On Mother’s Day, the gift of family planning

One of the defining characteristic of mothers with the good fortune of living in developed nations is having the means … Continued

One of the defining characteristic of mothers with the good fortune of living in developed nations is having the means to control childbearing to promote their health and their family’s welfare. The vast majority of women in the United States have used a family planning method at some point in their reproductive lives. And for all practical purposes, this cuts across all religious, social and cultural groups.

It is in this context, that as a Christian, I am mystified by the recent political debates about providers restricting access to family planning methods, because I believe the practice of fertility control is one of the core values of responsible parenthood. I am speaking from the perspective of a health professional who has worked for over 45 years on public health programs in developing countries and has seen the devastating consequences for women and their families when they have not had the freedom, the information and means to exercise fertility control.

Bangladesh provides a good example. For eight years in the period between 1965 and 1979, I lived and worked in Bangladesh (formerly East Pakistan before 1971). When I first arrived in 1965, women were averaging six births, but almost 20 percent of the children died before the age of 5. And women had a lifetime risk of greater than 1 in 16 of dying in childbirth.

When Bangladesh gained its independence from Pakistan in 1971, it was considered one of the world’s basket cases due to poverty, illiteracy, a lack of any industrial base or natural resources, and a very high population growth rate of over 3 percent per year.

The Bangladesh government was beginning to respond, but the national family planning program, largely based on clinical services, was very weak. Beginning in 1976, USAID supported a series of rural family planning projects that demonstrated the effectiveness of trained female field workers going house-to-house to deliver pills, injections and condoms backed by the full range of clinical services (intrauterine devices and sterilization) in helping women to achieve their fertility control goals. In three years, the use of family planning rose from 4 percent to 30 percent and birth rates dropped by 25 percent in the project area. Over the next three years, the government of Bangladesh adopted this strategy, recruiting more than 30,000 women field workers to reach a national population of over 85 million.

Over the next three decades, the fertility transition was dramatic. Around 55 percent of women in Bangladesh are now practicing family planning and the fertility rate has declined to 2.3 births per woman. Correspondingly, child mortality has fallen by 75 percent and the risk of death in childbirth has dropped by 70 percent. Over this same period, as mothers have gained control over their reproductive lives, social and economic development has rapidly advanced. For example, now 90 percent of children go to elementary school.

I could recount similar stories in many other parts of the developing world where mothers have gained control of their fertility and experienced great improvements in health and welfare. To me, a value central to motherhood is the ability to choose when she will bear children, and how many she will have. We know from the experience in our own country that given the knowledge and means, the overwhelming majority of women will exercise this choice by practicing family planning when they wish to delay or prevent a pregnancy. The global tragedy is that there are upwards of 215 million women around the world who have an “unmet need” for effective family planning, and thus cannot fully share in the joys of being a mother who can responsibly care for her family.

Returning to the debate mentioned earlier, I should note the fact that there is no controversy about family planning among the vast majority of Christian organizations actually working in the field of international health. In 2008, Christian Connections for International Health, a network of 160 Christian organizations working in international health around the world, conducted a survey of its members. The results revealed the majority were providing family planning services and saw family planning as an important component of international health. Furthermore, in June 2011, at a major interfaith consultation in Nairobi, Kenya, an Interfaith Declaration supporting family planning as an essential component of maternal and child health and family welfare was crafted with participation by Muslims, Hindus, Buddhists, and both Catholic and Protestant Christians.

The provision of modern family planning services does not exclude Catholics, since American Catholics use all the same modern methods used by non-Catholics. In addition, the World Health Organization now recognizes a natural method known as the Standard Days Method as a modern method of family planning. Natural methods are used widely by Catholic health programs.

Fortunately, the international community interest in supporting family planning has been reinvigorated in the past few years. I am encouraged to see the interest of philanthropist Melinda Gates of the Bill and Melinda Gates Foundation, speaking from her Catholic background, in getting this issue back on the global health agenda. Her talk April 5 at the TEDxChange made the case that there is no legitimate reason family planning should be controversial and that it enables couples to give their children a chance for a healthy and productive future. I agree. Let’s return the discussion of family planning back to the health issue it is, and not the political issue it has become.

W. Henry Mosley, MD, MPH, is professor emeritus at Johns Hopkins Bloomberg School of Public Health. He is also a member of Christian Connections for International Health.

This post has been updated.

  • ccnl1

    Note: Some words hyphenated to defeat an obvious word filter. …

    The Brutal Effects of Stupidity:

    : The failures of the widely used birth “control” methods i.e. the Pill ( 8.7% failure rate) and male con-dom (17.4% failure rate) have led to the large rate of abortions and S-TDs in the USA. Men and women must either recognize their responsibilities by using the Pill or co-ndoms properly and/or use safer methods in order to reduce the epidemics of abortion and S-TDs.- Failure rate statistics provided by the Gut-tmacher Inst-itute. Unfortunately they do not give the statistics for doubling up i.e. using a combination of the Pill and a condom.

