Category Archives: Family Planning

Family planning: A major environmental emphasis

CORVALLIS, Oregon – People who are serious about wanting to reduce their “carbon footprint” on the Earth have one choice available to them that may yield a large long-term benefit—have one less child.

A study by statisticians at Oregon State University concluded that in the United States, the carbon legacy and greenhouse gas impact of an extra child is almost 20 times more important than some of the other environmentally sensitive practices people might employ their entire lives—things like driving a high mileage car, recycling, or using energy-efficient appliances and light bulbs.

The research also makes it clear that potential carbon impacts vary dramatically across countries. The average long-term carbon impact of a child born in the U.S.—along with all of its descendants—is more than 160 times the impact of a child born in Bangladesh.

“In discussions about climate change, we tend to focus on the carbon emissions of an individual over his or her lifetime,” said Paul Murtaugh, an OSU professor of statistics. “Those are important issues and it’s essential that they should be considered. But an added challenge facing us is continuing population growth and increasing global consumption of resources.”

In this debate, very little attention has been given to the overwhelming importance of reproductive choice, Murtaugh said. When an individual produces a child—and that child potentially produces more descendants in the future—the effect on the environment can be many times the impact produced by a person during their lifetime.

Under current conditions in the U.S., for instance, each child ultimately adds about 9,441 metric tons of carbon dioxide to the carbon legacy of an average parent—about 5.7 times the lifetime emissions for which, on average, a person is responsible.

And even though some developing nations have much higher populations and rates of population growth than the U.S., their overall impact on the global equation is often reduced by shorter life spans and less consumption. The long-term impact of a child born to a family in China is less than one fifth the impact of a child born in the U.S., the study found.

As the developing world increases both its population and consumption levels, this may change.

“China and India right now are steadily increasing their carbon emissions and industrial development, and other developing nations may also continue to increase as they seek higher standards of living,” Murtaugh said.

The study examined several scenarios of changing emission rates, the most aggressive of which was an 85 percent reduction in global carbon emissions between now and 2100. But emissions in Africa, which includes 34 of the 50 least developed countries in the world, are already more than twice that level.

The researchers make it clear they are not advocating government controls or intervention on population issues, but say they simply want to make people aware of the environmental consequences of their reproductive choices. “Many people are unaware of the power of exponential population growth,” Murtaugh said. “Future growth amplifies the consequences of people’s reproductive choices today, the same way that compound interest amplifies a bank balance.”

Murtaugh noted that their calculations are relevant to other environmental impacts besides carbon emissions—for example, the consumption of fresh water, which many feel is already in short supply.

Reproduction and the carbon legacies of individuals by Paul A. Murtaugh and Michael G. Schlax (PDF file)


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Save Lives—and Money! by Richard Grossman MD

Can you think of any state-funded program that can save seven dollars for every dollar spent? Voluntary family planning programs for teens and young women offer that wide a margin of benefit!

Indeed, family planning can do much more than just save money. It has the ability to change the prospects for people, especially young women. By postponing parenthood, people have the opportunity to mature emotionally, complete their education and improve job skills. An experiment, the Colorado Family Planning Initiative (subsidized by a generous grant) has shown the benefit of making effective contraception available to all women.

OK, I have to admit, women bear an unjust proportion of responsibility for family planning. That is the way it is now; I hope that the future will hold more in the way of birth control for men other than just condoms and vasectomy.

An anonymous donor (reported to be the Susan Thompson Buffet Foundation) gave money to fund contraception for women who otherwise couldn’t afford it. This program started in 2009 and finished this summer (2015). It paid about $5 million each year for more than 36,000 women to receive contraceptive information, services and supplies.

Fortunately, during this interval the need for funding decreased because the Affordable Care Act (Obamacare) picked up perhaps 25,000 Colorado women who didn’t have prior coverage. Unfortunately there are still many people who don’t have any insurance coverage and cannot afford contraception. They are especially unable to pay for Long-Acting Reversible Contraceptive (LARC) methods that are so effective, but have an initial cost of about $1,000. LARCs include four IntraUterine Devices (IUDs) and one hormonal implant.

How did this program save money? If they had gotten pregnant, many of these women would have been on Medicaid or other state-supported programs. Their children would also likely be on taxpayer-funded programs, including children of undocumented women who are citizens as soon as they are born in the USA. The estimate of the amount of money the grant saved just for obstetrical services is $79 million.

