Since the early 1960's, the United States has been giving money to organizations that run "voluntary family planning" programs around the world. However, these programs have not always been as "voluntary" as the words "voluntary family planning" might suggest. These programs have often harmed women and ignored their human rights.
In 1998, the United States government passed a new law stating that family planning programs that receive money from the United States must not violate women's human rights. The law describes certain things that family planning programs must not do if they get money from the United States. This brochure describes those things and will tell you what to do if someone in a family planning program violates your rights or, if you work in such a program, asks you to violate someone else's rights.
No Targets or Quotas
United States law says that "Any voluntary family planning project [funded by the United States] shall meet the following requirements: (1) service providers of referral agents in the projects shall not implement or be subject to quotas, or other numerical targets, of total number of births, number of family planning acceptors, or acceptors of a particular method of family planning (this provision shall not be construed to include the use of quantitative estimates or indicators for budgeting and planning purposes)."
This means that family planning projects cannot try to make a woman use a certain contraceptive method, drug or device just because project leaders need more women to contracept. If a woman says she does not want to use a contraceptive drug or device, the family planning workers must accept her answer. Family planning workers cannot, as they did in Peru, keep going back to the same houses again and again to pressure women into accepting sterilizations they do not want. Family planning workers must listen to women. No must mean no.
Family Planning workers kept coming to Juana's house day after day to convince her to be sterilized even though she told them she didn't want to have the procedure. Neighbors say that when she finally went in a cab to the clinic she was taken "almost by force." What happened to Juana is an example of a violation of US law governing the funding of family planning programs around the world.
If a worker or volunteer asks you more than once or twice to accept or start using family planning or if he or she checks your name off of a list or seems to need you to participate according to a "plan," contact the Population Research Institute directly, or the person or organization working with PRI in your region.
United States law says that projects "shall not include payment of incentives, bribes, gratuities, or financial rewards to (A) an individual in exchange for becoming a family planning acceptor, or (B) program personnel for achieving a numerical target or quota of total number of births, number of family planning acceptors, or acceptors of a particular method of family planning."
This means it's illegal for family planning programs to offer women money, food, clothing, electronics, airline tickets, toys for their children, household goods, medical care or anything else in exchange for using contraception or agreeing to be sterilized. These are only a few of the items which family planning programs have tried to use to get women to decide to use a contraceptive drug or device they really did not want to use and would not have used if they had not been pressured into it.
This also means that family planning workers cannot be offered money (in the form of bonuses), food, clothing, electronics, travel tickets, toys for their children, household goods, medical care or anything else as a reward for getting women to accept family planning or for meeting a target or quota.
Women in India have been sterilized in almost assembly line fashion, with medical staff finishing each woman's sterilization in less than three minutes. When the women come to these places for sterilization, the family planing workers who brought them collect their rewards, prizes and bonuses for having brought more than their quota. Offering these prizes is an example of a violation of US law governing the funding of family planning programs in the world.
If a family planning worker or volunteer offers to give you food, clothing or anything else in exchange for accepting sterilization or contraception, contact the Population Research Institute directly, or the person or organization working with PRI in your region.
Also, contact us if you know that a family planning worker or volunteer will get extra money, food or anything else because you agreed to be sterilized or to accept contraception.
United States law says that projects "shall not deny any right or benefit including the right of access to participate in any program of general welfare or the right of access to health care, as a consequence of any individual's decision not to accept family planning services."
This means that a family planning program which gets money from the United States and your government cannot tell you that you must be sterilized or accept contraception in order to participate in some other government program.
For example if someone from the government or an family planning project comes to your door and offers to examine your children, that's fine. But if they then declare that your children need food or medicine and that you can only have what your children need if you first agree to be sterilized or accept contraception, that is illegal and they cannot do it.
The type of program does not matter. In some countries the government or Non-Governmental Organizations (NGO's) have told women that they must accept contraception if they want their hungry children to receive food from the government (Peru), medicine or medical care (Peru), housing (Indonesia), business licenses (India), employment and freedom (China).
In Peru, Maria Elena's third child, a daughter, was born with low birth weight and needed supplemental food. Maria enrolled her in a food program. After Maria's daughter had received food for two months, authorities came to Maria and told her that in order for her daughter to continue in the program she would have to agree to be sterilized. Maria refused and her daughter was removed from the program. This is an example of an abuse which is illegal under US law governing the funding of population control programs.
As a woman and mother, you have human rights. No family planning program funded by the US government can keep you from getting a benefit because you won't agree to accept sterilization or contraception. It is illegal for any family planning workers to tell you that you must agree to be sterilized in order to participate in a government program. If someone has told or done this to you contact Population Research Institute directly, or the person or organization working with PRI in your region.
