How family planning methods help to curb population growth

By Jan Greguš and John Guillebaud | 11 September 2023
MDPI

(Credit: YouTube / screengrab)

The following has been extracted from a paper titled “Scientists’ Warning: Remove the Barriers to Contraception Access, for Health of Women and the Planet”. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

There is a large but much-neglected literature on how family planning methods and services help to curb population growth. The availability and full accessibility of these methods are essential for another reason: it is a fundamental human right that humans can freely regulate the number of their children and the spacing between them, just as children have the right to be born as wanted children. These rights have been repeatedly reaffirmed in international conferences and treaties.

The human population grows by over 80 million a year. Of the 121 million unintended pregnancies, many miscarry, and others are aborted, so some 80 million are carried to term. Coincidentally, the number of unintended births is close to the net growth of the human population. In a hypothetical world, in which everyone is aware of contraception methods, has ready access to them, and uses them appropriately, there is a good chance that the human population would stabilise and/or start decreasing without the need for other measures.

We need to say here that it is at least as important to avoid unintended pregnancies in the countries of the Global North as in the Global South because these cause the most environmental impact, due to high consumption and resource use per person. At the same time, it is important in the Global South and among developing countries, since ending population growth there is a key to improving poorer people’s lives.

Some can object that family planning is a Western concept and should not be imposed on cultures and religions that like having many children. Yes, Western scientists invented contraception, but since the 1960s, governments and communities worldwide have welcomed it. Many countries in the past and present were able, due to the use of family planning methods and services, to curb their population growth, and they now benefit from improving economies (South Korea, Taiwan, Singapore, Thailand, Kerala, Rwanda, Costa Rica). One could equally say that the technologies used to improve health and survival of children are Western concepts. Deploying one without the other is what triggered population growth and made traditional cultural and technological practices ill-adapted to the new, crowded circumstances. Both disease control and birth control should be seen as fruits of science, completely unrelated to West or East, North or South divisions. The Pill, or contraception in general, helps women decide when and how many children they want. Obviously, this creates dislike and conflict in cultures in which males dominate. However, the primary people who should decide are women.

Economists and others who argue that people in low-resource settings need, and choose to have, large families ignore one vital fact: that potentially fertile intercourse occurs far more frequently than the minimum needed for desired conceptions. Hence, having a large rather than a small family is usually not, as portrayed, a planned decision—couples in low-resource settings actively setting out to have many children for economic and “social security” reasons. It is instead an automatic outcome of human sexuality. If fertile, sex at normal frequency and absent family planning equates to a large family, irrespective of any socio-economic motivation or reasoning. There is no other option. Something active needs to be done to separate sex from conception—namely, family planning. Without that being easily accessible, the “default state” for all fertile couples in every possible setting is a large family: quite simply, that is what happens when you are not able to not have a large family. However, it is typical of cultural norms that the inevitable becomes not only expected but desired, so information and often the blessing of religious or tribal leaders is needed to make small families an accepted and desirable option.

The repeated experience of countries and regions with very varied cultures, religions, and politics has been that birth rates drop rapidly, regardless of poverty, illiteracy or rural settings, when governments or NGOs implement culturally sensitive family planning services and public education campaigns.

However, access to family planning is often difficult in resource-poor settings, so that many children arrive by chance not by choice (though this fact is overlooked because, usually, and entirely naturally, they are then welcomed). The primary cause is the many barriers to women being able to choose a smaller family, including the basic barrier of no access to a good range of family planning methods themselves. Obviously, increasing per capita wealth usually removes this and other barriers. Yet, there is no need to wait in the (often forlorn) hope of that happening, nor to use compulsion to hasten change. There is no country with above-replacement fertility which cannot now, with purely voluntary measures, make a good start in enabling couples to reduce average family size.

To change the context of decision-making in low-resource settings requires contraceptives to be available and accessible and promoted, by good use of the media. The multiple barriers to their use need to be removed. These include fatalism (“God has planned my family size”), misinformation about contraceptive side effects, religious prohibitions, cultural pronatalism, political correctness, and also economic pressures. As shown in many countries, such barriers are removable: through education and empowerment of girls and women, but also of boys and men, and all measures to reduce gender-based violence. The education must have a component that leads to greater environmental literacy, including the environmental and reproductive ethics of small(er) families, namely Fewer Children Ethics.
Eliminating the barriers women face, caused largely by men, in a rights-based way, is a tried and tested means which has worked in the many success-story countries (e.g., Iran or Thailand) and states (e.g., Kerala within India).

Moreover, there is no way it can be legitimately deemed “coercive” to advocate for removal of the barriers, tangible and intangible, to what women actually want! Providing family planning methods and services is the ethical thing to do.

Some contraceptives also have positive non-contraceptive benefits, such as protection from ovarian cysts, endometriosis, infertility, as well as ovarian, endometrial, and colo-rectal cancer.

Moreover, family planning is not an issue for women alone. Men have an often neglected yet reliable option, namely vasectomy. Therefore, significant funding should be allocated to educate men and the public generally about this highly effective and safe contraceptive option.

Family planning is not only ethical, and wanted as a choice, it is also pragmatic and cost-effective. According to the Copenhagen Consensus, for every USD 1 spent on family planning, the return on investment is USD 120. Not only are timely precautions far cheaper, saving on additional costs such as maternal and newborn care, but they also save the lives of women and children.

Last and certainly not least, contraception can help to mitigate both climate change and the species extinction crisis which has resulted from massive habitat destruction, through agriculture and other endeavours of a single inordinately successful species, H. sapiens.

Sir David Attenborough on overpopulation

The Scientist’s Warning

Hastening the Inevitable Demographic Revolution | Christopher Tucker | TEDxPenn

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