15 September 2025
World Contraception Day takes place annually on 26 September. It was launched in 2007 as a global campaign to raise awareness about contraception and empower proactive management of sexual and reproductive health and family planning. However, access to contraception and its use are governed by a range of legal, political, religious, health and lifestyle factors and varying degrees of regulation, restrictions and uptake around the world. As such, the benefits and challenges associated with contraception can raise a number of issues and create variable outcomes in practice, particularly in terms of women’s bodily autonomy and ability to make informed and independent choices about their lives, health, fertility and the conception and birth of children.
Different Types of Contraception
Contraception comes in a variety of forms. These include barrier methods, such as condoms or vaginal diaphragm, hormone treatment like the combined contraceptive pill or long-acting implants or injection, the morning after pill and non-hormonal alternatives including the copper coil. In the UK, through the NHS and network of sexual health clinics, the ability to access contraception and contraceptive advice has become widely accessible and can be largely obtained free of charge.
Take Up of Contraception
However, despite widespread contraceptive access amongst women resident in England and Wales in 2022 there were still 251,377 abortions that year according to accredited UK government statistics from the Office for Health Improvement & Disparities (updated 9 April 2025). (1) This was an an increase of 17% compared with 2021, producing an overall abortion rate of 21.1 per 1,000 women across England and Wales – the highest rate since the Abortion Act 1967 came into effect on 27 April 1968. This upwards trend in abortion may be partly due to the fact that mifepristone and misoprostol were first temporarily approved for home use by women in England and Wales to terminate a pregnancy (up to 9 weeks and 6 days’ gestation) in March 2020 given Covid-19 restrictions before being made permanent by the Health & Care Act 2022. However, the steadily increasing trend in abortion numbers in England and Wales suggests that there are wider factors at play preventing consistent take up and use of contraception.
In the US, access to contraception produces a mixed picture. Women from ethnic minority communities and those living in poverty or without medical insurance encounter the biggest obstacles to accessing contraception. Unlike in the UK, contraception is not available free of charge in the US and it can cost anywhere from $0- $50 for a month’s supply depending upon availability of government programs or insurance according to Planned Parenthood Federation of America (PPFA), which strives to protect and expand access to sexual and reproductive healthcare and education. Added to this, access to free or reduced-cost family planning and contraception services varies from state to state depending upon public funding availability (e.g. through Medicaid or Title X) and restrictive policymaking. According to the Guttmacher Institute an estimated 1,038,000 abortions were carried out in the US in 2024, with an overall abortion rate of 15.4 abortions per 1,000 women aged 15–44. (2)
From a global perspective, 9 percent of women of childbearing age (i.e. 15 – 49) worldwide have unmet contraceptive needs according to data from the United Nations Population Fund (updated 14 January 2025). In addition, 74 million women each year living in low-and middle-income countries fall pregnant accidentally, resulting in 25 million unsafe abortions and 39,000 maternal deaths every year, according to the World Health Organisation (the WHO). (3)
This overall picture provides some insight into the scale of the challenges faced by women around the world in terms of accessing and using contraception and their ability to achieve bodily autonomy and reproductive choice. It also brings into greater focus the extent of societal inequalities encountered in this regard by millions of women and the ongoing need to address this.
Wider Benefits of Contraception
In addition to reducing unwanted pregnancies, contraception has a role in minimising the numbers of children entering the care system and lessening the transmission of sexually transmitted infections (STI’s) if barrier methods are used, as well as restricting the numbers of high-risk abortions or maternal mortality rates.
Hormonal contraception can also be used to help manage the symptoms of several medical conditions. These include lightening the bleeding and cramps associated with polycystic ovary syndrome (PCOS), endometriosis and adenomyosis and tackling irregular menstrual cycles and hormone imbalances. In doing so, contraceptive use does not function as a cure and the long-term effects of some of these condition can lead to fertility struggles, hindering conception and contributing to more high-risk pregnancies. It also plays an important role for those women taking contra-indicated medications in pregnancy to manage other medical conditions and prevent the conception and birth of children with malformations and serious disabilities.