The most important savings is in the decrease in the teen pregnancy rate. It is true that all over the country fewer teens became pregnant during the past few years, so not all of the decrease in our state is due to the Initiative. However, Colorado’s teen pregnancy rate dropped an outstanding 40% from 2009 to 2013, largely because of this Initiative.

Colorado's Teen Birth Rate

No one is in favor of unintended pregnancies. This Initiative illustrates what we have known all along: the best way to prevent abortion is with good contraception—and this has been proven over the past 5 years. From 2009 to 2013 the abortion rate for Colorado teens fell 42%, and for women aged 20 to 24 it also dropped significantly.

Good things come to an end, and the Initiative’s grant ended in July. Don Coram, a Republican state representative from Montrose, tried to garner support to continue the program—but unfortunately failed. Fortunately, private foundations stepped in to assure that funding is available.

So far 12 foundations have collaborated to pay $2 million during the next year to continue the Initiative. It remains to be seen whether this will be enough to provide services to all who need them, but it is hoped that more funding will follow. Optimistically the State Legislature will see that this program is saving money and empowering young women to become healthier, more productive citizens and will finally fund this program. And maybe other states will then get on the bandwagon to follow Colorado’s lead by funding similar programs.

Dr. Eve Espey is chair of the department of OB-GYN in Albuquerque where I trained many years ago. Her paper “Feminism and the Moral Imperative for Contraception” documents the importance of contraception in the modern world. Not only does family planning provide social benefits to individuals and to their societies, but also it saves lives. Spacing the births of babies promotes healthier children and decreases infant deaths. “It is estimated that, in 2008,” she writes “44% (272,040) of maternal deaths were prevented in 172 developing countries owing to use of contraceptives….”

Not only does contraception save money; globally it saves a quarter million women’s lives yearly!

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How to Really Defend Planned Parenthood by Katha Pollitt 

WHY does the pro-choice movement so often find itself in a defensive crouch?

I cringed as I watched Planned Parenthood’s president, Cecile Richards, apologize in a YouTube video last month for the lack of “compassion” in two doctors’ language at supposed business lunches arranged and secretly recorded by the anti-abortion Center for Medical Progress.

Not because she wasn’t eloquent, but because of what her words said about the impossibly narrow path abortion providers now are forced to walk. After all, have you ever heard an apology from a crisis pregnancy center for masquerading as an abortion clinic? What about the women in Texas who lost access to gynecological care when the state defunded Planned Parenthood and did not, as promised, adequately replace its services? Has anyone said SORRY about that?

Logically, it’s not important how doctors talk at supposedly private meetings. If they were heart surgeons I doubt it would be an issue. But these are abortion providers, and that makes all the difference. So far, the surreptitiously filmed videos, five of which have now been released, do not, as claimed, show that Planned Parenthood sells fetal tissue for profit, which is against the law.

But the videos do cleverly evoke visceral feelings of disgust—graphic images, physicians using the words “crush” and “crunchy”—to activate the stereotype that abortion providers are money-grubbing baby killers. Why women end up having second trimester abortions, why they choose to donate fetal tissue, what good the research achieves—who cares, when there is outrage to provoke and express?

There are two reasons abortion rights activists have been boxed in. One is that we’ve been reactive rather than proactive. To deflect immediate attacks, we fall in with messaging that unconsciously encodes the vision of the other side. Abortion opponents say women seek abortions in haste and confusion. Pro-choicers reply: Abortion is the most difficult, agonizing decision a woman ever makes. Opponents say: Women have abortions because they have irresponsible sex. We say: rape, incest, fatal fetal abnormalities, life-risking pregnancies.

These responses aren’t false exactly. Some women are genuinely ambivalent; some pregnancies are particularly dangerous. But they leave out a large majority of women seeking abortions, who had sex willingly, made a decision to end the pregnancy and faced no special threatening medical conditions.

We need to say that women have sex, have abortions, are at peace with the decision and move on with their lives. We need to say that is their right, and, moreover, it’s good for everyone that they have this right: The whole society benefits when motherhood is voluntary. When we gloss over these truths we unintentionally promote the very stigma we’re trying to combat. What, you didn’t agonize? You forgot your pill? You just didn’t want to have a baby now? You should be ashamed of yourself.

