Pregnancy status. In surveyed countries an average of about one-third of all women with unmet need are pregnant or amenorrheic. The percentage varies by country, 237, 238).

The fact that many women with unmet need are pregnant or amenorrheic is closely related to the fact that unmet need is most common among women who have recently given birth. Fecund, sexually active women are likely to become pregnant soon if they do not use contraception. In a study of 33 countries, John Hobcraft found that 17% to 22% of pregnancies occurred within nine months of a previous birth (88). Many women give birth much sooner after the previous birth than they would like. In 25 surveyed countries an average of only 11% of women wanted another birth within two years after a previous birth, but 35% had given birth that soon (238).

Limiting or spacing. The distinction between unmet need for limiting and for spacing births is important for family planning programs. First, women who want to space births would be interested in temporary contraceptive methods, while women who want to have no more children may prefer long-term or permanent methods. Also, the main reasons for unmet need differ between potential limiters and spacers. For example, in the DHS, among women who do not intend to use contraception, apparent ambivalence is the most important reason among potential spacers, while few potential limiters appear to be ambivalent about their reproductive intentions. More than twice as large a percentage of potential limiters, however, do not intend to use contraceptives because they consider themselves not exposed to the risk of pregnancy (see Figure 7).

In most countries outside sub-Saharan Africa, unmet need is either greater for limiting than for spacing or is divided evenly between the two (see Table 2). In most sub-Saharan countries, however, there is little unmet need for limiting births. Women tend to want large families, or they may be reluctant to acknowledge to survey-takers that they would prefer not to have any more children. In sub-Saharan Africa most unmet need is for spacing births.

Previous use of contraception. Generally, most women with unmet need have never used contraception. In Guatemala, Madagascar, Mali, Niger, Nigeria, Pakistan, and Senegal, more than 80% of women with unmet need have never used contraception. Still, in some countries a substantial number have used contraception but have discontinued use, reflecting side effects, poor services, ineffective methods, or other concerns (see Chapter 2.2). The percentage of the unmet need group who have never used contraception ranges from 30% in Trinidad and Tobago to 88% in Niger (see Table 5). Such differences reflect differences among countries in levels of contraceptive use.

Intention to use contraception. Slightly over half of women with unmet need intend to use contraception within the next 12 months. This percentage varies widely among countries, however, ranging from 24% in Mali to 79% in Bangladesh (237) (see Table 5).

Women with an unmet need who intend to use contraception are different from those who do not. In a study of DHS data from Egypt, Jordan, and Morocco, John Stover and Laura Heaton found that intenders resemble contraceptive users, and nonintenders resemble nonusers, in such characteristics as ideal and actual family size, awareness of a contraceptive method, personal and husband's approval of family planning, discussion of family planning between wife and husband, and previous use of contraception. In particular, most intenders had used contraception before. Among women who did not intend to use contraception, nearly half appeared to face little risk of becoming pregnant (208) (see Figure 11). Recent research in Morocco found that most women followed up on their intentions to use—or not to use—family planning. In 1995 researchers surveyed some of the same women who had been surveyed in the 1992 Morocco DHS. Among women who said in 1992 that they intended to use family planning, more than 75% had done so by 1995. Those who had not done so were the most likely to have an unmet need for family planning in 1995. In contrast, among women who said in 1992 that they did not intend to use contraception, just under 30% had changed their minds and done so by 1995. When Sin Curtis and Charles Westoff took other influences on family planning use into account, women who intended to use contraception in 1992 proved to be more than twice as likely actually to have used contraception by 1995 as those who had not intended to use it. As a predictor of contraceptive use, intention to use was second only to previous use of a method (48).

Thus women who intend to use family planning in the future, even if they have no unmet need now, probably would respond better to family planning program efforts than women at risk who do not intend to use contraception (48, 53, 108, 153, 207, 236). Research in Nepal, for instance, has found that women with unmet need who intend to use contraception are more likely than nonintenders to view family planning and health workers favorably (207). In contrast, many nonintenders may not feel strongly about avoiding pregnancy or may face little risk of pregnancy. In Morocco, among women who in 1992 had an unmet need but did not intend to use contraception, most responded in 1995 either that they wanted to have more children or that they were not likely to get pregnant (48). Low risk of pregnancy is often an important reason for nonuse among women presumed to have unmet need. In some countries—including Bangladesh, Burkina Faso, Egypt, Ghana, Jordan, Turkey, and Zambia—the DHS find that one-third to one-half of all women with unmet need say that they face little risk of becoming pregnant because they are old or hardly ever have sexual relations (238).

Many women who are not using contraception and do not currently have unmet need—that is, women who presumably are trying to have a child—say that they intend to use contraception in the future. For example, in each of eight countries in Africa, Asia, and Latin America studied using DHS data, the number of women without current unmet need who report that they intend to use family planning equals or exceeds the number with unmet need who do not intend to use family planning (179).

Interest in family planning is substantial even when the comparison is limited to intention to use contraception within the next year. Among 16 countries from all regions of the developing world, in 7 countries the number of women without unmet need who intend to use contraception in the next year equals or exceeds the number of women with unmet need who do not intend to use contraception in the next year. In 12 of the 16 countries, at least half of all women without unmet need intend to use contraception within a year.

Similarly, in Bangladesh 12% of married women are not using contraception and want a child in the next two years—thus they do not have unmet need—and yet they intend to use contraception within the coming year. Apparently, they anticipate needing family planning. Again, this group is equal in size to the group of women with unmet need who say that they do not intend to use family planning (13). Such findings suggest that "a large reservoir" of potential interest in family planning exists beyond women with unmet need (179). In terms of personal characteristics, these women resemble those with an unmet need for spacing (179). They may respond as readily to unmet need strategies as women who currently have unmet need.