The first thing that strikes an objective reader in Adding it Up: the Benefits of Investing in Sexual and Reproductive Health Care, by The Alan Guttmacher Institute, (AGI) is the presupposition, that, “sexual and reproductive health” is a good thing. Normally, any kind of health is self-evidently a good thing but, as defined by AGI and their allies at the United Nations Population Fund (UNFPA) and the International Planned Parenthood Federation (IPPF), “sexual and reproductive health” consist of pouring huge quantities of contraceptive chemicals and devices into the world along with so-called “safe” abortion. “Health,” in this sense, consists in disabling the reproductive system, rendering it, in fact, unhealthy. This is frequently done in opposition to the cultural, moral and religious values of the peoples concerned, rendering these programs not only imperialistic but in some cases tyrannical.
Medical Evidence
A huge body of medical evidence deems contraception not only unsafe but downright harmful. The administration of some of the programs sponsored by the UNFPA, including the vicious “one-child policy” of the People’s Republic of China, is cruel and brutal. It was the complicity of the UNFPA in this cruel and brutal program that caused the U.S. State Department to shut off its funding to the UNFPA according to U.S. law. Furthermore, in the view of most of the world’s major religions the agenda put forth in the report constitutes a downright moral evil; a consideration dusted off by the population controllers as so much superstition.
True to form, AGI rolls on in this report as if the cultural, moral and religious objections to this agenda — held by more than half the world — either do not exist or are unworthy of consideration. AGI presumes its agenda is a done deal. AGI is the statistical and research arm of IPPF. As such it has a vested interest in promoting contraception and abortion as the solution to the world’s problems, especially in the developing world. The fact is that the agenda presumed in the report is plain cultural imperialism. Those poor people don’t know what’s good for them; AGI and friends do. The report treats the “sexual and reproductive rights” agenda as a fait accompli. No further discussion is needed.
In reading the report it is clear that, in AGI’s view, contraception is the answer to all the world’s ills, which is, in tum, like saying human beings are the cause of the world’s ills and fewer of them would solve everything. The report is a call for more funding for more “sexual and reproductive health care.” But what about simple comprehensive health care, which would include legitimate obstetrical and gynecological services? For decades stories have flooded back from health care missionaries in the developing world of medicine storerooms bulging with contraceptive chemicals and devices, with no penicillin or supplies to treat actual illnesses.
Families for the State
The report seems to suggest that the family exists in service to the state, in this case to the state’s economic development. The report says,
[I]nvestments in health care services, including those related to sexual and reproductive health, can make valuable contributions to wider development goals. For example, family planning allows women to achieve higher levels of education and a better balance between family and work. (Adding it Up, P. 5)
While no civilized person opposes educational and professional opportunities for women (an attitude population controllers frequently and falsely ascribe to their opponents) the report here upholds what has become the Western ideal of the mother working outside the home. Would it not be a better development goal to aim for a society where a woman is free to choose a career as a housewife and mother? Population controllers will point to examples of cultures where a wife is treated as her husband’s “property” to serve his sexual whims. Husbands in this scenario are portrayed as brutal, refusing condom use as threats to their manhood and ability to “control” his wife, using her fertility to keep her in vassalage. This is hardly the norm. And where it exists would it not be better to encourage the formation and enforcement of laws against domestic abuse rather than throwing contraceptives at the problem, contraceptives which only serve to keep the woman enslaved, thus compounding the abuse?
Respect, Not Abuse
One of the ideologies undergirding the population control movement is a particularly angry and dogmatic form of radical feminism which views cultural and familial abuse of women as the norm, The Judeo-Christian teaching of respect for women and protection for women is ignored. The role of marriage as having a civilizing influence on men, where a husband is called to lay down his life for his wife is ignored. Interestingly, the word “husband” never appears in the document. The word husbands, plural, occurs just three times. The more politically correct word “spouse” does not appear either. The substitute word “partner” appears only four times. Instead the report and the ideology behind it seeks to drive a wedge between husbands and wives. The implication is that women need protection from their husbands by purveyors of contraception who seek to spread contraception as a farmer spreads feed to chickens.
