Women’s Reproductive Desires (and Rights)

I remain perplexed—by global (but particularly American) resistance to addressing population and family planning issues. 

It is my impression that every woman I’ve ever met—certainly every woman I’ve ever discussed population and family planning issues with (which is quite a number)—would like to be able to determine her own fertility behaviour.  That is, women generally seem to want to decide how many children to have and when to have them.  “Modern” birth control technology—where available—more or less allows women to do that; and most American women, for instance, take advantage of that possibility—even those who profess religions whose patriarchs forbid it.   Without such access, western women would have far less educational, political and economic success than they do have.  They would also have worse health and fewer options for self-actualization.

Many of the women I’ve met in developing countries, and some village women I’ve known very well, have no (or at least insufficient) access to these technologies. An early (and intensely interested) question I’ve often been asked is “How is it that you have [borne]only two children?”—the answer is suspected; the women want to know more about birth control possibilities.  Specific recurrent examples from Bali and Iran come easily to mind.  A researcher friend told a similar story from her work in Latin America—in the village she studied, the women came to her repeatedly, wanting abortions (not something she was able to supply)—no birth control was available.

In the Sultanate of Oman (where I lived from 1986-1990), one of the first words I learned in Arabic, heard over and over from the women I was interviewing, was ta’aban (tired)—many had 10 or 12 children and few modern conveniences.  The death rate had fallen drastically with the Sultan’s health care improvements, but the women were still carrying water home from community canals in jugs on their heads.  Discussion of family planning was governmentally taboo.  The closest I was allowed to come to research on this topic was to look at childbirth and traditional birth attendants.  An additional consideration was the small birth canals of many of the women who’d grown to adulthood during a time of less adequate nutrition; many were in greater danger of problems during childbirth because their babies, now better nourished in utero, were too big for these small birth canals.  Caesarian sections were commonly needed.

In Long Segar, a remote village in Borneo where I lived for a year (1979-80), the women were clear:  They wanted birth control technology.  I managed to arrange for it, via the national family planning program (by learning to take blood pressure and fill out the appropriate forms).  When I left, I trained two local women to take over these tasks.  It is the only ‘development effort’ I’ve tried that really worked and sustained itself.  Still available last time I visited, some three decades later—the interest was definitely there. 

In both these cases, there were different views from the men.  Omani women predicted that if they were able to reduce their childbearing, their husbands would get another wife—not something the women desired.   In Borneo, the headman—though putting no serious constraints in place—feared that reduced childbearing would have two adverse consequences:  fewer Uma’ Jalan people for him to lead and fewer naming parties, which would in turn mean fewer of the special cakes (anye’) prepared for such festivities that he so enjoyed.

Some men object to women having access to birth control.  They may fear possible increases in married women’s infidelity, greater uncertainty about paternity, more illicit sexual acts among young girls, even the educational, political and income generating opportunities that the ability to control one’s fertility makes available to women.  But there is ample evidence that women who have access to birth control do indeed have better life chances [This means a life improvement for at least half the human population, remember].  And many of a woman’s new potentialities mean positive changes for the whole family.  A woman with fewer children may spend more time on productive activity on the farm, she may be able to earn more money—which she is more likely than men to spend on the family—and/or even just spend more time cooking more nutritious meals.  She may be able to afford better educational opportunities for all  her children (and particularly her girl children who would otherwise have been taking care of a younger sibling), better health care for the whole family.  She may even have more energy for a more passionate love life with her husband!

I am fully convinced that women want access to birth control technology, to use as they deem fit.

I also understand that there is a history to global efforts at top down population control.  I was interviewed one time (late 1970s) for a job with a US-based family planning project.  The leaders made it very clear to me that their goals were to increase ‘the number of acceptors’ and that almost ‘anything goes’ to bring those numbers up.  I declined to participate, of course—but someone else surely took that job.  We all know what happened in India, with sterilization of poor women; and we’ve heard of abuses in this country as well.

At one time, Americans blamed developing country women for over-population, seeing them as the prime contributor to global environmental decline—-completely ignoring our own dramatically more (or at least as) impactful consumption patterns.   This has been a central complaint from women in developing countries at a number of international conferences on women, population and development (e.g., Cairo, Beijing, Mexico City).  My own sense is that blaming developing country women for degrading the Earth has more or less faded away.  There is widespread recognition of the central role that our own consumption plays in global warming and other environmental challenges.

There are a number of legitimate reasons people may want to bear more children:  One concern comes from indigenous peoples whose numbers have been decimated by external forces (war, disease, adverse policies and ‘development’).  Yet another concern is the work load that women bear and the functions children can fulfill (help with daily work, contributions to income, security in old age).   Finally, some local populations have been decimated by diseases like HIV/AIDS and malaria.  All of these are legitimate concerns that any individual woman might have, and want to respond to by continuing to have babies.  That should be her right.

A less legitimate concern, in my view, comes from some economists, who argue that as incomes rise, women will automatically adopt birth control—so nothing need be done.  That may be, for those whose incomes rise (though certain parts of the Middle East represent a notable exception to this rule).  But what about those whose incomes have not yet risen, and in fact show no signs of rising?—-as is the case in and around the world’s tropical forests.  Are these women to be doomed to a life of continual childbearing, with increasing numbers of living children and with older people living longer, both representing ever greater dependency on these same over-worked women?  This does not strike me as a fair scenario, but it’s an accurate one in many places.

The legitimate concerns mentioned above do not mean that we should deny the existence of a global population problem on the one hand, and genuine, life-enhancing potentials for women who have access to birth control on the other.  The secret is not to pretend that either of these issues does not exist—as has been done in recent years, a silence that continues in many important policymaking circles.  Rather it is to link birth control access to women’s desire for such services, to provide these services where they are wanted—and ideally as part of a [locally appropriate] package focused on reproductive and primary health care.  I have imagined and proposed linking such services to forest management efforts at my own institution—-however, with little success.  The fear of touching this subject is deep and wide.

The interest of many women in controlling their own births, combined with the global concern about population, means that this issue could benefit both individual women and the global environment.  Women gain the capacity (if and when they want) to control their fertility; and the number of births almost inevitably declines.  The sticky part is making sure that birth control is provided in a respectful and responsive way that recognizes human rights and desires—including women’s, most fundamentally.  Women’s bodies are the vessels from which children come and through which they are largely nurtured—as things now stand.  As/If men’s roles in childcare increase, their voice in reproductive decision-making should increase as well.  But women should always have a stronger voice.

My perplexity remains…if people see these facts, they should act to address these issues.  If they are simply ruled by fear, they should be ashamed—and overcome their fear!  Women’s lives depend on it; and the world could be a better place when populations are stabilized (even reduced!) and when women’s lives are less constrained by unwanted fertility.

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