Control your population

The New York Times reports a study by researchers at John Hopkins University that indicates maternal mortality could be slashed by nearly a third if women had greater access to contraception. Giving birth, as is known, can be a very dangerous activity in resource-poor settings. Of course, maternal mortality is just the indicator of choice here: adequate access to contraception is likely to have other benefits for the women besides lowering their risk of premature death, as well as avoiding the negative impacts of overpopulation for the local economy and environment. The issue of family planning, it seems, is coming back on the radar after being eclipsed by the rise of HIV/AIDS; as funding for HIV/AIDS has risen, funding for family planning has plummeted. The Gates Foundation, for one, is backing family planning initiatives, including the recent London Summit on Family Planning in which global leaders and institutions pledged to provide voluntary family planning services to an additional 120 million women in the world's poorest countries.

There is something ironic about family planning initiatives funded/led by developed, affluent countries that are directed at less affluent, developing ones. Family planning is a worthy objective that is politically and culturally touchy, everywhere. In the United States, there was much controversy this year about whether President Obama's Patient Protection and Affordable Care Act involved forcing religious institutions to provide health care insurance that included coverage for contraception. There is the ongoing legal and ethical debate about whether pharmacists can refuse to dispense emergency contraception (Plan B) on religious grounds. Then there are the ongoing battles about the content of sex education in US schools. So one can hope that these large-scale family planning initiatives aiming at low-resource countries will go beyond the biomedical perspective, and develop creative, locally-driven, culturally sensitive, politically savvy and women-empowering ways to control the rate of births. One can also hope that if that happens, the lessons learned can be brought back to bear on the developed world, since it is a call for progressive social change.