In 2012, Melinda Gates embarked on a journey dedicated to what may be one of the world’s most controversial and vital parts of women’s rights activism — family planning. Her pledge was simple, a commitment to help 120 million women and girls around the globe access birth control in eight years.
Now approaching five years since its inception, Family Planning 2020, as the initiative is called, has reached 24 million women worldwide and helped them access safe, effective, and affordable birth control. Addressing that staggering number of 120 million, however, does not begin to scratch the surface of the worldwide crisis of unplanned pregnancy. According to the World Health Organization (WHO), as of July 2017, 214 million women of reproductive age living in developing communities, and wanting to avoid pregnancy, are not using effective contraception. 214 million women — this is the true number reflecting the global unmet need for contraceptive resources.
The scale is massive. Yet for the sizeable impact, the better part of the discussion surrounding the push for global contraceptive access is kept out of the public sphere. Women worldwide are faced with limited choices in methods, as well as both cultural and religious opposition; the ability to acquire effective methods is rare in poverty-stricken areas, and those that are available often lack quality. Even beyond those restrictions, the discussion is an issue that many women consider a personal, private journey, something Gates empathizes with in her article “Keeping Our Promise to 120 Million Women and Girls” published this week for Family Planning 2020’s five-year milestone.
For such a taboo subject, however, the inaccessibility of contraceptives has drastically negative consequences for communities. First and foremost, it is a global health issue. Though a natural process, pregnancy has an unambiguous and taxing impact on the health and well-being of a woman and her body. Lack of family planning can increase the risks of health problems surrounding pregnancy, and even the risk of death especially in older women who encounter augmenting complications during childbirth.
Unplanned pregnancies are more likely to lead desperate women to dangerous and unhygienic abortion attempts; poorly timed births from unplanned pregnancies currently contribute to some of the world’s highest infant mortality rates. According to the United Nations Population Fund, if all women in developing areas without access to contraceptives used modern methods, approximately 35 million abortions and 76,000 maternal mortalities would be prevented every year. But it is not just an issue concerning women. Since the outbreak of HIV/AIDS in the 1980s, the disease has run devastatingly rampant, especially in places like sub-Saharan Africa with less access to contraceptives.
The mortality and orphaned children rates have skyrocketed, and nearly 40 years later, the epidemic still persists. Among women living with HIV, access to family planning methods mitigates the risk of inadvertent pregnancies and reduces the number of affected babies. Among the greater population, however, contraceptive methods such as male and female condoms (when used properly) safeguard against the spread of the disease between parties. The conclusion? It is a global, rather than a women’s, health issue.
What many around the globe have yet to realize, moreover, is that the debate surrounding contraceptives goes beyond the world of social and moral concerns, and touches the realm of cold, hard figures. For developing countries, and developed countries seeking to leave a positive footprint on this planet, this should be seen as an economic discussion. At the macroeconomic level, studies have shown that reducing exponential population growth helps spur socio-economic development in some countries, the best known example being that of the Asian Economic Miracle.
As the study goes, between 1960 and 1990, the five economies experiencing most rapid growth were all found in East Asia — South Korea, Singapore, Hong Kong, Taiwan, and Japan. Yet simultaneously, there was a decline in the average number of childbirths — an average of six at the beginning of this period to an average of approximately two at the end. When further investigated, analysts agreed that the experience of East Asian countries suggested the downward childbearing trend lessened dependency burdens and supported high savings rates. On the smaller scale, a woman who has access to contraceptives has fewer children; she can devote more resources to each child and improve their respective futures; she has the capability, time, and energy to re-enter the workforce.
Align that hypothetical trajectory with the scale of the problem — 214 million more individuals with the ability to contribute to the local, national, and even global economy — and it is evident why countries, especially developing ones, should have a vested interest in contraceptives. Access to family planning is paramount to lifting both individual families, and in turn nations, out of poverty.
In “Keeping Our Promise to 120 Million Women and Girls,” Gates writes about how she came to grasp the necessity of contraceptives in the global community after growing up in a family where their importance was not emphasized:
“Everything changed when Bill and I launched our foundation, and I started spending time with women in the world’s poorest places. Everywhere I went, the conversation turned to contraceptives. I met women who were getting pregnant too young, too old, and too often for their bodies to handle. I met women who were desperate not to get pregnant again because they couldn’t afford to feed or care for the children they already had. In Malawi, everyone I met knew someone who had died in pregnancy. In India, I asked a group of women if anyone had lost a child, and every single woman raised her hand.”
Since the 1990s, contraceptive use has increased, albeit marginally — between 1990 and 2015, WHO calculates global usage has risen from 54% to 57.4%. It is a statistic that does not reflect a plateaued need, but an alarming lack of access for a world who claims it exists a hyper-modern age. Gates’ experiences, however, are not statistics.
The stories she has heard and the ones she has shared — they are personal and human. They are the eyes, the words, and the heartbreak of women across the globe; they are the eyes, the words, and the heartbreak of their families. They are 214 million women we should be pursuing with an unfettered tenacity and equipping with brighter futures to create a better, more productive world that is in all of our best interests.
To read Gates’ article, click Family Planning 2020 to find out more or learn about other positives developments associated with family planning like “Keeping Our Promise to 120 Million Women and Girls” and Global Impact of Family Planning.