planning assumes we all want children,” one reader from Canada said. A woman from Scotland said she had experienced “debilitating side effects from contraceptives” and had requested sterilisation since she didn’t want to have children. “I have been met with the ‘you’ll change your mind’ attitude every time I have requested sterilisation, and have at the age of 34 given up asking,” she said.

In China, Kirsty Grace, 27, said cultural factors made it difficult for women to take control over their reproductive health. “In a country where the permitted number of children is dictated and penalised severely, women are incredibly restricted in their means of prevention,” Grace said. “China has seen such rapid progression: academically, economically and technologically in the past couple of decades, however my experience here leads me to conclude that the treatment of women lags far behind.”