United States law says that projects "shall provide family planning acceptors comprehensible information on the health benefits and risks of the method chosen including those conditions that might render the uses of the method inadvisable and those adverse side effects known to be consequent to the use of the method."
This means that when you consider whether to use a contraceptive or accept a sterilization, family planning workers must tell you honestly, completely and in a language you can understand about that method's possible problems, risks and dangers. Family planning workers cannot tell you that sterilization can be easily reversed when it cannot be, as was done in Peru, or that a method has few side-effects (which is almost never true). They also cannot offer to explain a contraceptive method and then tell you only what is good about that method. Informed consent does not mean you listen to a "sales pitch" about a method, it means that family planning workers explain the method fully.
It also means that a family planning program cannot give you a contraceptive or a drug without telling you. In Mexico, women who gave birth in government clinics often were pressured to accept a family planning device called an IUD even while they were still in labor. If they persisted in saying no, the doctors went ahead and inserted one into their uterus anyway. It later made some of them very sick. It is illegal for family planning programs funded by the US government to use a contraceptive drug or device on a woman without her consent.
In Guatemala, Senora Flores heard of a mobile medical clinic coming near her village offering free medical exams and she traveled an hour through the forest to get one. Weeks after the exam she began to bleed as though she were getting her period but the bleeding was very heavy and lasted a long time ' never really stopping. Desperate, she traveled days to a town big enough to have its own doctor. There she discovered an IUD had been inserted in her. She had never asked for one or been told one had been inserted. Her tissue near the IUD had become infected and she could have died. She may never be able to have children because of the damage the IUD caused her. Flores' trouble is an example of what is illegal under US law governing the funding of family planning programs.
Remember, if it sounds too good to be true, it probably is. If you think a family planning worker has withheld information about a contraceptive, don't accept it! If you suspect you have been given a contraceptive drug or device without your knowledge, contact the Population Research Institute directly, or the person or organization working with PRI in your region.
United States law says that projects "shall ensure that experimental contraceptive drugs and devices and medical procedures are provided only in the context of a scientific study in which participants are advised of potential risks and benefits."
This means that if someone wants you to participate in a test of how a contraceptive works on women, they must clearly tell you that you are taking part in a study. They must tell you that the drug or device is experimental. They must let you stop being part of the test whenever you wish. They cannot threaten you to get you to participate in a test against your will and they cannot lie to you about being part of a test.
In Bangladesh and Haiti women were told they would be given a five-year contraceptive which had few side effects. They were not told they were part of a test (called a "trial") of the contraceptive device called Norplant, which is injected under the skin and is meant to last for years. When the Norplant made some of the women very sick, they were told they could not have it taken out. Some women went blind after using it.
Women in other countries, like Vietnam, have been sterilized with a pill called quinacrine which looks harmless but actually dissolves into a strong acid in the body. Quinacrine sterilizes by burning the uterus to cause scars. This is not an accepted method anywhere in the world and cannot be used ethically.
In Vietnam, Nan was told to report to her place of work for a gynecological exam. Only after she was on the table in pain, did she realize something unexpected was going on – that the doctor was hurting her. She had been sterilized with quinacrine without her consent. This is an example of something that is not allowed under US law governing the funding of population control programs.
If someone offers to let you be part of a new contraceptive test, or if they offer you contraceptives for free that sound too good to be true, don't accept. If someone offers to sterilize you with pills, do not let them. Instead, contact the Population Research Institute directly, or the person or organization working with PRI in your region. Either that organization or PRI can tell you if the contraceptive they want to test on you has been tested in other places or on other women and what your rights are in such a test.
What Will Happen'
United States law says that "not less than 60 days after the date on which the Administrator of the United States Agency for International Development determines that there has been a violation of the requirements contained in paragraph (1), (2), (3), or (5) of this proviso, or a pattern or practice of violations of the requirements contained in paragraph (4) of this proviso, the Administrator shall submit to the Committee on International Relations and the Committee on Appropriations of the House of Representatives and to the Committee on Foreign Relations and the Committee on Appropriations of the Senate, a report containing a description of such violation and the corrective action taken by the Agency."
This means that it is now against US law for the United States government to ignore what has been happening to women around the world for years. It means that if a family planning program has violated your rights they must stop or lose their funding. All over the world and for many years family planning programs have pressured, forced, coerced, commanded and shamed women into making decisions they did not want to make. Now that can change. If enough women come forward to tell about what happened to them we can put an end to such programs which abuse women.
If a family planning program has done any of the things described in this pamphlet, or if you are just unsure about something a family planning program has done to you, a relative, a friend or a coworker, contact the person or organization working with PRI in your region, or PRI directly. We will listen to you. We are here and we want to help.