This Statement has been prepared by the International Medical Advisory Panel (IMAP) and was approved in November 2016. Profound changes in demographic patterns are taking place globally. Birth rates are falling in most countries around the world. Many governments are concerned about the impact of population ageing, and its consequent effects on lower economic productivity and escalating costs for medical care for older people. Some argue that birth rates must be stimulated to increase again. A few have begun to question the legitimacy of contraception and parenthood by choice, as well as challenging the principle of gender equality. This concern may also result in reduced focus on ‘the other side of the story’, namely that 225 million women who wish to avoid or delay pregnancy are not using modern contraception. Such restrictive approaches contravene people’s right to “reproduce and the freedom to decide if, when and how often to do so” as agreed at the 1994 International Conference on Population and Development, and reiterated through the 2015 Sustainable Development Goals. Much of the current public discourse is based on a misunderstanding of basic demographic concepts and trends. Indeed, on average, women in countries with low birth rates want more children, while women in countries with very high birth rates want fewer on average. Therefore, the ‘right’ thing to do is also the ‘smart’ thing to do.