The second reason we’re stuck in a defensive mode is that too many pro-choice people are way too quiet. According to the Guttmacher Institute, nearly one in three women will have had at least one abortion by the time she reaches menopause. I suspect most of those women had someone who helped them, too—a husband or boyfriend, a friend, a parent. Where are those people? The couple who decided two kids were enough, the grad student who didn’t want to be tied for life to an ex-boyfriend, the woman barely getting by on a fast-food job? Why don’t we hear more from them?

It’s not that they think they did something wrong: A recent study published in the journal PLOS One finds that more than 95% of women felt the abortion was the right decision, both immediately after the procedure and three years later. They’ve been shamed into silence by stigma. Abortion opponents are delighted to fill that silence with testimony from their own ranks: the tiny minority of women who say they’re plagued by regret, rape victims glad they chose to continue their pregnancies, women who rejected their doctor’s advice to end a pregnancy and—l ook at these adorable baby pictures!—everything turned out fine.

Make no mistake: Those voices are heard in high places. In his 2007 Supreme Court decision upholding the Partial-Birth Abortion Ban Act, Justice Anthony M. Kennedy specifically mentioned the “unexceptionable” likelihood that a woman might come to regret her choice. That women (not mne!) need to be protected from decisions they might feel bad about later—not that there was any evidence supporting this notion –is now a legal precedent.

It is understandable that women who have ended pregnancies just wanted to move on. Why should they define themselves publicly by one private decision, perhaps made long ago? I’ll tell you why: because the pro-choice movement cannot flourish if the mass of women it serves—that one in three—look on as if the struggle has nothing to do with them. Without the voices and support of millions of ordinary women behind them, providers and advocates can be too easily dismissed as ideologues out of touch with the American people.

Women aren’t the only ones who need to speak up. Where are the men grateful not to be forced into fatherhood? Where are the doctors who object to the way anti-abortion lawmakers are interfering with the practice of medicine?

On the issue of fetal-tissue research, we need to hear loud and clear from the scientific community. Anti-abortion activists are calling for a ban on this research, which ironically is used primarily to find treatments for sick babies. Will scientists let that happen?

Planned Parenthood is big. It estimates that one in five women have visited its clinics for health care. But the implications of the video sting, and the congressional scrutiny Planned Parenthood now faces, are even bigger. They’re about whether Americans will let anti-abortion extremists control the discourse and dictate the agenda around reproductive rights, medicine and scientific research. Silence, fear, shame, stigma. That’s what they’re counting on. Will enough of us come forward to win back the ground we’ve been losing?


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Regulating Abortion and Boating: A Modest Proposal by David A. Grimes 

"I Trust Women" bumper sticker from

The recent avalanche of state abortion regulations (for the sole purpose of improving safety) has had the desired salutary effect. Indeed, thanks to the Republican Party’s preoccupation with gynecology, the risk of death from abortion has over the past decade gone from one death per 100,000 procedures to one death per 100,000 procedures. (The challenge was considerable, since getting lower than one is tough.) After the bevy of new restrictions, abortion today is safer than an injection of penicillin (as it was before the new regulations). Emboldened by their dramatic success in improving abortion safety, Republican-led state legislatures should now direct their medical expertise to non-gynecologic public health threats.

Danger in an abortion clinic?

According to the Centers for Disease Control and Prevention, over the past decade the average number of deaths in the U.S. from legal abortion has been about 10 per year. Induced abortion and miscarriage remain the safest possible conclusions of pregnancy. In my home state of North Carolina, no abortion-related death has occurred in decades.

Danger on the high (and low) seas

In North Carolina, 16 persons have died in boating accidents in the first few months of 2015. In 2014, 26 persons died in boating accidents in the state. Most fell overboard and drowned, and most of these deaths could have been prevented had life jackets been worn.

Nationwide, 610 persons died in boating accidents in 2014, for a boating risk of death of 5.2 deaths per 100,000 registered boats. Many of these deaths were preventable. Among drownings for which information was available, 84 percent of victims were not wearing a life jacket.

Time for new laws!

As these federal statistics reveal, each year about 60 times more Americans die from boating than from abortion. While the risks are not directly comparable, having a boat is clearly more dangerous than having an abortion. Hence, more boating regulations are needed. Modeled after the highly successful abortion regulation blitz, the following is a tongue-in-cheek legislative agenda for the Republican Party.

