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It’s O.K. to Talk About Birth Control Again


Melinda Gates
Melinda Gates at the family planning conference her foundation held with the British government on July 11. She said that African women in particular like an injectable contraceptive because it is discreet and convenient.

Every once in a while an event takes place in relative obscurity that nonetheless holds the potential to change the world. That is not a small statement, but it may prove applicable in coming years to the family planning summit in London on July 11.

Dozens of governments, United Nations agencies, foundations, research institutions, the private sector and a huge array of groups advocating for women’s health and rights came together for just one day— armed with facts and commitments and past the need for more debate. The steadily dwindling aid to family planning in the developing world in the last few decades has cost the lives of millions of women, their babies and young children too poor to survive.

It is too early to say how much potential for change in both attitudes and action this concerted effort will actually achieve, but it was the first such organized and large-scale family planning event in decades. Among those attending were high-level delegations from Africa, the poorest continent with the fastest growing populations.

During the conference and days afterward, pledges of several billion dollars were made and action plans presented. A partnership involving private funds, UN agencies and the British and American governments, for example, announced a project to supply 12 million doses of an inexpensive injectable contraceptive to women in sub-Saharan Africa and South Asia from 2013 to 2016. Injectables are increasingly the method of choice for many women with access to modern contraception in developing countries.

The tenor of the London gathering is reflected in the title of a new Web site, There Is No Controversy in Contraceptives, produced by the Bill and Melinda Gates Foundation, a sponsor of the London summit with the British Department for International Development. A central message comes through clearly: women in poor countries deserve the same choices that women in richer countries (and affluent couples in developing nations) have enjoyed for many years. The well-being and future prospects of millions of families are at stake.

“I’m often asked, what is the single most important intervention to improve the lives of women and girls in developing countries?” Isobel Coleman, a specialist on women in development at the Council on Foreign Relations, wrote in a blog on the conference day. “I usually answer by urging investment in girls’ education. But a close second — and in some cases I would put first — is birth control. Access to family planning is a matter of survival for many of the world’s women, and their children too.”

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The figures are well known among advocates for women’s health and rights. More than 220,000 women are estimated to want the tools of family planning but have no access to them. Hundreds of thousands of babies and children die every year because their mothers cannot bear healthy infants or keep them alive after birth. Pregnancy is the largest cause of death among teenage girls, many of whom have been forced into early marriages.

Numerous explanations are given as to why public support for family planning, which so successfully slowed global population growth rates and aided families economically everywhere in the 1960s and 70s, began to be eclipsed and suffered a significant drop in financing.

Other priorities intervened, like the crucial need to battle HIV/AIDS globally. Local traditions, cultures and religious practices often worked against women’s opportunities to space or avoid births. The Vatican is still arguably the world’s most powerful voice against family planning, and some of its propagandists tagged the London event an “abortion summit.” Demand for sons forces many women to continue bearing children even when a couple’s chromosomal match appears to be stacked against male births.

In the early post-colonial years, many people in the global North as well as the South accepted the idea that a focus on contraception, or aid earmarked for family planning, was tantamount to suggesting there were too many brown and black babies in the world. In the wake of the 1994 International Conference on Population and Development in Cairo, some women’s rights groups objected on the grounds that population control advocates were using women’s bodies to achieve their goals.

The only people not  heard enough from in this somewhat academic debate were the world’s poorest women.

The United Nations Population Fund, UNFPA, was noticeably not a sponsor of the London summit, though it participated. There have been differences of opinion within the organization over how much public emphasis should be put on contraception, partly out of concern that donor governments under political pressure from strong lobbies against family planning aid will withdraw their funds.

Under the administration of President George W. Bush, the US cut off all American money to the Population Fund, budgeted at $34 million a year at the time. The move prompted two American women, Jane Roberts, a French-language teacher, and Lois Abraham, a lawyer, to form the 34 Million Friends of UNFPA, which sought a dollar donation from each supporter to match the federal cut. The Friends have raised $4.2 million to date.

“Family planning is central to women’s health and to women’s equality,” Roberts wrote recently in the Redlands Daily Facts, a California newspaper. “It is too important to leave to governments alone. It is the most noble of causes going forward for people, the planet and peace.”

The administration of President Barack Obama restored American contributions to the Population Fund, which now stand at $35 million annually.  At the  London summit, which was also World Population Day, Secretary of State Hillary Clinton issued a statement supporting the fund.

“The partnership between the U.S. government and UNFPA is critical to advancing sexual and reproductive health and reproductive rights for women, men, adolescents and youth around the world,” Clinton said. In addition, the US Agency for International Development has given over $640 million this fiscal year in direct aid to governments for family planning and reproductive health generally.

“We must continue to build on this solid foundation and advance solidarity within the international community for the right of women and young people to make decisions about their own bodies,” Clinton said in welcoming the London conference. “Our efforts are critical to improving the status of women and upholding these basic human rights around the world.”

Related articles

Five Countries Hold Back Success at Meeting Child Mortality Goal

The Spotlight Returns to Family Planning

A Rockefeller Got It Right on US Population Growth

‘Americans for UNFPA’ Gets a New Name

Barbara Crossette is the senior consulting editor and writer for PassBlue and the United Nations correspondent for The Nation. She is also a member of the Council on Foreign Relations. She has also contributed to the Oxford Handbook on the United Nations.

Previously, Crossette was the UN bureau chief for The New York Times from 1994 to 2001 and previously its chief correspondent in Southeast Asia and South Asia. She is the author of “So Close to Heaven: The Vanishing Buddhist Kingdoms of the Himalayas,” “The Great Hill Stations of Asia” and a Foreign Policy Association study, “India Changes Course,” in the Foreign Policy Association’s “Great Decisions 2015.”

Crossette won the George Polk award for her coverage in India of the assassination of Rajiv Gandhi in 1991 and the 2010 Shorenstein Prize for her writing on Asia.

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