Everyone knows that world population is increasing. In fact, even if every woman in the world decided tomorrow to stop at two children, world population would continue to grow because of the rapid increase in life expectancies worldwide. In the early 1950s life expectancy exceeded 70 in just 5 nations, all in northern Europe. Now the list of countries enjoying such longevity includes Chile, Singapore, and Costa Rica.
There is much good news on the family planning front, but the simple fact is that most of the world’s people are not yet "stopping at two," and the numbers of us are ballooning. A few countries – Iraq and Mongolia are examples – are actually trying to increase their populations, but most are growing ever more serious in their efforts to encourage (and in some cases enforce) limitations on family size.
The obstacles are many. The Population Crisis Committee notes that effective family planning efforts are often impaired by plodding bureaucracies, political turmoil, and religious opposition, particularly in developing nations. Ethical concerns are also legion, particularly around the issue of abortion – even those strongly supportive of a woman’s right to choose generally concede that abortion is not really a "desirable" form of birth control.
Among women themselves, the desire for smaller families seems to be growing. For example, 46% of married women in Peru, 37% in South Korea, and 34% in Sri Lanka did not want their last child – sad news for the child, but a promising trend in terms of overall population growth. And new developments in both birth control technology and in our understanding of social factors related to population allow room for hope that we may yet curb the worst outcomes of this undeniable explosion.
The following press summaries (collected by IC staff and volunteers) provide one window on the enormously complicated mosaic of world population and family planning trends. To pursue these trends in more depth, consult the "Resources" section on page 61.
CHINA
A Chinese surgeon has developed the "no-scalpel vasectomy," an important alternative because of the psychological "scalpel trauma" and the possibility for secondary infection suffered by some men who undergo the traditional procedure (which involves a 1 cm incision in the scrotum). The new procedure involves locating a sperm tube by feel, pinching it in a fold of skin with a clamp, poking a hole in the scrotal skin with forceps, pulling the sperm tube out through the hole, and cutting or cauterizing the tube. The New York-based Association for Voluntary Surgical Contraception has sponsored the dissemination of the technique to 13 Asian countries. (Far Eastern Economic Review, 2 May 1991)
GERMANY
Prior to reunification with West Germany, East Germany’s approach to family planning and sexuality was generally recognized as exemplary. Family planning centers have offered free contraceptive pills since the 1960s, as well as counseling for marriage and sexuality problems, infertility treatment, and related matters. Abortion in the first trimester has been free on demand since 1972. However, unification has created conflicts over abortion (which is highly restricted in the West) and raised concerns in the East over the possible loss of generous maternity leave and child health care benefits. (WorldWatch, Sep/Oct 1990)
GHANA
In 1969 Ghana adopted a pioneering national population policy. It never got off the ground, and Ghana’s population doubled during the next twenty years. Then in 1986 a small group of professors from the University of Ghana worked together with members of the media to form the Population Impact Project (PIP). Through a mixture of publications, seminars, and television and radio programs, PIP reached out to government leaders, women’s groups, educators, business executives, and health professionals. As a result, public awareness of population issues has risen dramatically, but fertility levels remain high, with only 13% of married women using birth control as of 1988. ("The Population Impact Project of Ghana," Population Reference Bureau, 1990)
HUNGARY
In the early 1960s Hungary began a campaign to distribute condoms, pills, and IUDs, and to educate the public with the express intent of reducing the abortion rate and improving reproductive health. The program was considered a success. Though faced with a shrinking population, "official government policy grants the right to encourage additional births only if they are ‘able to ensure the circumstances necessary for bringing up children.’" (WorldWatch, Sept/Oct 1991)
INDIA
Over the past decade, compact ultrasound machines have made it possible for Indian parents, even in rural areas, to select the sex of their children. The machines, used in the developed world to evaluate the health of the fetus, are used in India almost exclusively to determine the sex of the unborn child. Girls are often aborted. India already has the lowest female-to-male ratio in the world and is one of only five countries where male life expectancy surpasses that of females because of parental discrimination in nutrition and health care. However, one Indian state (Maharashtra, whose capital is Bombay) has recently outlawed prenatal gender testing. (The Sunday Oregonian, 15 Dec 1991)
INDONESIA
Fertility has dropped in Indonesia by more than 25% since 1962, but stabilized at 4.3 children per women, "close to the average number of children – 4.1 – that Indonesian parents want." Indonesians use 65 million condoms a year and take 100 million cycles of the birth control pill. Contraceptives are supplied free to all citizens, and Indonesia was also the first country to test Norplant, a female contraceptive implant that slowly releases hormones into a woman’s bloodstream and provides protection against pregnancy for up to five years. "In Jakarta, family planning jingles play at stoplights…. At 5 pm in Bali, church bells ring to remind women to take their birth control pills." (Seattle Post-Intelligencer, 2 Feb 1992, and The Economist, 20 Jan 1990)
