This news brief presents the US President's wife's statement on the association between use of family planning and a decline in abortions worldwide. Hillary Rodham Clinton attended the Sixth Conference of Wives of Heads of State and Government of the Americas held in La Paz, Bolivia. The conference was suitably located in Bolivia, a country with the highest rates of maternal mortality in South America. Bolivia has responded by launching a national family planning campaign coordinated between government, nongovernmental, and medical organizations. Half of Bolivian women experience pregnancy and childbirth without the support of trained medical staff. Mortality from abortion complications account for about half of all maternal deaths in Bolivia. Voluntary family planning workers teach women about the benefits of child spacing, breast feeding, nutrition, prenatal and postpartum care, and safe deliveries. Bolivia has succeeded in increasing its contraceptive use rates and decreasing the number of safe and unsafe abortions. Bolivia's program effort was supported by USAID. USAID provided technical assistance and funds for the establishment of a network of primary health care clinics. Mrs. Clinton visited one such clinic in a poor neighborhood in La Paz, which in its first six months of operation provided 2200 consultations, delivered 200 babies, registered 700 new family planning users, and immunized 2500 children. Clinics such as this one will be affected by the US Congress's harsh cuts in aid, which reduce funding by 35% and delay program funding by 9 months. These US government cuts in foreign aid are expected to result in an additional 1.6 million abortions, over 8000 maternal deaths, and 134,000 infant deaths in developing countries. An investment in population assistance represents a sensible, cost-effective, and long-term strategy for improving women's health, strengthening families, and reducing abortion.
The Population Institute recently published a report, titled, Our Diminishing World: The Land/Population Crisis, that explains the relationship between rapid population growth and land degradation in the developing world. As populations in the poorest parts of the world increase, the percentage of land/person continues to decrease. There are approximately 32 billion acres of land, excluding Antarctica, on the planet. That equals only 5.98 acres/person; however, not all this land is suitable for habitation or food production. 1.2 acres is too steep, 1.3 acres is to arid, and 1 acre is too cold. Also, the population of the world is not spread out evenly across the land; thus, in many areas the population density is so high that the demands placed upon the land are greater than its capacity to produce. The Green Revolution that lasted from 1950 through the mid 80s did increase the total amount of yield/acre. Unfortunately the price for such productivity was a degradation of the land. Chemical inputs have contaminated ground water and sterilized the soil, irrigation has caused salinization and water logging (which is a form of decertification), and new tillage practices have eroded the top soil. Grazing cattle have caused enormous amounts of soil erosion and deforestation has removed 911 million acres of tropical forest alone to make room for a growing population. Wood is the single most important fuel source for the people of the developing world; yet, as it becomes scarce from deforestation, animal manures and crop residues have been substituted which further the diminishes the availability of fertile land. It must be understood that family planning save lives, reduces suffering, and slows the damage to the environment. Family planning is the single best way to make an impact in the attempt to end poverty and hunger.
UNICEF's 1992 State of the World's Children Report observes that family planning is one of the most effective and least expensive ways of improving quality of life on earth. If all women were able to determine the size and spacing of their families, the report notes, there would be 1.3 billion fewer people in the world by the year 2025. A recent World Fertility Survey underscored the demand for family planning, pointing out that 1/3 of all pregnancies in the world are unwanted. Increased access to family planning services could go a long way toward decreasing maternal and child mortality and improving the quality of life for women and children. Family planning could save the lives of up to 1/3 of the 1/2 million women who die every year from pregnancy and birth related causes. Family planning could also prevent many of the 50,000 illegal abortions which are performed around the world every day, and could decrease the incidence of high risk pregnancies involving women under 18, over 35, or who already have more than 3 children. The report says that women who practice birth control have more time for education, earning income, child care, and leisure. And as parents are able to devote more time and resources to less children, the quality of child care rises. Unfortunately, as UNICEF executive director James P. Grant notes, the benefits of family planning have been obscured by controversy. But as recent experience has demonstrated, family planning can be promoted and practices in a way that is sensitive to the religion and culture of almost any society. The failure to realize the potential of family planning, the report says, is one of the greatest mistakes of our time.
