Intended for healthcare professionals


Impediments to effective fertility reduction

BMJ 1999; 319 doi: (Published 09 October 1999) Cite this as: BMJ 1999;319:932

Contraception should be moved out of the hands of doctors

  1. Tim Black, chief executive
  1. Marie Stopes International, London W1P 5PG

    On 12 October world population will reach 6 billion. It is just 12 years since the five billion mark was passed. In another 12 years we will approach seven billion. On the front line of reproductive health provision there is optimism, tempered with frustration. The good news is that a revolution in reproductive behaviour is sweeping the developing world; the bad, that we are failing to meet the needs of millions of couples who want to plan their families but cannot access contraceptive services.

    In the 1960s 10% of couples in developing countries used contraception. Today 50% do. Total fertility has fallen from six children per couple to just over three. The principal cause of this decline has been the rapid and widespread adoption of contraception.1 The number of couples practising contraception is approaching western levels of use (75%). In Latin America it has reached 68%, in Asia 60%, and in the Middle …

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