JAPAN
"After WWII, the Japanese government created a national family planning program to provide contraceptive information and counseling…. Between 1949 and 1956, Japan cut its population growth rate from just under 2.2 percent to scarcely 1 percent. Remarkably, Japan made this demographic advance before the advent of modern contraceptives, such as the pill and the IUD." (State of the World 1989, Worldwatch Institute)
Currently, however, contraception use in Japan is 60% of women – a lower rate than in Costa Rica. (The Economist, 20 Jan 1990)
KENYA
Long regarded as a family planning failure, Kenya’s fertility rate stood at about 8 children per woman through the early 1980s. Neither politics nor cultural mores supported family planning efforts. But a very recent shift in government policy towards family planning has quickly reduced fertility rates to 6.7 and earned the country a citation by the Population Crisis Committee as one of the year’s five most dramatic "success stories." (Population Crisis Committee)
MALI
There is a high level of knowledge of modern birth control methods in Mali, but a low level of use. Why? Because (1) having children is considered the purpose of marriage; (2) the number of children is the measure of the success of a marriage; (3) refusing the husband is a traditional contraceptive method that is used, especially among older women, mothers with small babies, and families with co-wives; (4) there is a profound lack of communication between spouses about family planning; and (5) Malian religious beliefs suggest that it’s up to God when a child will be conceived. (International Family Planning Perspectives, Sept 1991)
MEXICO
Mexico has pioneered the use of the "family planning soap opera" (see article on p. 42). When television goes off the air in Mexico, an injunction to "love carefully" is shown instead of the flag. (Seattle Post-Intelligencer, 2 Feb 1992)
MOROCCO
The average number of children born to each women has fallen dramatically, from 7 in 1980 to 4.5 today. Contraceptive use has risen to 40%, prompting the Population Crisis Committee to name Morocco as one of five success stories for 1991. Morocco’s progress stands out against the background of many other Middle Eastern nations, where purdah, the custom of confining women to the home and sheltering them from public life, creates a situation whereby child-bearing (especially son-bearing) is the woman’s only significant means of gaining social status. (Christian Science Monitor, 4 Feb 1992)
POLAND
Polish women are "forced to rely on traditional but relatively ineffective forms of birth control, such as withdrawal and rhythm." As a result, they "experience high rates of unintended pregnancies…. Some analysts say as many as half of all pregnancies end in abortion." (WorldWatch, Sept/Oct 1991)
ROMANIA
The brutal Ceaucescu regime attempted to spur population growth by taxing childless women and criminalizing both abortion and contraception, creating an atmosphere of fear and humiliation. Since Ceaucescu’s ouster, 207 obstetric centers all over the country have begun performing legal abortions and 68 centers are now delivering modern contraceptives, free of charge. Abortion has now been made safe and legal up to the end of the 12th week of pregnancy. Many women remain afraid of contraception, however, because of the harsh propagandizing of the Ceaucescu regime. (MS. Magazine, Jul/Aug 1991)
RUSSIA
"The Soviet Union is home to some 70 million women of childbearing age, yet does not have a single factory producing modern contraceptives. Poor quality condoms are available, but are widely disparaged as ‘galoshes’…. The worsening economic situation and continuing currency restrictions make it difficult to import either the raw materials to manufacture contraceptives or to import them…. In the absence of contraceptive alternatives, abortion became the most prevalent birth control method almost by default…. The average Soviet woman will terminate between five and seven pregnancies during her reproductive years." (WorldWatch, Sept/Oct 1991)
TURKEY
Family planning programs have succeeded in reducing the number of children per women from 6.8 in 1976 to 3.7 today. However, at that rate, Turkey will still double its population in just 32 years. "Clever ads for ‘O.K.’ condoms are broadcast (without actually using the word condom) and many Islamic preachers, who are trained by the government, are said to promote contraceptive use." (Seattle Post-Intelligencer, 2 Feb 1992)
UNITED STATES
The US was singled out by the Population Crisis Committee in February 1992 for "abdicating its leadership in family planning internationally and also reducing access to family planning at home." The average family size in the US has increased from 1.8 to 2.1 children since 1988. The resulting 2.7 million population increase expected in 1992 is nearly one-third higher than the average increase of 2 million in the 1980s. (Seattle Post-Intelligencer, 2 Feb 1992)
Meanwhile, the so-called "epidemic of infertility" often reported in the media is a misperception driven largely by the increasing numbers of women who delayed the bearing of their first child, experienced age-related difficulties in conceiving, and sought treatment. Impaired fecundity rates – the rate at which women are unable to conceive – have actually decreased since the 1960s, even for women aged 35-44. (American Demographics, Apr 1991)
ZIMBABWE
A program to train traditional birth attendants in modern hygiene and basic medical practice has recently been expanded to include additional training for prenatal care and family planning. Some 6,000 women have received training. (WorldWatch, Jul/Aug 1991)
