Why global support for contraception is critical in the pandemic age

Saturday, September 26th is World Contraception Day. This key date is a reminder that access to affordable contraception and reproductive health services is a fundamental human right across the globe. Furthermore, family planning and reproductive autonomy (particularly in the Global South), together with lowering our personal environmental impacts (particularly in the Global North) is fundamental to addressing the rapidly unfolding climate and ecological emergency.

by Michael Bayliss, Sustainable Population Australia

This year, World Contraception Day is more critical than ever. Since the COVID-19 pandemic, access to health services has been disrupted in many parts of the world. As a result, millions of people are encountering barriers to accessing desperately needed contraception and family planning services.

According to the Los Angeles Times:

“Across 37 countries, nearly 2 million fewer women received services between January and June than in the same period last year…1.3 million in India alone. The organization expects 900,000 unintended pregnancies worldwide as a result, along with 1.5 million unsafe abortions and more than 3,000 maternal deaths.”

In parts of West Africa, the provision of some contraceptives fell by nearly 50% compared to the same period last year, according to the International Planned Parenthood Federation.

Al-Jazeera reported that:

“Tens of thousands of girls across Asia are being forced into child marriage by desperate families plunged into poverty because of the coronavirus pandemic, as campaigners warn that years of progress tackling the practice is being undone… unless urgent action is taken to tackle the economic and social impact of the virus – an additional 13 million child marriages will take place in the next decade.”

Indeed, without a global commitment to reverse these trends, the world is at risk of creating a ‘COVID generation’ with children born into entrenched hardship and poverty and the intensifying complications of climate change, population pressure and a destabilised global environment. It is worth noting that climate change could displace more than a billion people, with those in the Global South being particularly vulnerable. The magnitude of this crisis can be mitigated if women gain more agency overall, and this includes their right to reproductive agency.

On top of this, the recent rise of right-wing populist governments has compounded the problem with the rise of anti-choice ideologies. US president Donald Trump is promising to “fully defund” Planned Parenthood, pass a nationwide abortion ban, and stack the courts with anti-choice judges if he wins a second term. The prospect of a new anti-choice judge on the US Supreme Court, together with closure and removal of funding for sexual and reproductive health services, are the ingredients for the perfect storm.

According to UNFPA, the mission of World Contraception Day is to:

“Improve awareness of all contraceptive methods available and enable young people to make informed choices on their sexual and reproductive health.”

Fifty years after the introduction of the pill, this job is far from done. As UNFPA says:

“There are 3.5 billion people under the age of 30 in the world today – the largest generation of young people ever…. Yet, young people face especially serious barriers to accessing life-saving contraceptives and family planning services, including insufficient knowledge about modern methods and healthcare providers who discourage use of contraception among unmarried people.”

According to Family Planning Australia:

“Low fertility rate leads to contained population growth which is a key factor in socio-economic development and resource management,” while “good reproductive healthcare can save women’s lives.”

The International Planned Parenthood Federation argues that:

“To live to their full potential, young people need to have the autonomy to make their own informed decisions about contraception.”

It is evident that reproductive healthcare is a fundamental human right. It is also one of the best tools we have in addressing the human footprint on the planet. According to Project Drawdown, access to family planning combined with education and empowerment of women and girls, is one of the most effective means of mitigating carbon emissions in the medium to long term. It is however important to emphasise that access to education alone and without access to family planning is considerably less effective.

It is also worth considering that in those nations with higher rates of consumption, the ‘carbon offset’ of an individual choosing to have one less child is much more significant than reductions or changes in lifestyle and consumption choices. Therefore, access to contraception and family planning is a critical global issue no matter where in the world a person happens to live. Ongoing opposition to these services is reflective of the deeper need for the systemic change that we urgently need. This means transitioning away from patriarchal societies and societies that empower corporations and vested interests to societies that create resilient, empowered, low carbon communities.

It is no surprise that the Global South has the widest gaps between demand and access to contraception and reproductive health services. According to Marie Stopes, there are 214 million women worldwide who do not have access to contraception and are therefore unable to exercise their right to reproductive choice. Around 61% of unintended pregnancies end up in abortion, often performed illegally using unsafe methods. As a result, 47,000 preventable maternal deaths occur each year.

Unfortunately, the general public in developed nations requires more convincing on the merits of grassroots, cooperative, foreign aid-funded family planning and sexual health programs. Many people remain sceptical of overseas foreign aid providing family planning. This is often because of a perception that this means enforcing population control on the Global South. This has been the main thrust of environmental writer George Monbiot’s recent criticisms of advocates of population sustainability. While some on the political left chastise family planning and population sustainability as ‘colonial’ and ‘patriarchal’, these arguments fail to hold under proper scrutiny.

The reality is that conservative and patriarchal conditioning is a barrier to reproductive autonomy and it even winds back progress on this front. For example, the status of women in many Pacific island nations is low and they are often raised not to question male authority. The social taboos around sexual norms and gender roles are often exacerbated by the dominant patriarchal religious institutions in the region. This is a barrier for women who might otherwise seek sexual health services. The fear of judgement and exclusion within their communities is considerable.

It is sometimes incorrectly assumed that foreign aid for family planning is forcing health services onto women that they do not want. More correctly, family planning is closing the gap on unmet need. Sustainable Population Australia has liaised with women from our Pacific neighbours who have informed us directly that contraception and reproductive health services are desired by women in these countries and that more, not less, support from Australia is needed. Recently, the author interviewed CHASE Africa, a Kenyan NGO that provides direct grassroots family planning and sexual health services to communities in Kenya. From their direct experience, the majority of women they support do not wish to have larger families (a false assumption often made by critics).

A seminar on family planning in the Pacific region held by Sustainable Population Australia. Photo by Michael Bayliss.

It seems contradictory to say that the Global North needs to be proactive in ensuring that there is wealth and material equity across the globe when on the other hand, the act of providing access to contraception and reproductive health services is rejected for being too interfering. It is true that family planning has sometimes had a chequered past, but the rare instances of coerced sterilisations or abortions within national programs were never condoned by international funding agencies. Family planning services have come a long way since the 1960s and there is now a much higher degree of vigilance in place, so that those same mistakes will not be repeated. One thing that history has taught us is that vigilance is always required whenever the Global North and the Global South work together.

The vision of World Contraception Day is a world where everyone gets to choose the number of children that they want, and all children are born to parents who want them and are in a position to nurture them. To achieve this, modern contraception must be accessible and affordable for everyone, and people need to know the benefits they can gain from limiting births. Women, girls – and men – must have sufficient rights to access contraception, without coercion from their partners, families, or governments. Ultimately, there is no hope of stabilising, let alone reducing the world population, if women and girls do not have the right to determine if and when they bear children. On world contraception day, let us advocate for a world where this is possible.

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