Opinion: If Family Planning is the Solution, What’s the Problem?

By | May 3, 2018

Washington, D.C., May 4 (C-Fam) What is the problem that faith-based organizations and family planning groups are partnering to solve, and how will they know if and when they have succeeded?

According to panelists at a recent Wilson Center event co-sponsored by World Vision, “healthy timing and spacing of pregnancies” (HTSP) is a way to frame family planning that is more acceptable to the many faith-based organizations that provide international aid, and the often-conservative populations they serve. But it is up to religiously-motivated providers of care to determine whether HTSP in practice is a transformative approach to a deeply sensitive issue or merely an appealing euphemism for business as usual for the family planning advocacy movement.

If religious people and organizations embrace the HTSP message, it is because it centers on health and human dignity, safe motherhood and child survival. As USAID global health director Dr. Alma Golden stated in her remarks, this occurs within the context of “family-centered care,” not just family planning. It incorporates the key first thousand days of a child’s life – beginning in the womb – and emphasizes the value to mother and child of breastfeeding during the first two years.

It is clear that faith-based organizations are an invaluable component of international assistance, both from their generosity and commitment to helping others and their deep and trusted community relationships. Religiously-affiliated academic institutions like Georgetown University have also played a critical role in developing the evidence base for natural and non-contraceptive methods of family planning, which are acceptable to both providers and recipients who have religious objections to other methods.

Even so, controversies remain. As Georgetown professor Victoria Jennings pointed out, abortion and family planning “unfortunately remain linked in the minds of so many.” Perhaps even more unfortunately for faith-based groups working on family planning, partner organizations that are serious about removing that linkage are few and far between. Indeed, many family planning organizations lobby against the U.S.’s Mexico City Policy and Helms Amendment, which draw a line between the two.

Beth Schlachter, director of FP2020, said the reason there isn’t a “GAVI or a Global Fund for women’s reproductive health” is that “the world won’t pool its funding with the U.S.” due to the restrictions on funding for abortion groups.

But if both GAVI and the Global Fund exist to combat infectious disease epidemics, where is the crisis that only family planning can solve, and not without severing ties to abortion proponents?

The evidence presented at this event suggested that community-based interventions can increase contraceptive use and knowledge of different methods. If this has been causally linked to increased child spacing and improved maternal and child survival, that data was not shown. All of the findings presented were from countries in sub-Saharan Africa – a region notable for its high fertility, but also the fact that it tends to have wider spacing of pregnancies than other developing regions, including in large families, and a lower percentage of pregnancies classified as unintended than other regions. As in the rest of the developing world, lack of access is not a major reason why women and couples do not use family planning.

If faith-based groups are serious about promoting healthy pregnancy outcomes through timing and spacing interventions, then increased levels of contraceptive use should be seen as a means, not an end – and then only if it is linked to improved maternal and child survival. For faith and family planning to be friends, not foes, the “healthy timing and spacing of pregnancies” (HTSP) partnership needs to be a transformative paradigm, not just a fig leaf for more funding for family planning groups that already receive billions of dollars of U.S. funding every year.