Family planning exchange in The Guardian: pragmatism meets magical thinking

By Rebecca Oas, Ph.D. | June 11, 2018

Last week, UK newspaper The Guardian published an editoral about family planning policies, raising several interesting points:

  • China is moving toward scrapping all policies imposing family size limits.  China’s strict one-child policy, the engine of coercive practices including forced abortions, was grimly successful in “turning the demographic dividend, which fuelled its economic miracle, into a demographic timebomb.”  But the subsequent move to a two-child policy did little to drive up birth rates.
  • Even with far less heavy-handed policies, Singapore’s birth rate dropped so far in the last few decades that the government is begging its citizens to have more children.
  • Meanwhile, Egypt is urging couples to have no more than two children: “The country’s president, Abdel Fatah al-Sisi, has placed population growth on a par with terrorism as the greatest danger to the country.”  (At least he stopped short of saying the two were directly linked, as some U.S. officials have suggested.)

The editorial concludes thusly:

“Still, Egypt might want to proceed with care. As China and Singapore have found, an apparently desirable fall in the birthrate can have unanticipated consequences. Governments are able, in the last resort and at great human cost, to enforce maximal limits. Making people have more children is trickier.”

I note with satisfaction the absence of an attempt to draw a false moral equivalence between restricting abortion and forcing abortion and sterilization on women, as the Guttmacher Institute is fond of doing.

But to the international family planning lobby, when all you have is an IUD, everything looks like a uterus.

Arthur Erkin communications director of the United Nations Population Fund (UNFPA) wrote a response, first asserting that family planning is a human rights issue, then saying this:

“Sadly, more than 200 million women lack access to modern contraception, with about $700m needed to meet their demand for something that will save and transform their lives.”

That 200-plus-million-women figure is the incessantly repeated total of women described as having an “unmet need” for family planning, which measures neither access to nor demand for anything.

Only about 5% of “unmet need” in developing countries is attributable to lack of access, according to the Guttmacher Institute.  (As a side note, given the fact that Guttmacher and UNFPA frequently collaborate on publications, you would think by now UNFPA would have figured out what their metrics really mean, or Guttmacher would at least attempt to correct this obvious and ubiquitous mistake.)

Also adding their two cents is Population Matters, who apparently thought Malthus and Ehrlich hadn’t create sufficient alarmism:

“Yes, there are challenges associated with lowering birthrate and promoting smaller families. Those are infinitely easier to solve than the environmental devastation exacerbated by the increasing billions of people on our finite planet. This is solvable through ethical, non-coercive means and the available technology of family planning – but only if we grasp the nettle now and take positive action.”

It’s amazing what one can approve of as “ethical, non-coercive means” if the alternative is a literal doomsday scenario.

Not only do UNFPA and Population Matters fail to claim the reports of precipitous fertility decline from China, Singapore, and, by the way, the U.S., as a good thing, they don’t even bother to acknowledge them at all.

Instead, they fall back on the sort of magical thinking that dominates the current discourse on family planning: namely, that access is a human right, access means use, and non-use means lack of access.  If you can find a way to label a big group of women as “needing” contraceptives, whether they want them or not, you can yell bloody murder about a human rights violation to secure funding, then try to work out how to convince them to adopt—and not discontinue—the use of modern family planning methods.  If translating access to use proves difficult in practice, you take a page from the FP2020 playbook and just use them interchangeably in print: a target of “empowering 120 million women and girls with access modern family planning methods” sounds a lot more ethical and voluntary than the more technical version of the target: “adding 120 million new users.”

But all that hand-waving isn’t enough to lift you across the chasm between access and use, especially when most women with a so-called “need” express personal opposition to contraceptives, whether for health reasons or religious convictions.

The Guardian editorial is on the right track: the legacy of heavy-handed family planning policies has resulted in catastrophic legacies of coercion and suicidally low fertility rates that remedial incentives seem unable to reverse.  And instead of attempting to correct course, the organizations that cheered when those draconian policies were first enacted are urging us to “grasp the nettle” and march—ethically and voluntarily—off the cliff.

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