Key messages
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Increases in contraceptive use account for about 75% of fertility decline in developing countries in the past six decades and have substantially reduced the proportion of pregnancies in women of high parity, which pose a greater-than-average risk to maternal survival
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In 2008, contraceptive use averted over 250 000 maternal deaths worldwide by reducing unintended pregnancies, which is equivalent to 40% of the 355 000 maternal deaths that occurred that year
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If all women in developing countries who want to avoid pregnancy use an effective contraceptive method, the number of maternal deaths would fall by a further 30%
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Because of its effect on births to women of high parity and on the need to resort to unsafe abortion, contraception also reduces the risk of maternal death per pregnancy; each 1 percentage point increase in contraceptive use reduces the maternal mortality ratio by 4·8 deaths per 100 000 livebirths
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Contraceptive use has the potential to improve perinatal outcomes and child survival by widening the interval between successive pregnancies; in rich and poor countries the risks of prematurity and low birthweight are substantially raised by short intervals, and in developing countries, risk of death in infancy (ages <1 year) would fall by 10%, and in ages 1–4 years by 21%, if all children were spaced by a gap of 2 years
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The health benefits of specific contraceptive methods far outweigh the health risks, although minor side-effects result in high probabilities of discontinuation, particularly of hormonal methods