    Added information before making your next move:

    from the CDC-2006

    “Se-xually transmitted diseases (STDs) remain a major public health challenge in the United States. While substantial progress has been made in preventing, diagnosing, and treating certain S-TDs in recent years, CDC estimates that approximately 19 million new infections occur each year, almost half of them among young people ages 15 to 24.1 In addition to the physical and psy-ch-ological consequences of S-TDs, these diseases also exact a tremendous economic toll. Direct medical costs as-sociated with STDs in the United States are estimated at up to $14.7 billion annually in 2006 dollars.”

    And from:

    Consumer Reports, January, 2012

    “Yes, or-al se-x is se-x, and it can boost cancer risk-

    Here’s a crucial message for teens (and all se-xually active “post-teeners”: Or-al se-x carries many of the same risks as va-ginal se-x, including human papilloma virus, or HPV. And HPV may now be overtaking tobacco as the leading cause of or-al cancers in America in people under age 50.

    “Adolescents don’t think or-al se-x is something to worry about,” said Bonnie Halpern-Felsher professor of pediatrics at the University of California, San Francisco. “They view it as a way to have intimacy without having ‘s-ex.’” (It should be called the Bill Clinton Syndrome !!)

    Obviously, political

  • persiflage

    Regular use of contraception among impoverished nations is the only thing that will contain the run-away population growth that threatens massive resource shortages of every kind. Lack of food, water, and basic medical intervention are an imminent threat to many millions. We’re predicted to see the catasrophic results within a generation.

    The Catholic Church is one of the biggest impediments standing in the way of population containment.

  • usapdx

    Earth now with SENEN BILLON humans and another TWO BILLION more projected by 2050, what are those who speak against birth control going to say when earth cannot feed all the humans?

  • ccnl1

    For more on fertility rates and where there are problems regarding family planning, see:

    https://www.cia.gov/library/publications/the-world

  • Catken1

    It’s not food that we’ll run out of first – it’s energy, clean water and clean air. And then there’s the waste products we produce…

  • usapdx

    Catken1, When you say WE , if you mean the USA, yes but for the WORLD, it will be food and when people do not get food, they will be very violent. We in the USA will pay very dearly for food and the miltary will control our southern border. The bright side in the USA, pleasently plump people with be only a memory. Our we living within or means? No.

  • amelia45

    Thank you for your story and for supporting more widespread availability of contraceptives. Women do die when they cannot have access to the right form of contraceptives for their situation and their health.

    The current state of the discussion in the U.S. is led by Catholic bishops who have lost all sense of proportion. There are Catholics in each European country and in Australia, for example, who live in societies where the government health program includes contraceptives. And the Catholic universities and hospitals are just as Catholic today as they were they day before whatever country they are in adopted universal availability of birth control.

    As a Jesuit priest from Australia put it: “…in Australia, our taxes and health insurance premiums undoubtedly help to fund abortions, sterilisations, and the provision of contraceptives at more affordable rates. Most Australian Catholics, including most of our bishops, accept that universal health cover includes some remote material cooperation with activities which might not pass muster with the strictest codes of Catholic moral behaviour. We do not lose any sleep over this.”

    I am one of the majority of Catholic pew sitters who think our bishops have gone a little crazy. Believe me, folks, this is not about religious freedom – it is about contraceptives.

  • ccnl1

    Added details–

    Note: Some words hyphenated to defeat an obvious word filter. …

    The Brutal Effects of Stupidity:

    : The failures of the widely used birth “control” methods i.e. the Pill ( 8.7% failure rate) and male con-dom (17.4% failure rate) have led to the large rate of abortions and S-TDs in the USA. Men and women must either recognize their responsibilities by using the Pill or co-ndoms properly and/or use safer methods in order to reduce the epidemics of abortion and S-TDs.- Failure rate statistics provided by the Gut-tmacher Inst-itute. Unfortunately they do not give the statistics for doubling up i.e. using a combination of the Pill and a condom.

    Added information before making your next move:

    from the CDC-2006

    “Se-xually transmitted diseases (STDs) remain a major public health challenge in the United States. While substantial progress has been made in preventing, diagnosing, and treating certain S-TDs in recent years, CDC estimates that approximately 19 million new infections occur each year, almost half of them among young people ages 15 to 24.1 In addition to the physical and psy-ch-ological consequences of S-TDs, these diseases also exact a tremendous economic toll. Direct medical costs as-sociated with STDs in the United States are estimated at up to $14.7 billion annually in 2006 dollars.”

    And from:

    Consumer Reports, January, 2012

    “Yes, or-al se-x is se-x, and it can boost cancer risk-

    Here’s a crucial message for teens (and all se-xually active “post-teeners”: Or-al se-x carries many of the same risks as va-ginal se-x, including human papilloma virus, or HPV. And HPV may now be overtaking tobacco as the leading cause of or-al cancers in America in people under age 50.

    “Adolescents don’t think or-al se-x is something to worry about,” said Bonnie Halpern-Felsher professor of pediatrics at the University of California, San Francisco. “They view it as a way to have intimacy without having ‘s-ex.’” (It should be called the Bill Clinton

  • ccnl1

    We await all volunteers to make room for the next generations.

  • usapdx

    Most USA RCs do not agree with the RCC teaching on birth control. The USA RC bishops do not want birth control health part of OBAMA CARE coverage for their flock but the USA RC bishops cannot take a right from any American by our supreme law, the Constitution.

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