Population control: Unseating family planning to the detriment of women’s & children’s health Print E-mail
First, a selection of feminist research:
Betsy Hartmann. Reproductive Rights and Wrongs: The Global Politics of Population South End Press, 1995 [Second Edition, Scroll down to read a brief summary and commendations]

Malini Karkal. Population control: the Indian experience. Green Left Weekly, Issue 232, Wednesday, May 22, 1996 [Scroll down to read in full]

Then read HERE for 2010 to 2012 reports of India's shamefully malnourished children, with girls destined to in turn become mothers at greatest risk


Reproductive Rights and Wrongs: The Global Politics of Population Control by Betsy Hartmann

Reproductive Rights and Wrongs provides a compelling and urgently needed critique of the economic, political, health and human rights consequences of population control as practiced by the U.S. population establishment, national governments, and international agencies.  Through extensive research, the author reveals how the narrow goal of reducing birth rates has distorted contraceptive development and undermined the quality of family planning programs.  From a combined feminist, developmentalist and civil libertarian perspective, Betsy Hartmann argues that the real solution to the population problem lies not in coercive population control programs but in the improvement of living standards, the position of women, and the quality of health and family planning services.

Praise for Reproductive Rights and Wrongs:
This is a book of conscience.  Shocking, eloquent, carefully researched, it should be read – and acted upon.- Gena Corea, author of The Hidden Malpractice and The Mother Machine

Stands out amid the rising tide of books on the population question. Hartmann’s critique of global special interests in population and the environment is must reading for students and policy analysts. - Judy Norsigian and Norma Swenson, co-authors, The New Our Bodies, Ourselves

At this juncture in history when victim blaming has become more blatant and oppressive, there is a need for voices of sanity.  This book is such a voice.  It reflects conviction, courage, sensitivity, and deep insight. - Mira Shiva, Asian Representative, International People’s Health Council

 Issue 232 ~ Wednesday, May 22, 1996

Population control: the Indian experience

By Malini Karkal
Except for China, India is the most populous country in the world. In 1952 it became the first country to introduce national family planning. At that point, the program was instigated to improve maternal and infant health, but the objectives altered when the US Congress made population control mandatory for countries seeking assistance of any kind in the 1960s.

India is also one of the exceptional countries (along with Bangladesh, Bhutan, Nepal and Pakistan) that has fewer women than men. In large part this is due to the shorter life expectancy of younger females; from birth to five years, 111 girls die for every 100 boys; from age five to 14, 122 girls die per 100 boys; and between ages of 15 to 35, 130 females die per 100 males. Only females who live through the hazards of these 35 years can anticipate that their death rate will be less than that of age-matched men.

India's maternal mortality rate is amongst the highest in the world and, like its infant mortality, is comparable with the abject rates in some African countries.

Populationists claim that reduced fertility rates would simultaneously reduce population and maternal and infant mortality. They have popularised notions of contraceptive population control in India and the majority of other countries in the Asian-Pacific region, Central and South America and Africa.

More recently, the dominant funding agency of the populationist lobby, USAID (United States Aid for International Development), spent $9 billion conducting a National Family Health Survey [NFHS] in India, Bangladesh, the Philippines and Indonesia.

The survey claims to represent 99% of the Indian population, and, because of the extravagant investment and vast numbers involved, the accumulated data is further claimed to be the most reliable to date. Yet, as the following figures illustrate, population control is a crime against humanity, most specifically against women, but also against their children and partners.

In India where marriage is early and universal, married women aged 13 to 49 were interviewed for the survey and revealed that 46.9% of women or their husbands were using some form of contraception. However, sterilisation was the most common method, and was eight times more prevalent in women than in men (27.3% compared with 3.5%).

In contrast with the experience in other countries where temporary contraceptive methods are adopted prior to settling for permanent contraception via sterilisation, the data also revealed that Indian couples had no experience with temporary barrier or hormonal contraceptives before they were sterilised, which in itself implies that sterilisation was a coercive rather than personal decision.

The survey also found that 36.2% of women were under 25 years at the time of their sterilisation, and another 36.4% were between the ages of 25 and 29. Translating to three of every four wives being sterilised before age 30, this indicates that the medical and social problems associated with sterilisation procedures such as tubal ligation and tubectomy are the almost exclusive burden of younger women.

