Have You Heard the One About Seven Billion People Hurtling Through Space on a Rock?

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conferences, fertility, population

Crowds outside the White House in 1945 (National Archives)

The reproductive rights movement, in all of its glorious diversity, is a loose collection of individuals and groups who wish to see, variously (and not exhaustively), access to contraception and safe abortion facilities within a medical context, more comprehensive sex education, a greater variety of birth control options for men and women, and the protection of the inalienable right of every human being to make informed decisions about his or her health (sexual and otherwise) and well-being. A major part of that health and well-being includes women’s right to choose when they will conceive and carry a pregnancy to term, and a host of factors, including biological, social, economic, cultural, and environmental considerations factor into this choice. This is a discussion which Margaret Sanger famously provoked, and a discussion which has continued to rage well into the next century. It is especially timely in light of a recent UN report, released this week in which the world population reached an especially large, round number.

Sanger organized the first World Population Conference, held in Geneva, in 1927. Members in attendance included, from left: Lucien March (France), F.A.E. Crew (Great Britain), C.C. Little (USA), E. F. Zinn (USA), H. P. Fairchild (USA), C. Gini (Italy), Bernard Mallet (Great Britain), J. S. Huxley (Great Britain), R. Pearl (USA), A. M. Carr-Saunders (Great Britain), B. Dunlop (Great Britain) and J. W. Glover (USA). (From the Proceedings)

By now, many of our readers will likely have heard that population experts estimate that the seven-billionth baby was born on October 31st – ideally a joyous occasion for mother, baby, and family, wherever they are. Much of the discourse surrounding this seven-billionth birth has been positive, uplifting, and light-hearted: Population Action International has a web app which allows you to determine where you fall, chronologically, among the seven billion. There’s an iPad app by National Geographic in a similar vein, and the BBC has its own version of the “where am I?” meme. There is something tremendously exciting about passing such a major population milestone, despite the fact that 7 billion followed 6 billion much faster than 6 billion followed 5 billion, and 8 billion is likely to arrive even more quickly – such is the nature of exponential growth.

There is a dark side to population growth, however: overcrowded cities, food shortages and famine, over stretched water systems that fail to flush away sewage and provide clean drinking water, and other symptoms of infrastructure forced to operate at its breaking point. Once we start to consider the environmental toll, the future can may seem grim indeed. While there is no shortage of hand-wringing in the global North over the failure of the younger generation to procreate in sufficient quantities to support social structures for their parents’ generation, and while fertility may be decreasing in most parts of the world, the fact remains that globally, the human race is not getting any smaller. Even in 1920, Margaret Sanger was writing about the negative effects of overpopulation – and how these conditions meant that:

The fact is that we are not caring properly for the children now here and the conditions which are in prospect for the near future will make it impossible to give even such care to children as they are now getting. (Sanger, “Preparing for the World Crisis [full text]).

The fact that higher fertility rates are correlated with lower development indicators suggests that conditions in areas with the highest fertility are less favorable for healthy child development and survival. If a woman does not feel physically, emotionally, or financially capable of caring for a child to the fullest extent possible, that woman needs the right to choose whether or not to become pregnant.

Five days ago, on October 26th, the UN launched its State of World Population Report, which provides an overview of current trends, patterns, and emerging issues in world population studies and which contains an explicit endorsement of

“better and more universal access to reproductive health services particularly family planning for the countries. These services must be based on and reinforce human rights and should include sexuality education for young people, particularly adolescent girls” p. 6 (full report.)

Sanger, ca. 1917

An earlier UN publication, in August 2011, emphasized the legal restrictions placed on access to abortion and contraceptives worldwide, and called on member states to remove or relax restrictions in order to make family planning services more accessible. This documentlinks gender equality, health, and the socioeconomic context of gender roles and expectations to women’s fertility and the ways in which they are or are not permitted to control their own fertility. It is demoralizing that such an assertion should still be radical or controversial, given that in 1917 Sanger wrote:

When woman becomes conscious of her ego, her inner self, then shall she become a pivot in the world’s advanced thought, and shall hold within her hands the reins of human destiny. Those who have opposed her development and progress are simply those who refuse to accept this new Moral Standard for her.

They do not realize that Birth Control, which shall place woman in possession of her own body, is an epoch-making process in racial development (Sanger, “Voluntary Motherhood, (full text)).

Language evolves, and some of the language that Sanger uses may seem strange to twenty-first century eyes, but the central message is the same: allowing women to control their own fertility is crucial to the success, health, and overall well-being of the human race.

While the seven-billionth baby born is cause for celebration (not the least because babies are adorable), it is also worth pausing to consider that by continuing Sanger’s work and providing safer and easier access to contraception and other reproductive health services, we help to ensure a world in which the eight-billionth baby is wanted and born in the social, economic, and environmental conditions that will offer the best chance of a long and rich life.

95th Anniversary of the Brownsville Clinic

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anniversaries, Brooklyn, Brownsville clinic

October 16th, 1916: The Brownsville Clinic opened its doors to the public, staffed by Sanger, Ethel Byrne (her sister and a registered nurse), and an interpreter to facilitate communication with the residents of the multi-ethnic neighborhood. Ten days later, after providing information about contraception and the female reproductive system to roughly 400 women, the clinic was raided by the police and shut down. Although Sanger opened the clinic twice more, on November 14th and 16th, it was finally closed after the staff were evicted by the building’s landlord.