The attitude towards women throughout the document is subtly but notably utilitarian:
Prenatal care and obstetric care protect the health of both mothers and children and strengthen the family. Education about STIs, including HIV/AIDS, helps promote a healthy workforce and reduces the stress that these infections impose on communities. (P. 5)
The suggestion here is that preventing STIs and HIV/AIDS is good for business and a healthy workforce. This is no doubt true, but is it not a secondary concern at best when it comes to the profound human suffering of these terrible diseases? This misplaced priority runs throughout the report.
Racism?
One cannot help but sense an undercurrent of racism in the document as well as a classism belied by a “benevolence” which is more patronizing than charitable. It is a notion that the poor in the developing lands are incapable of anything approaching virtue, especially in the sexual sphere. Men are always and everywhere presumed to be brutes, women always and everywhere presumed to be victims in need of contraception and “safe” abortion.
Speaking of misplaced priorities,
[I]t can be difficult to capture the spillover benefits that investment in one area may have in other areas, For example, health care providers in many countries offer women Pap smears during family planning visits. The tests may result in the early detection and treatment of cervical cancer or precancerous lesions, yet analyses rarely measure reductions in cervical cancer as a benefit of investment in contraceptive services. Similarly, solving a particular social problem may require investment in several areas, yet analyses often attribute the solution to just one. The spillover benefits of sexual and reproductive health services, some of which are highlighted in this report, suggest that some services may often be most effectively provided as an integrated package. (P. 6)
Once again the implication here is that comprehensive health care is an adjunct to “sexual and reproductive health care,” which has priority. Why should a pap smear be a by-product? Should something as serious, albeit routine, as a pap smear be left to be a mere “spillover benefit?” Why not work for widespread comprehensive health care and examinations rather than “family planning clinics” focused on one aspect of human health? There is a discernible obsession at work in the minds of the population control movement that must be questioned by all involved. One is reminded of the “Qualitarians” in Walker Percy’s black comedy The Thanatos Syndrome, where the supposed “quality of life” takes priority over life itself. Whose life is deemed worthy of “quality” and whose is worthy of prevention or termination — who is being served? This is the age-old, tiredly familiar recipe for tyranny.
Who Decides?
As ever, the question is “who decides?” AGI and their allies are speaking from a perch that assumes they know best what is good for the developing world. The report speaks repeatedly about the mortality rate — including the infant mortality rate — from “unsafe abortion,” with the implied accusation that their opponents somehow favor “unsafe abortion.” The glaring fact is that all abortion is unsafe — far more unsafe than natural birth for the mother — and always one hundred percent fatal to the infant!
On page 5 the report states, “contraceptive use does confer health benefits: It protects women and infants from the medical risks of pregnancy, delivery and the postpartum period… .” An odd bit of logic considering that of course a woman will be “protected” from the medical risks of pregnancy if no pregnancy occurs. Except for scant mention of “side effects” of contraception nothing is said about the serious medical risks of contraception. The specific types of contraceptives in play are not mentioned in the report and the impression is given that mainly condoms and the pill are involved. However, no one familiar with the population control movement expects its proponents to limit their options.
Stories have proliferated over the years of devices such as IUDs being placed in women in developing countries with no instruction or provision for having them removed. AGI’s cohorts at the UN — UNFPA and IPPF — have argued forcefully for widespread distribution of so-called “emergency contraception” especially in refugee situations and war torn regions ignoring reports of deadly results even in the best of conditions in the developed world.