What Factors Influence the Use of Contraception?
There are a variety of factors which can hinder or prevent the use of contraception. In addition to legal, political and financial considerations, women may choose not to use contraception due to side effects or concerns about associated health problems. Reported side effects of hormonal contraception in women can include breakthrough bleeding, headaches, nausea, mood swings, fatigue, weight gain, bloating, sore breasts and acne. Hormonal contraception can also increase the risk of blood clots and breast cancer (albeit the risk is very low). Side effects associated with a copper coil may include breakthrough bleeding or heavier and lengthier bleeding with more pain. Furthermore, there are rare risks that an intrauterine device (such as a coil) can lead to a pelvic infection, movement of the device itself or damage to the womb.
For some, religious considerations can prevent the use of contraception.The Roman Catholic Church forbids the use of contraception. Other religious faiths can place restrictions on the types and context in which contraception can be used including Judaism and Islam. Moreover, differing opinions within relationships can prove a barrier to accessing and using contraception as can lack of understanding and education about sexual and reproductive health.
A decision to use contraception to prevent an unplanned pregnancy can also be taken by women for a variety of reasons. They may be focused on their education, professional training and career to maximise their work opportunities, finances and ability to achieve economic stability, security or home ownership. They may simply not be in a financial situation where they can afford to have and raise a child and they need to defer their family building as a matter of circumstance rather than choice. They may also be in a relationship where the prospect of parenthood is not practical (e.g. they have embarked on a new relationship or one party is not ready or accepting of children). For others, they may not be in a steady and committed relationship.
In other cases, there can be health and medical reasons which dictate the use of contraception. For those with serious heart conditions, renal disease, severe epilepsy, certain auto-immune conditions and severe hypertension there may be medical reasons for preventing pregnancy or needing to advance plan and carefully manage a pregnancy.
Contraception and Family Building
Alongside the factors influencing contraception and its usage, it is also important to put into place effective legal and practical strategies to plan fertility, pregnancy and birth during life and after death (posthumous conception). There is no international harmonisation of fertility law. Added to this fertility and family law can raise complex legal issues depending upon your personal situation and your family building wishes and conception arrangements. This is especially relevant if you have a a complicated personal life or you are looking to conceive using assisted reproductive technologies or surrogacy.
A decision to use contraception to delay having children can also impact viability of gametes and embryos and pregnancy and birth as individual fertility declines with age. As such, it is advisable to obtain specialist legal advice to maximise individual fertility and protect the legal rights, storage and use of any frozen gametes and embryos for use in future family building during life or after death.
To find out more about fertility preservation law in the UK click here.
To find out more about fertility treatment law in the UK click here.
To find out more about surrogacy law click here.
To find out more about posthumous conception law in the UK click here.
Specialist Fertility and Family Law
Are you struggling with fertility, contraception, pregnancy or other aspects of sexual and reproductive health? If you are concerned about the legal issues associated with family building in light of this and require specialist fertility or family law advice please contact Louisa Ghevaert by email louisa@louisaghevaertassociates.co.uk or by telephone+44 (0)20 7965 8399.
Images: Louisa Ghevaert CEO & Founder Louisa Ghevaert Associates
To find out more about Louisa Ghevaert click here.
(1) UK Government Office for Health Improvement & Disparities accredited official statistics, abortion statistics, England & Wales 2022 (updated 9 April 2025), https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2022/abortion-statistics-england-and-wales-2022.
(2) Guttmacher Institute, Fact Sheet April 2025 “Abortion in the US”, https://www.guttmacher.org/fact-sheet/induced-abortion-united-states.
(3) FOCUS 2030, “The Access to Contraception Around the World: Situational Analysis and Current Challenges” (published 6 March 2024 in Facts & Figures and updated 13 March 2025), https://focus2030.org/The-access-to-contraception-around-the-world-situational-analysis-and-current.