The Vatican has failed in its attempt to prevent the UN Children's Fund (UNICEF) from spreading the message of family planning in developing countries. Over the strong objections of the Holy See, the 41-member Executive Board of UNICEF has asked the agency to cooperate with the UN Population Fund (UNFPA) and the WHO "to support family planning in the context of sustainable national healthcare systems." A member of the Executive Board said the Vatican held the view that UNICEF had no legitimate right to be involved in family planning. "But the Holy See was in a minority of one," he said, adding that "the whole problem arises from the fact that the Vatican continues to equate birth control and abortion with family planning." A recently concluded board meeting unanimously adopted a resolution requesting UNICEF to "contribute substantively" to the UNFPA-sponsored International Conference on Population and Development (CPF) set to take place in 1994 in Cairo. The board also asked UNICEF Executive Director James Grant to submit a policy paper "on the involvement of UNICEF in family planning, taking into account the health of the child and the mother." The paper is to be presented for the consideration of the board at its regular session next year, with a view to approving it prior to the ICPD. Prior to the adoption of the resolution, J. Klink, a spokesman for the Holy See, told the Executive Board that there were "concerns" over calls for UNICEF to involve itself in family planning activities. He said UNICEF should not be concerned with family planning because there were other agencies entrusted with that mandate. Responding to the support given by Nordic countries to the UNICEF resolution, Klink said that wealthy nations must not impose dictates as to the "appropriate" size of poor families. "The Holy See would not propose that UNICEF halt its current balanced, informational approach to the spacing of births," he said. "Families must be free to decide their size." UNICEF, he pointed out, had clearly stated that it was not involved in abortion or sterilization and did not provide contraceptives. "UNICEF must continue to respect cultural and religious diversity," he said. At a meeting of the Preparatory Committee of the UN Conference on Environment and Development (UNCED) in April this year, the Vatican succeeded in striking a reference to family planning from a blueprint for development known as Agenda 21. Paragraph 99 of Agenda 21 had originally referred to the need for "integrated healthcare, including universal access to family planning services and the provision of safe contraceptives." But this paragraph was deleted in the final document adopted at UNCED in Rio de Janeiro in June. Given that family planning is the single most effective means with which to contain population growth, the UNFPA considered the omission a retrograde step in handling the dangers of overpopulation and environmental degradation. In Rio de Janeiro, Werner Fornos, president of the Washington-based Population Institute, criticized the Holy See "for interfering in the lives of people throughout the world because of religious dogmas." Grant told the board meeting last month that UNICEF would work with the UNFPA to spread knowledge and support program activities for successful family planning which he said was integral to safe motherhood. Birte Poulsen of Denmark told the meeting that reduced population growth was a prerequisite for sustainable development, and the UNICEF "must accord family planning issues top priority." And Inger Ann Ravum of Norway said the integration of family planning activities into UNICEF's program was welcome.
Evidence suggests that slowing population growth will accelerate economic development. This according to the 1992 State of the World Population Report published by the UNFPA. Between 1970-85 developing countries cut their portion of the very poor from 52-44%. But because of their rapid population growth there were 210 million more poor people, 50 million more hungry, and 60 million more children not in secondary school. Of 82 developing countries studied by the UNFPA, 41 with slower population growth increased their average incomes by 1.25% annually; but, 41 with faster population had average incomes drop by 1.25% annually. Even if every women alive had only 2 children the world population would still grow by 3 billion. Instead of treating people like machines and trying to directly control population, circumstances must be created that will allow people to freely choose to have fewer children. Evidence clearly indicates that this can be accomplished by lowering infant mortality rates, increasing access to education, especially for women, and giving women greater legal control over their own economic destiny. The stakes are very high, success in reducing world wide fertility could stabilize world population at 8 billion, failure would mean 12.5 billion. A difference of up to 4 billion people, or the world population in 1975, would mean a great deal less suffering.