The median age, or the age by which at least 50% were sterilised, has fallen from 28 to 26 years during the past 10 years. This probably indicates that the population control program has become increasingly oppressive over that time.

Disempowering women
In the initial years of family planning in India, men had somewhat equally shared reproductive responsibilities with women. However, the survey showed that the burden of population control has increasingly been shouldered by women; aside from the smaller proportion of vasectomised men compared with tubectomised women, only 7.1% of men were using condoms. In effect, population control has reinforced patriarchy and disproportionately exposes women to the hazards of temporary contraceptives such as intra-uterine devices and a variety of hormonal contraceptives.

The survey noted that an equal frequency, one in five, of vasectomised men and women using temporary contraceptives complained of one or more side effects.

However, the survey excluded women who had discontinued using IUDs, depo-Provera and Norplant, and it is reasonable to conclude that the incidence of complaints in this group would match the one in four complaint rate of sterilised women. By actively promoting problematic permanent and temporary contraception, the population control lobby has exposed its war against people which, reinforced by patriarchy, amounts to a war against women.

Over decades, indeed centuries, reports consistently indicate that women want fewer children than they actually bear. The NFHS survey also found that women aged 13 to 29 wanted no more than two children, and those over 30 wanted only two to three children. Importantly, neither group desired a large family.

Interpreted by populationists as women's unmet need for contraception, this idea has been applied to legitimise long-acting, hormonal contraceptives, such as depo-Provera, Net-En, Norplant and anti-fertility vaccines.

All are provider-controlled and serve to further disempower women who have already admitted their powerlessness to bear the exact number of children that meets their personal aspirations. In this context too, population control plays a major role in bolstering cultural patriarchy to deny women control over both their body and their sexuality.

Contraceptive acceptance rates were 5% in women with no children, 20% in those with one child, 46% in those with two children and 60% in those with three children. On average, women gave birth to 3.1 children, but after infant mortality was taken into account, the number fell to 2.6 per woman.

Child mortality

The survey failed to demonstrate that child mortality was caused by high fertility. Infant and childhood mortality was spread equally between women bearing one, two, three, or more children.

The survey also established the nutritional status of the children under five years, and found that 53.4% of the children were below standard weight or wasted, 52% were below standard height or stunted and 17.5% were severely malnourished. The survey concluded, "These levels of undernutrition are among the highest in the world".

Importantly, the birth order of the child made very little difference to his or her growth lag, which clearly confirmed that family planning had failed to solve the problem of malnourishment within the population.

In India, where 95% of infants are breastfed, the survey found that the proportion of malnourishment increased with age; one in five babies was malnourished within six months of birth, but between six and 12 months, this figure rose to one in two, and clearly reflected the poor health of the mother.

India also reports the highest incidence of low birth weight babies, the proportion being one in three. According to World Health Organisation guidelines, low birth weight babies, or babies weighing less than 2500 grams at birth, have poor prospects for both survival and normal growth. Low birth weight babies also have dismal educational and employment futures because of their school drop-out rates and sub-optimal performance in labour activities.

Contrary to popular perceptions, this amounts to population control having a detrimental effect on the intellectual and physical potential of the population.

Marriage age
Obviously, the issue of child/girl brides lies at the heart of the maternal and infant mortality, and as the survey noted, though marriage of girls under 18 years is unlawful in India, 20% of the interviewed women were married at age 13, 37% at age 15, and 68% by 18.

Over recent years, the marriage age of girls has increased marginally, but only to the extent that 50% of the women now aged 20 to 24 were married when aged 17.4 years, whereas those now aged 40 to 49 were married at age 15.5 years.

In the climate of premature marriage, child bearing begins at a young age. The survey noted that approximately 28% of the women were mothers by 17, and another 23% by the age of 19. At the same time, due largely to the impact of sterilisation, child bearing ends by age 30.

In the face of this data, and contrary to populationist gospel, women are undesirous of large numbers of children and are perfectly capable of regulating their fertility accordingly. In spite of this, however, the population control that has supplanted family planning has assured them of neither their own good health, nor their children's survival.

[Dr Malini Karkal is from the Forum for Women's Health in Mumbai (Bombay).]