Boaters’ Right to Know Act

Because of the dangers involved, women must receive state-mandated counseling about boating safety before launching. A script written by part-time politicians in the state capital will advise boaters of the risks, benefits, and alternatives of boating. The state-scripted counseling must include the following:

  • Boating causes long-lasting psychological distress related to leaving terra firma (dubbed the “post-nautical stress syndrome”).
  • Government-issued nautical charts are unreliable; the earth is indeed flat, and boats routinely fall off the edge.
  • Wearing a life jacket increases the risk of breast cancer from friction with the chest.

Crisis Boating Centers

State-mandated counseling will refer potential boaters to information centers sponsored by golfing organizations opposed to boating. Proceeds from state-sponsored license plates saying “Choose golf” will subsidize these centers, which provide both on-site and Internet information about boating.

Ultrasound requirement

All boats must have an ultrasound transducer (sonar). The boat operator must provide a narrated description of the contours of the bottom of the river, lake, or ocean to women passengers before launching.

Hospital proximity

Boats can only be operated on waters within 30 miles of a hospital in the rare event that hospitalization of a passenger or crew member is needed.

Mandatory waiting periods

Because women boaters are flighty and irresponsible, a mandatory waiting period is required. A three-day wait sounds about right. For example, if a woman decides after work on Friday to take her children fishing, she could receive the obligatory state counseling about risk and then cast off from the dock… on Monday evening. She has the entire weekend to reflect on whether fishing was a prudent plan for her family.


Only Coast Guard-licensed captains can operate boats (despite decades of evidence that such extensive training and experience are unnecessary).


Since ambulatory surgical centers are (incorrectly) thought to be safer than abortion clinics, similar upgrades are needed for boating:

  • Only Coast Guard-inspected vessels may be used for recreational boating.
  • Boats must be at least 40 feet long and 14 feet wide, with a canvas or hard top for sun protection.
  • All boats must be equipped with a chart plotter, autopilot and radar.
  • Only diesel engines are allowed, since this fuel is less flammable than gasoline used in outboard engines.


With state regulation of abortion coverage in health insurance as a model, states will determine which private insurance carriers can underwrite boat insurance policies. Insurance companies need legislative help.

Politics and public health

As Groucho Marx aptly noted, “Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies.”

Dr. David A. Grimes is the author of Every Third Woman in America: How Legal Abortion Transformed Our Nation. He is the former Chief of the Abortion Surveillance Branch at the Centers for Disease Control (CDC). Source: Huffington Post 05/27/2015. Follow David A. Grimes on Twitter:

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WHO expands list of recommended birth control options in order to save women’s lives by Al Jazeera Staff Reporters

Every year, 87 million women become pregnant unintentionally due to the underuse of modern methods of contraception.

Every year, 87 million women become pregnant unintentionally due to the underuse of modern methods of contraception.

The World Health Organization just added a series of long-acting, hormonal contraceptives to the list of globally recommended birth control methods, which will significantly reduce mothers’ risk of dying during childbirth, experts say. The WHO’s guidelines relax restrictions on the use of hormonal methods for breastfeeding women who are less than six weeks postpartum, according to researchers at the John Hopkins Bloomberg School of Public Health.

The guidelines are welcome in many poor countries, where the researchers hope policymakers and health industries will adopt the updated recommendations to battle high maternal death rates.

More than half of women in low- and middle-income countries (defined as nations with a gross national income less than $12,615 per capita) become pregnant within two years of a first birth, despite their desire to postpone pregnancy or not have another baby at all, according to a study in Contraception, a reproductive health journal. Pregnancies that occur within that interval are at higher risk of resulting in maternal, newborn or child death, according to the researchers.

Experts writing on ‘Global Health Now’, a blog affiliated with Johns Hopkins Bloomberg School of Public Health, called the move “bold” and “overdue” – one that increases women’s chances to access safe reproductive healthcare worldwide.

Every year, 87 million women become pregnant unintentionally due to the underuse of modern methods of contraception, according to a 2014 study in 35 low- and middle-income countries published in Human Reproduction, an Oxford University journal. An estimated 222 million girls and women who want to avoid another pregnancy are not using any method of contraception, according to the WHO.

While more than 92% of mothers do not wish to give birth again soon after a pregnancy, 61% of postpartum women in low- and middle-income countries do not use family planning methods, according to the Contraception study.

But at least half of these women give birth again within an interval that’s deemed unsafe to the mother’s health, according to the same study. Even when a mother is using contraceptives, the study found, she is relying on short-acting methods rather than long-acting ones such as implants.

