Contraceptive use can help protect women's lives and health by avoiding pregnancies. It is one of three crucial measures to improve maternal health: (1) reducing the number of pregnancies, (2) reducing the likelihood of complications during pregnancy, and (3) improving outcomes for pregnant women with complications (210). Reducing complications and improving outcomes require access to better obstetric care, more health care for poor and rural women, and improvements in women's living standards (86, 135, 202, 240, 284, 311). Currently, emergency care often is unavailable.

Women who do not want to become pregnant can reduce their exposure to the risks of pregnancy and childbirth by using effective contraception (135, 203, 227, 284, 318, 363, 380). In this sense, using contraception is a strategy that women themselves can adopt to protect their health (99).

Family planning and concern about maternal health have long been linked. The hope to relieve women's suffering and save lives inspired early advocates of contraception in both developed and developing countries (50, 143) (see box, "The Death of Sadie Sachs" at the end of this Chapter). Now, worldwide, policy-makers recognize the importance of contraceptive use to women's health. The Draft Program of Action of the International Conference on Population and Development asserts that countries "should seek...reductions in maternal mortality through measures to reduce high-risk births, including births to adolescents, eliminate all unwanted births and all unsafe abortion, [and] expand cost-effective obstetrical and gynaecological care..." (321). Answering a 1989 UN questionnaire, 62 of 67 countries wishing to modify fertility levels cited improving family well-being as a rationale (324).