Culture and Society
Religious, moral, and ethical concerns are dismissed throughout the report as something negative, an obstacle in the way of progress or the good of women. For example, all moral, ethical, or religious considerations are reduced to “cultural pressures” or cruel, backwards attitudes resulting in “social stigma”:
For a low-income woman in a developing country, a trip to the health clinic may be extremely costly in terms of the value of forgone time and cultural pressures. Delaying childbearing, being HIV-positive or using a condom may leave women, and men, vulnerable to social stigma. (P. 15)
The blanket assumption is made that the majority of “right thinking” women would choose “modern methods” of birth control were they not hindered by “problems” like “cultural values” or misguided personal preferences:
If contraceptive services were available, many — but not all — of the 201 million women in developing countries with unmet need would adopt a modern method. Some women will always have problems with modern methods, as a result of side effects, misconceptions, cultural values or personal preference. At the same time, however, some women who are not considered to have an unmet need (usually because they plan to have a child soon) say they intend to use a modem contraceptive method. (P. 17)
Then of course there may be objections which are simply reduced and dismissed as “cultural perceptions”:
Comprehensive estimates should include all costs, regardless of the source of funding — international donors, national or local governments, nongovernmental organizations, program clients or a combination of these. They should also include costs from the perspective of the client or patient who is using the services — both the time required to access services and the social sanctions that may stem from cultural perceptions of, for example, STIs, abortion or not having a child soon after marriage. (P. 26)
Side Effects
Similarly, the very serious side effects of contraception are dismissed in passing just as blithely. Page 8 cites a report which, “also documented drawbacks, such as the side effects of contraceptive methods and family disapproval of contraceptive use.”
Page 12 carries a similar passing reference where a “project also investigated some of the costs to women of using contraceptives. These included side effects (both real and suspected) and fear of husbands and other relatives who opposed use of contraceptives.” Note the doubt cast by the phrase “both real and suspected.” Again, these concerns are mentioned only in passing and therefore dismissively. Cultural considerations aside, the medical literature is filled with very serious concerns about the side effects of contraceptive chemicals and devices especially where close follow-up care is not always available, as in the developing world at issue here. The report shows a distinct callousness in this regard toward those who are ostensibly being served.
The terms “religion” and “religious” are not found anywhere in the report, an odd omission for a report of such wide cultural import and the daily — even intimate — lives of peoples deserving of respect. The word “family” occurs as part of the term “family planning” or in the pressures of balancing work and family. Family, one can glean from this report, is viewed generally as something that restricts a woman’s movement and curbs her freedom rather than as a source of joy, love or fulfillment. There is no occurrence of the word “families” (plural) in the document, nor, it should come as no surprise, is the word “love” to be found in the report.
No Family, No Love
The word “love” may seem quaint or unscientific in a report such as this except the central act under discussion is normally and traditionally considered an act of love. The word ought to spring to mind instantly in a civilized person wherever children are concerned. There are better ways to solve the problems of poverty and disease than eliminating the possibility of more persons coming into being who may turn out to be sick or poor. The central focus ought to be on preventing the poverty and sickness not those who may potentially fall victim to them.
The poor people of the world are certainly capable of virtue, even — though it may come as a surprise to AGI & Co. — sexual virtue. They are also capable of love, both giving and receiving love, which is the primary reason human beings exist. There are such things as untimely, inconvenient pregnancies but the person, however conceived, once conceived, deserves to be welcomed as royalty. Where love does not exist the duty of every civilized person is to put it there.
The Catholic Church — whom AGI & Co. consider public enemy number one — has, along with other religious missionaries, for centuries built up a worldwide system of caring for the poor and otherwise unwanted based on this premise, that each human life is a gift from a loving God worthy of being treated as such. In a word — love.
There are alternatives to the conclusion of AGI and their allies that people are the problem. People are a great treasure, and a wealth in themselves. It is a counsel of despair that others must not be born and prevented by artificial means so that those already born may live well. The message of hope is for all to be welcomed and to live well. It may be that “the poor we will always have with us” but the challenge for those of us lucky enough not to be poor is to improve their lot, not prevent them from existing. AGI and friends is a bad investment. Add it up.
