Resource Library

High Impact Practice:Offer contraceptive counseling and services as part of facility-based childbirth care prior to discharge from the health facility.

Providing contraception during childbirth increases its use and reduces unintended or closely spaced births, which are harmful to mothers and babies. Despite this benefit, many women lack access, especially in low- and middle-income countries. The COVID-19 pandemic further disrupted access to these critical services. The World Health Organization recommends offering family planning information and services throughout pregnancy, childbirth, and postpartum care to improve women’s health and well-being.

This report examines trends in adolescent childbearing using techniques that focus on the most vulnerable girls, such as child mothers, girls with repeat adolescent childbearing, and births that occur in dangerously quick succession. In using these new measures, it uncovers the untold story of more than 50 years of adolescent childbearing in the world’s low- and middle-income countries.

The new measures reveal that the issue is not just about whether or not a girl gives birth in adolescence but if, when and how many births she experiences. That is, adolescent childbearing comprises three fundamental and interconnected fertility processes: (i) the timing of a first adolescent birth, (ii) the spacing between adolescent births and (iii) the quantity or total number of births to each adolescent mother.

This multifaceted process is most immediately shaped by factors such as the age of menarche and sexual debut, the frequency of sexual activity, the patterns of marriage and union formation, and the use and effectiveness of contraception. It is worth emphasizing that the majority of first births to girls aged 17 years and younger, in 54 developing countries with data, occur within marriage or cohabiting unions. More distal determinants – such as girls’ education – are also critical to the process and include gendered social, economic, cognitive and psychological factors at the individual, peer, family and community levels.

Additionally, broader norms, values, inequalities, events, economic forces, and national laws, policies and priorities shape the adolescent fertility landscape.

This report is accompanied by Supplementary Material and an Executive Summary.

This brief underscores the pivotal role of social norms in shaping family planning behaviors and outcomes. It highlights that interventions aimed at shifting harmful social norms can significantly enhance community support for family planning, thereby empowering individuals and couples to make informed reproductive choices. The article discusses various strategies, including reflective dialogue, interpersonal communication, and the use of mass and social media, to foster positive changes in social norms. By addressing gender inequalities and cultural barriers, these interventions not only improve the uptake of family planning services but also contribute to broader health and well-being. The article calls for the implementation of evidence-based practices to create supportive environments where individuals can freely exercise their reproductive rights.

This brief highlights the critical role of effective communication between partners in enhancing reproductive health and family planning outcomes. It highlights that interventions encouraging couples to discuss their fertility intentions and make joint decisions significantly increase the uptake of modern contraceptive methods. The article underscores the importance of addressing gender inequalities and cultural norms that often hinder open communication. By fostering equitable power dynamics and supporting both partners in making informed decisions, these interventions not only improve reproductive health outcomes but also strengthen relationships. The article calls for the implementation of evidence-based practices to promote healthy communication, ensuring that all individuals can freely and responsibly decide the number and spacing of their children.

This strategic planning guide emphasizes the crucial role of involving men and boys in family planning to improve reproductive health outcomes. It outlines a strategic process for program managers and decision-makers to identify effective investments in male engagement, addressing gender norms and promoting gender equality. The guide highlights the importance of respecting women’s autonomy while encouraging men to participate as contraceptive users, supportive partners, and advocates for family planning. By fostering open communication and equitable decision-making within couples, the guide aims to transform social norms and enhance the uptake of family planning services. The article underscores that engaging men and boys is essential for creating supportive environments where reproductive health decisions are made collaboratively and responsibly.

This publication is designed to be used by programme planners and managers as a resource when designing interventions to integrate postpartum family planning into national and subnational strategies.

Postpartum family planning should not be considered a ‘vertical’ programme, but rather as an integrated part of existing maternal and child health and family planning efforts. Successful interventions for postpartum family planning require holistic and evidence-based programme strategies that contribute to strengthened health systems and sustained improvements in high-quality services that put people at the centre of health care.