In the industrialized countries, the trend toward smaller families has emerged gradually over the last century. In the developing world, by contrast, the swiftness of the change has been dramatic. The rapid pace of urbanization in most countries, improvements in education and the spread of the mass media have exposed people to new ideas, new values, new expectations, new economic pressures and new opportunities.
Early union can also make women more vulnerable to abuse and discrimination.
The use of modern contraceptive methods, including voluntary sterilization, to avoid unplanned childbearing has increased rapidly over the past 30 years, especially in countries with strong family planning programmes. The high level of unmet need for quality contraceptive services is a key reason why there is frequently a gap between the number of children women say they want and the number they actually have. Women need access to a broad range of reproductive health services in addition to birth control. For example, all women, regardless of their age or whether they are sexually active, need routine gynecologic care.