For any procreative decision to have ethical significance, the woman involved must have moral agency, authority, and freedom. However, this is not the case when there is a lack of contraception.
Globally, 74 million women living in low and middle-income countries have unintended pregnancies annually. This situation occurs because, mainly, women lack access to contraceptive methods or contraceptive counseling.
In some cases, contraception is not chosen because sex is the result of coercion or violence, such as in cases of rape. Such a situation involves a clear violation of women’s rights and integrity. Since women do not autonomously decide to have sex and get pregnant, childbearing is not open to an ethical evaluation in these cases.
Besides, most cultures are pronatalist. Pronatalism is the promotion of baby-making for a nation’s social, political, and economic purposes. In pronatalist cultures, women face intense pressure to have children. This pressure leads them to choose not to use contraception. Here, childbearing is, again, not voluntary but is a result of cultural pressure.
Overall, procreation is not always a choice. Therefore, only voluntary childbearing should be subject to ethical evaluation.