Sakina Sani was married off when she was 12 years old amid conflict and food shortages in northern Nigeria. She became pregnant at 15 but miscarried and then had two children in rapid succession.
"I will never allow my daughter to go through what happened to me," she told UNFPA , the UN sexual and reproductive health agency.
What happens when conflict displaces tens of thousands of people in hotspots like Nigeria, the Democratic Republic of the Congo (DRC) and Ukraine, and women die every day in childbirth or pregnancy?
UNFPA is there, equipping displacement camps and medical personnel with lifesaving supplies.
When an earthquake tumbles whole city blocks, it puts contraceptives onto emergency relief convoys alongside kits for delivering babies and medicines to stop internal bleeding.
When a cyclone slashes through remote island communities, the agency sends contraceptives just as it sends sterile medical equipment, including condoms, oral and injectable contraceptives, contraceptives implants and intrauterine devices (IUDs).
Why? Because contraceptives are part of lifesaving humanitarian care.
This may be counterintuitive to some, but it is a settled fact in the eyes of medical science, humanitarian responders and women themselves.
Even outside emergency settings, having access to modern, safe contraceptives empowers women to make their own decisions about their fertility, which in turn reduces unintended pregnancies and unsafe abortions, improves health outcomes and lowers the risk of maternal and child mortality.
In short, family planning saves millions of lives. Here are some of the reasons why:
Getting pregnant does not stop in emergency settings
More than 60 per cent of all maternal deaths are estimated to take place in humanitarian crises and fragile settings, places where women struggle to access the care and nutrition needed to safely carry a pregnancy.
Even in the best circumstances, alarming proportions of women are unable to say no to sex, roughly one quarter of women, according to the most recent data .
In a humanitarian crisis, women experience about twice the rates of gender-based violence as well as the heightened risk of rape as a weapon of war and tool of genocide and the increased risk of intimate partner violence. All of this elevates their vulnerability to an unintended pregnancy.
Preventing fatal complications
While contraception is sometimes criticised - incorrectly - as a new medication, one that is unnatural or poorly understood, the truth is that they have existed for millennia. Condoms, for example, have been used for centuries.
When it comes to modern forms of contraception, they are among the most prescribed and well-studied medications in existence. Contraceptives have been investigated not just by pharmacologists and medical researchers, but also by healthcare economists, epidemiologists and policymakers, and the findings are conclusive: by preventing unintended pregnancy, contraceptives prevent women from dying.
How? Every pregnancy carries a risk, and pregnancies in crisis settings, where health systems are in tatters and medical care scarce, are particularly dangerous.
Lifesaving aid because babies don't wait
What happens when a woman is ready to give birth after a hurricane or in a war zone?
In the crisis-addled DRC, a breakdown in healthcare infrastructure has led maternal mortality rates to soar, with three women dying every hour from pregnancy or childbirth complications.
"Many women in northwest Syria lose their lives while being transferred between hospitals in the absence of essential supplies for critical conditions," Dr. Ikram Haboush, in Idlib, said .
Unintended pregnancies are also directly correlated with higher maternal mortality rates.
"That is why every public health programme designed to reduce the number of maternal deaths incorporates contraception as one of the pillars of action," according to the experts who wrote UNFPA's flagship annual publication, the State of the World's Population Report, Seeing the unseen: The case of action in the neglected crisis of unintended pregnancy .
By preventing unintended pregnancy, contraceptives also reduce the incidence of maternal injuries and illness, stillbirth and neonatal death.
In 2023, UNFPA's dedicated supplies partnership procured $136 million worth of contraceptives, which is estimated to have prevented nearly 10 million unintended pregnancies and over 200,000 maternal and newborn deaths. It is estimated these contraceptives also prevented nearly three million unsafe abortions.
Preventing fatal illness, chronic ailments
Contraceptives like male and female condoms additionally save lives by decreasing the chances of contracting sexually transmitted infections (STIs), including HIV .
Even a treatable STI can be life-threatening in settings with limited access to medical care, as is the case for women and girls in Haiti, for example, where widespread and relentless sexual violence has led to rising rates of unintended pregnancy as well as STIs, while the health system has all but collapsed.
Only around three per cent of survivors in Haiti report receiving post-rape treatment within 72 hours of being assaulted. This treatment includes emergency contraception to prevent pregnancy and post-exposure prophylaxis to prevent HIV transmission.
Contraceptives also treat ailments unrelated to sexual activity that are debilitating in even stable and secure circumstances like polycystic ovarian syndrome, endometriosis, dysmenorrhea and extremely heavy bleeding.
For women like Omaira Opikuko from Venezuela, there is no question that long-term contraception after her sixth delivery was lifesaving.
She suffered both haemorrhaging and a prolapsed uterus during her last labour.
"I was on the brink of death," she said.
Cost-effective humanitarian interventions
Family planning is cost effective.
In 2023, more than 50 countries that received UNFPA contraceptive supplies made collective savings of over $700 million through reduced healthcare costs for pregnancy, delivery and post-abortion care.
Numerous studies have shown that family planning is a critical investment for society, not only by averting unintended pregnancy and the maternal health problems that accompany it, but also by increasing education and employment gains among women.
In humanitarian settings, contraceptives are all the more critical, helping women and families survive and stabilise and leaving them better prepared to recover.
No one knows this better than survivors of humanitarian crises themselves
"There is a lot of demand for family planning services," one emergency responder said in the immediate aftermath of a deadly cyclone .
Amid the world's growing precarity , rising catastrophes and increasing displacements, these services are a light in the dark for women and girls around the world.
As Ms. Opikuko in Venezuela said, "I don't want to be scared anymore."
