Africa: Contraception Is So Good It Should Be Compulsory?

It's a very misleading title: 'Contraception for the 215 Million Women Who Want It'. It turns out that 215 million is the number of women "who want – but do not have – access to or information about modern contraception". The article goes on to suggest that the implications of this lack includes "complications from pregnancy and childbirth", these being "the leading cause of death among women in their reproductive years in developing countries".

However, if women in Western countries were suffering from complications during pregnancy and childbirth, would it be concluded that many of them shouldn't have had a child, or shouldn't have had so many children? Many of the 350,000 maternal deaths per year could be prevented by safe and accessible healthcare. So why is contraception so often held up as the most appropriate solution?

In fact, some contraceptive methods probably involve substantial risks to women, especially in developing countries. Injectable Depo Provera hormonal contraceptive, hardly used outside of high HIV prevalence African countries, has been implicated in increasing transmission of HIV from women to men and from men to women. Some other forms of birth control involve invasive procedures, which also carry the risk of transmission of HIV and other blood borne diseases.

So the issue is confused: Western NGOs have always been keen on birth control for developing countries, for purely eugenic reasons and because of fears of a 'population explosion' and the inability of the world to produce enough food for everyone; so they tend to cite figures that suggest that birth control is the answer to various problems relating to development, sometimes even all problems relating to development.

The article calculates that if everyone who is said to need information on contraception has fewer (or no?) children, maternal mortality will be cut by one third, infant mortality by 10-20% and the need for abortions by 70%. Even the need for maternal and newborn health services is acknowledged, but not the need for safety. In some countries (such as Ethiopia), it is the very people who receive maternal health services who are more likely to be infected with HIV. Universal access to safe healthcare does, indeed, save lives. But is the author of this article advocating healthcare for all (safe or otherwise), or just healthcare that involves uptake of contraceptive services at levels that the Bill and Melinda Gates Foundation would approve of?

Because it is the Gates Foundation that is behind the article, although it is written by Kathy Calvin of the United Nations Foundation, funded by Ted Turner, another philanthrocapitalist who shares Gates' worries about world hunger, overpopulation, food shortages and the like. So what are the limits of 'healthcare' and even philanthropy for such people? After all, Gates is also behind other dubious programs, such as mass male circumcision, unethical research, almost total reliance on drugs and other technological solutions, genetically modified organisms, geoengineering, etc.

There's always the claim that contraception, especially certain methods, 'empower' women. But which ones do? Ones that may increase risk of infection with HIV, like Depo Provera? Ones that involve other healthcare risks? Or is it just the ones that make a lot of money for pharmaceutical companies and others who have a vested interest? Many NGOs have been set up to work primarily with birth control and receive a huge percentage of aid money every year. The article mentions 'voluntary' contraception, but I wonder how voluntary a lot of programs are.

Of course, associating such programs with women's empowerment, maternal and child health, environmental sustainability and protection of resources makes it difficult for anyone to question the fervor for advocating for something on behalf of people who may not have had much say in the matter and may themselves feel quite differently about it. I don't doubt that the UN and Gates Foundations have "the power to save the lives of women today, and create a better world for tomorrow", but I am not convinced that is their aim. I'm not convinced that either operate in a transparent and democratic manner; and by 'democratic', I don't mean 'administrated by Westerrners'.

[For more about non-sexual HIV transmission and how to avoid it, see the Don't Get Stuck With HIV site.]