Previously, medical practitioners were discouraged from prescribing hormonal birth control such as patches and implants to women who are less than six weeks postpartum. Many women rely on barrier methods, such as condoms, or believe that practicing breastfeeding prevents pregnancy, fueling many unwanted births that put mothers’ health at risk, according to the John Hopkins Bloomberg School of Public Health’s researchers.

“The support for postpartum family planning contained in the revised MEC [WHO recommendations] should usher in a wave of policy changes that make the FP2020 commitment an attainable goal rather than a lofty target,” the researchers added, referring to the Bill and Melinda Gates Foundation’s public health target of reaching 120 million more women and girls with voluntary family planning options.


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Thoughts on Pope Francis’ Laudato Si by Herman Daly

The big ideas of the encyclical are Creation care and justice, and the failure of our technocratic growth economy to provide either justice or care for Creation.

The big ideas of the encyclical are Creation care and justice, and the failure of our technocratic growth economy to provide either justice or care for Creation.

As a Protestant Christian my devotion to the Catholic Church has been rather minimal, based largely on respect for early church history, and for love of an aunt who was a nun. In recent times the Catholic Church’s opposition to birth control, plus the pedophile and cover-up scandals, further alienated me. Like many others I first viewed Pope Francis as perhaps a breath of fresh air, but little more. After reading his encyclical on environment and justice, dare I hope that what I considered merely “fresh air” could actually be the wind of Pentecost filling the Church anew with the Spirit? Maybe. At a minimum he has given us a more truthful, informed, and courageous analysis of the environmental and moral crisis than have our secular political leaders.

True, the important question of population was conspicuous by its near absence. In an earlier offhand remark, however, Francis said that Catholics don’t need to breed “like rabbits,” and pointed to the Church’s doctrine of responsible parenthood. Perhaps he will follow up on that in a future encyclical. In any case, most lay Catholics have for some time stopped listening to Popes on contraception. The popular attitude is expressed in a cartoon showing an Italian mamma wagging her finger at the Pontiff and saying, “You no playa da game; you no maka da rules.” Discussing population would not have changed realities, and would have aroused official opposition and distracted attention from the major points of the encyclical. So I will follow Francis’ politic example and put the population question aside, but with a reference to historian John T. Noonan, Jr.’s classic book, Contraception* which sorts out the history of doctrine on this issue.

The big ideas of the encyclical are Creation care and justice, and the failure of our technocratic growth economy to provide either justice or care for Creation. Also discussed was the integration of science and religion as necessary, though different, avenues to truth. And yes, the Pope supports the scientific consensus on the reality of climate change, but, media monomania to the contrary, the encyclical is about far more than that.

Francis’ voice is of course not the first to come from Christians in defense of Creation. In addition to his ancient namesake from Assisi, Francis also recognized Ecumenical Patriarch Bartholomew of the Eastern Orthodox Church, who has for two decades now been organizing conferences and speaking out in defense of rivers and oceans, including the Black Sea. The Orthodox Church lost a generation of believers to Communistic atheism, but is gaining back many young people attracted to the theology of Creation and the actions it inspires. Liberal mainline Protestant Christians, and more recently, conservative Evangelicals, have also found their ecological conscience. So Francis’ encyclical would seem to be a capstone that unifies the main divisions of Christianity on at least the fundamental recognition that we have a shamefully neglected duty to care for the Earth out of which we evolved, and to share the Earth’s life support more equitably with each other, with the future, and with other creatures. Many atheists also agree, while claiming that their agreement owes nothing to Judeo-Christian tradition.

This theology of Creation should not be confused with the evolution-denying, anti-science views of some Christian biblical literalists (confusingly called “Creationists” rather than “literalists”). Mankind’s duty to care for Creation, through which humans have evolved to reflect at least the faint image of their Creator, conflicts headlong with the current dominant idolatry of growthism and technological Gnosticism. Creation care is also incompatible with the big lie that sharing the Earth’s limited resources is unnecessary because economic growth will make us all rich. Francis calls this magical thinking. He skates fairly close to the idea of steady-state economics, of qualitative development without quantitative growth, although this concept is not specifically considered. Consider his paragraph 193:

“In any event, if in some cases sustainable development were to involve new forms of growth, then in other cases, given the insatiable and irresponsible growth produced over many decades, we need also to think of containing growth by setting some reasonable limits and even retracing our steps before it is too late. We know how unsustainable is the behaviour of those who constantly consume and destroy, while others are not yet able to live in a way worthy of their human dignity. That is why the time has come to accept degrowth in some parts of the world, in order to provide resources for other places to experience healthy growth.”

