Rex Tillerson hearing: Senator Shaheen repeats misleading family planning statistic
During today’s confirmation hearing for President-elect Trump’s Secretary of State nominee, Rex Tillerson, the following exchange occurred between Tillerson and Senator Jeanne Shaheen (D-NH):
SHAHEEN: Under your leadership in 2012, Exxon Mobil’s foundation also helped develop a roadmap for promoting women’s economic empowerment that specifically cited access to family planning and reproductive health services as a means to improve productivity and earning potential for women. You and I also served as we discussed in 2010 on the Center for Strategic International Studies commission on smart global health policy which also advocated for expanded access to family planning services. Will you pledge to continue to prioritize quality family planning and reproductive health services for women worldwide and ensure that resources and access to these programs are not conflated with support for abortion?
TILLERSON: Senator, there are statutory requirements in place around the foreign aid, they’re well known to yourself and myself as well. As I understand it, we currently invest something around half a billion dollars a year in programs directed at family planning through foreign assistance, and I think that’s an important level of support.
SHAHEEN: So, do I take that as a yes?
TILLERSON: Well, I would want to, if confirmed, and I have the opportunity to examine all of the aspects of that program, I just am aware that we do spend half a billion dollars now.
SHAHEEN: Well, as you know, if the approximately 225 million women worldwide with unmet family planning needs had access to modern methods of contraception, we would see 52 million fewer unintended pregnancies, resulting in 600,000 fewer stillbirths, 6 million fewer miscarriages, and 15 million fewer unsafe abortions, so I would attest that this is not only a humanitarian value that we should support, but also an economic one.
The source for Shaheen’s statistics is the 2014 UNFPA/Guttmacher publication “Adding It Up.” That publication estimates that $9.4 billion a year would be needed to meet the total “unmet need,” with the caveat that “[t]hese estimates assume that all women with unmet need would use modern contraceptives.” As it turns out, that’s a big assumption, given that less than a tenth of “unmet need” is attributable to lack of access to contraceptives, and that most women with an existing demand for family planning services are already using them.
Furthermore, the projected reductions in stillbirths and miscarriages would simply be a consequence of fewer pregnancies, whether intended or not. There is consensus within the global community that reducing stillbirths in particular is an often-overlooked necessity, but the best solution is to ensure that every mother receives high-quality care throughout her pregnancy and birth. In contrast, Shaheen cites a misleading statistic to posit a nonexistent demand for contraceptives that could theoretically be used to avert approximately 87 potential conceptions for every averted hypothetical stillbirth.
We cannot contracept our way to good maternal and child health, and good health policy leaves behind actual flesh-and-blood survivors, not statistical abstractions.
Finally, Senator Shaheen’s insistence that family planning funding should not be equated with abortion ignores the fact that the groups who receive U.S. funding for family planning are, with few exceptions, also abortion proponents or providers overseas. Because of the Helms Amendment, alluded to by Tillerson, they cannot directly use U.S. family planning funding to do so, but the money they receive to provide contraception unquestionably adds to their influence and legitimacy in foreign countries. Therefore, the justification for even their family planning funding from the U.S. government deserves close scrutiny.
For further discussion of the flawed “unmet need” statistic, please see my recent article at The New Atlantis.