Family Planning: Whose Business?

This is a story of a family who live on less than $5 a day.  Mama and Papa have six children.  Mama would have seven but she lost the first one. She’s not sure why he died but she has never had enough food in the house, and with close pregnancy spacing she was not able to breastfeed the child that died for very long.  Even now, there is not much food to go around and so many mouths to feed.  Mama is exhausted. She needs an operation, because of the fistula she developed when having her third baby. Mama and Papa do not have the money for this operation; it would leave them without food to eat and they are already hungry. Their oldest child Mala has to help care for the other children.  Mama would like her to get some education but it is also expensive plus who will help her with the household chores? Papa is too busy in the fields.  Mama wishes she could have less children but doesn’t know how that is possible.  

This narrative is typical for women in developing countries all over the world. Already burdened with the tribulations of being poor and struggling day-to-day, they face further struggles through lack of education, higher risk of death due to childbirth, problems related to under-nutrition, and a vicious cycle that entraps their children into the same ring of poverty. This is not a specific cultural issue; this is an issue of universal female empowerment. It is well-documented that more educated women have less pregnancies and most women with large unplanned families want less children.

Female empowerment is not difficult to achieve. Despite the current negative rhetoric in the United States and United Kingdom around family planning, some developing countries have shown that politicians need not dictate to women about family planning, and that family planning does not equal abortion. Less children mean there are less mouths to feed, so the mother can focus on fully satisfying the nutritional needs of her smaller family as well as herself. It also means she has more time to focus on her economic needs, by working on the side she can supplement the household income and better lift herself and her family out of poverty. This begins to break the vicious circle, as it often enables her daughters to have a chance at achieving an education, which further empowers them to be agents of their own body and life.

This is the side of the story that the U.S. Presidential election rarely touches upon. The right-wing conservatives that make family planning an issue only about abortion directly feed into rhetoric that disables the empowerment of women. This also contradicts policy and evidence-based initiatives that have proved time and time again that family planning increases the quality of life of a woman. The Global Gag Rule, enacted by George Bush Senior and then reinstated by his son, was aimed at abortion but also ended up restricting contraception access. As a result, unintended pregnancies in areas that receive US aid actually increased. How can a policy that contributes to the vicious cycle of women in poverty possibly be empowering for women?

Despite these challenges, we have seen some tremendous gains in women’s empowerment in the last thirty years, even within family planning programs. In the mid 1970’s, Bangladesh had one of the highest fertility rates in the world with the average woman bearing seven children. By 2004, using a coordinated effort of making contraceptives readily available and implementing a peer-to-peer support program that visited women at home to provide follow up, fertility per woman had reduced from an average of seven children to an average of three.  Further success has been seen through NGO’s such as BRAC. By using grassroots measures to influence policy, we can empower women and lift them out of poverty, but family planning is an integral part of the solution. We can’t let the argument about abortion mask gains for universal female empowerment.