Family Planning – Page 2 – Population Matters-USA

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Reproductive health abuses, especially coercion, have turned many people away from concern about human population. I agree: reproductive coercion should be shunned.

Examples of coercive actions include sterilization of both women and men in India—even though patients didn’t really know what was being done. Coerced sterilizations also happened in the early 20^th century in the USA—especially people who were who weren’t of the dominant race or were thought to be mentally or genetically deficient.

There were attempts to wipe out Native Americans, which started when Columbus “discovered” the New World, and may have continued into the 20^th century. This apparently happened at Indian Health Service hospitals, where a high proportion of Native women had their tubes tied. Fortunately, federal laws now require use of a special consent form that makes it difficult to perform sterilization procedure without real informed consent.

I have also read about Puerto Rican women being sterilized against their will in the past. When I practiced there in the 1980s, I saw no sign of coercive sterilization. In fact, the reverse was true. I remember Maria, who was desperate to stop having children. She couldn’t afford reliable birth control such as an IUD and pleaded with me to tie her tubes. Unfortunately, she didn’t have insurance and the hospital wouldn’t let me do the surgery unless they could be certain of payment.

That brings up the other side of reproductive coercion—women are often forced to bear, and raise, children that they did not intend to have.

Obamacare and many other programs will pay for contraception in the US. However, most governmental programs will not pay for an abortion when a contraceptive method fails. Unfortunately, unintended pregnancies occur with all methods, and some states prohibit abortion under any circumstance, including rape.

Since abortion has been tightly restricted or outlawed in many states, it has become impractical for countless women to obtain abortion care. Unfriendly laws have coerced many women to carry unintended pregnancies. Although networks exist to help women abort unwanted pregnancies, many people still aren’t able to make the choice they want.

A careful study of births in Texas found that abortion-limiting legislation increased unintended births. This research compared the number of births after Texas Senate Bill 8 (preventing abortions after 7 weeks of pregnancy) was in effect with the prior years’ births. They found that there were almost 10,000 more births in the relevant 9 months after SB8 took effect. Many of these excess births were probably unwanted because the women were coerced into carrying a pregnancy by their inability to access abortion care.

I predict that coercing women to bear and raise children will have bad effects on society. We know that people who result from unwanted pregnancies don’t do as well in life; they have more contact with mental health and with law enforcement agencies. We also know that Texas has one of the higher maternal mortality rates in our country, and forcing women to give birth is likely to cause the death rate to go even higher.I believe that the basis for antiabortion laws has little to do with the claimed religious beliefs; the states with the strongest “right to life” laws seem to have the weakest support of mothers and children after birth. I also believe that many people who advocate against abortion and for population growth do so for selfish economic reasons. Speaking of population growth, Nandita Bajaj, an expert on a cause of population growth—pronatalism—will be talking at Lifelong Learning in Durango on February 15^th.

There is good news about human population. Access to voluntary family planning and to safe abortion services has not only helped women achieve their goals, but also helped slow our retreat from sustainability.

Dr. George Denniston wrote that people in Mexico have experienced “…a real miracle! Women going from having 5 kids to just 2 kids in 20 years, thanks to soap operas.” His wife, Martha (now deceased) helped see the value of telenovelas (“soap operas”) to entertain and educate people about the advantages of small families. Thanks to the Population Media Center, millions of people in 50 countries are healthier, have less risk of HIV and have learned the importance of preventing unintended births.

Mexico has established excellent programs to decrease adolescent pregnancies. Teens would be most hurt by having a child too early in their lives. One program almost halved the teen pregnancy rate in just 4 years!

There is more good news: last month the Mexican supreme court decriminalized abortion. This decision stated: “… laws prohibiting the procedure are unconstitutional and violate women’s rights….” This is surprising since the majority of Mexicans are Roman Catholic.

Mexico is following a trend throughout Latin America propelled by the “green wave” of abortion-rights activists. In the past many countries in this area have had strict antiabortion laws, but that is beginning to change. In 2021 Argentina started the trend to allow abortion on request, followed by Columbia and Mexico. Globally, 50 countries have liberalized their abortion laws since 1994, and only 4 have decreased access to safe abortion services—including the USA.

Fertility is decreasing all over the world. The replacement Total Fertility Rate, which will lead to a steady population eventually, is an average of 2.1 children born per woman. That’s one child to replace the woman and the second for the man, plus a fraction for children who don’t live to reproduce. However, due to “population momentum”, the population of a country will continue to grow for a few decades after its TFR has dropped to 2.1.

50 years ago, the worldwide TFR was 4.4; now the global TFR is an amazingly low 2.3! We are getting closer to the goal of 2.1 replacement fertility. Already there are several countries that have shrinking populations, including Japan and the giant, China. In fact, the TFR is less than 2.1 in 124 countries out of the UN’s list of 240. One factor that has contributed to this fertility decline is that more than 100 million people around the world use long-acting reversible contraception—like intrauterine devices (IUDs).

Population growth is slowing down. The annual increase in global population is decreasing from a high of 92 million people in 1990 to 70 million or fewer during the past 3 years. In addition, we have reached “peak child”. We will probably never have as many children on the planet as we have now.

What is amazing is that this decrease in fertility has been done without coercion. The major factors that have permitted this are: increasing the availability of effective contraception, women’s education, and decreasing patriarchy. There is one other wonderful factor which is seldom touted, but which is worth celebrating. The mortality rate of young children has been halved over the past 30 years. People choose to have smaller families when they know their children are likely to survive.

Don’t get me wrong—we are still far from having a human population that fits sustainably on Earth! This is a progress report, not a final account of the effect of family planning on protecting the planet.