Under the Comstock Laws of the time, distributing information about birth control was obscene and therefore illegal. Rather than opening the clinic secretly and quietly, Sanger courted political and media attention in order to draw the public eye to her campaign. After the arrests and during the subsequent trial, Sanger used the sensation around the opening of the clinic and her struggle to disseminate information about contraception to her advantage, ultimately opening a legal birth control clinic three years later and eventually founding both the organization that became Planned Parenthood Federation of America and the International Planned Parenthood Federation.

This past Thursday, the BBC aired an interview with Alex Sanger (Margaret Sanger’s grandson) and Esther Katz (Editor and Director of the MSPP). During the interview, Alex Sanger mentions that despite her many successes, the first clinic, opened exactly 95 years ago, was one of his grandmother’s proudest achievements. It seems fitting, at a time in which women’s reproductive rights are increasingly under attack, to commemorate the bravery, spirit, and dedication shown by Sanger and the other staff members of the Brownsville clinic in their fight to make contraception accessible to women from all walks of life.

For more on the Brownsville clinic and Sanger’s work in the early years of the birth control movement, consult Volume I of the Selected Papers of Margaret Sanger: The Woman Rebel, 1900-1928.

The “Tech” of Safer Sex and Reproductive Technology

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birth control methods, Saturday Night Live

This video has been making the rounds since the weekend. It depicts an advertisement for “Lil Poundcake,” whose hair smells like frosting and who comes with accessories like a cell phone and earrings that her human friends can wear too. She is also equipped to administer the three shots over a six-month period that make up the HPV vaccine.

Shockingly (or perhaps not, if you speak satire/happened to watch Saturday Night Live this week), Lil Poundcake is a parody, designed to poke fun at the “HPV wars” that have been taking place during the Republican campaign for the Presidential nomination. It’s a humorous way of drawing attention to the hysteria surrounding the HPV vaccine and proposals (or legislation, where such legislation exists) to make it mandatory for all students – sometimes just female students, sometimes female and male – of a certain age.

One of the more striking things about the video is just how much it highlights the fact that when it comes to safer sex and reproductive health technologies, the delivery methods may have advanced (lower doses of pills than in my mother’s generation, condoms that “feel as though you aren’t using one,” silicone rings administering the same synthetic hormones in birth control pills) but the basic building blocks are the same. Even though there are advances being made (the much buzzed-about “male birth control” comes to mind), when it comes to contraception there are precious few options to choose from – and I recognize that I, living comfortably and legally in a medium-sized city, in a country with accessible health care provided by the provincial government, am coming from a place of serious privilege. If Margaret Sanger were to walk through a sexual health centre, she would most likely recognize most of the devices and methods on display as current – rather than former – birth control methods.

Over at RH Reality Check, Kirsten Moore has a great post up about the differences in technological advancement between smartphones and contraceptives, arguing that if consumer demand for advancement in one mirrored that of the other, the safer sex and contraceptive product market would look quite different:

The opportunities for innovation in products and services are as varied as the women and men who need them. There is no one silver bullet (or pill, or condom) when it comes to contraception: each woman is different and has unique and changing life circumstances. As consumers, we need to talk about what we like, what we don’t like, and what we wish we had when it comes to birth control.

Keeping safer sex and reproductive health technologies out of the public discourse – except to demonize and discredit them – does nobody any favors.

Sanger worked throughout her entire life to improve the accessibility and caliber of birth control in the United States and globally, using methods as diverse as government lobbying for increased research efforts and, when necessary, smuggling. Why, then, should we assume that what we have is “good enough,” and stop asking for something better?

Without open discourse about what works, what doesn’t, and who likes to use what (and for which reasons), there is no room for innovation. There is no question that for many, many people, the barriers to accessing what is actually available are financial, physical, and social. It is, however, possible to improve access to what does exist without forgetting to keep an eye on what might be coming over the horizon.

Happy World Contraception Day!

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anniversaries, population, World Contraception Day

Sanger and other family planning leaders at the IPPF's founding meeting, theThird International Conference on Planned Parenthood, held in Bombay in 1952.

From the International Planned Parenthood Federation: today, September 26, is World Contraception Day.

On the WCD2011 website, specifically targeting youth, you can learn more about contraception and your rights when it comes to sexual and reproductive health.

The WCD2011 website includes a drop-down menu where you can select your country of residence (from a limited list) in order to get more information about where you can access contraception, background information on puberty and anatomy, types of contraception, and STIs, and other resources for teens and youth.

The other major facet of WCD2011 is their release of the results of a multinational survey of youth touching on topics of sexual and reproductive health and education, including access to and use of contraception. Some of the results, including a staggering statistic that

“42% of respondents in Asia Pacific and 28% in Europe who could not get hold of contraception when they needed it claimed it was because they were too embarrassed to ask a healthcare professional,”

are available in the press release for WCD2011. The full report is available here.

Income, location, language barriers, legal status within a country, religious/social/parental pressures, and a host of other factors can have an impact on young people’s access to contraception. The fact is that there are any number of ways which infringe upon one’s right to access safe, affordable, accessible, and non-judgmental health care, especially regarding sexual health and even more so as a minor. In the face of such inequality of access, the work that individuals and organizations in the field of sexual and reproductive health advocacy and research do is as important now as it was when Margaret Sanger was alive.

On World Contraception Day, then, it seems appropriate to both celebrate the advances – scientific and social – that generations of sexual and reproductive health pioneers have worked for, and to continue to agitate for truly equal access. So once again, Happy WCD and let’s continue the good work that Sanger began.