Laudato Si is already receiving both strong support and resistance. The resistance testifies to the radical nature of Francis’ renewal of the basic doctrine of the Earth and cosmos as God’s Creation. Pope Francis will be known by the enemies this encyclical makes for him, and these enemies may well be his strength. So far in the US they are not an impressive lot: the Heartland Institute, Jeb Bush, Senator James Inhofe, Rush Limbaugh, Rick Santorum, and others. Unfortunately they represent billions in special-interest money, and have a big corporate media megaphone. They believe in letting The Market set policy and behavior. The encyclical calls out the opponents and forces them to defend themselves. Neither The Market nor technology created us, or the Earth that sustains us. Thanks to Francis for making that very clear when so many are denying it, either explicitly or implicitly.

* John T. Noonan, Jr., Contraception: A History of its Treatment by the Catholic Theologians and Canonists, Belknap Press, 1986. Noonan demonstrates the lack of a biblical basis for opposition to contraception, as well as the origins of church doctrine in secular Roman law, which was absorbed into canon law. The ancient Roman meaning of “proletariat” was “the lowest class, poor and exempt from taxes, and useful to the republic mainly for the procreation of children.” Clearly contraception was not indicated for them, although tolerated for patricians. This literal meaning of proletariat as the prolific class was lost when Marx redefined the word to mean “non owners of the means of production.” But the Malthusian connection with overpopulation and cheap labor has remained real, even if downplayed by Marxists as well as Catholics.

Source: The Daly News, 23 Jun 2015. <;

Also see: <Pope>

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Westerners Don’t Appreciate How Amazing Contraception Is by Faustina Fynn-Nyame

Faustina Fynn-Nyame

Faustina Fynn-Nyame

When Alima was 15-years-old she travelled to the Ghanaian capital to work as a head porter in the market, planning to save money to buy household items for her marriage. But girls working in the market often end up sleeping rough. Some end up pregnant because they are raped or forced to exchange sex for somewhere warm to sleep.

Fortunately, Alima heard about our clinic from peer educators who we had trained to raise awareness in the market. She went for counselling with the nurse and decided to take up a method. Alima spoke to our team about what she could do. We made some suggestions, and in the end she chose a five-year implant. Instead of buying crockery with her savings, she decided to go home and enroll in school.

Working in clinics in Ghana and Kenya, I have seen the consequences when contraception is not available. I’ve seen women dying in childbirth, mutilating their bodies or risking their lives with backstreet abortions. In developed countries such as the UK, contraceptive use has plateaued between 60% and 80%. In east Africa, if current trends continue, it will take another 45 years to reach 60%. While in west Africa, where I am from, the same rates will not be achieved for 500 years. That’s the year 2515.

I believe that being able to choose if and when to have children is a basic human right. Economically, it makes sense; for every additional pound invested in contraception, the cost of pregnancy-related care is reduced by £1.47. In fact, just last year a leading economist associated with the Copenhagen Consensus Centre think tank rated investments in sexual and reproductive health as “phenomenal” and described family planning as “inexpensive with clear benefits”.

But you also cannot underestimate the significance of contraception in giving girls and women control over their lives and futures. When girls have the choice, like Alima, they have children later. This means they can finish their education, become financially independent and contribute to society. They can space their births further apart, which means healthier lives for them and their babies.

Women in Africa want contraception. While the west waffles on about providing aid for family planning, Africans are asking for it. I met one woman called Hawa in a remote village in Kenya who knew about contraception but was living far from a clinic. She hadn’t been able to use it and was struggling to feed her five children. She was very angry and felt her life could have been very different if only she had access to contraception. Women and men see the importance of making our own choices and determining our own future. It’s not the west telling us to do something.

In my jobs as country director for Marie Stopes in Kenya and Ghana, I have met amazing girls and women whose stories make my heart swell. Women like Miriam who, after having four children one after the other, was at risk of becoming homeless when her husband became too ill to support them. Then she met one of Marie Stopes’ community workers and decided to use a copper IUD to protect her for years to come. We were also able to put her in contact with a women’s microfinance company that helped her find the money to set up a kiosk selling tinned food, soft drinks and biscuits. She told me : “Now I am using contraception I am finally in control of my life. Instead of begging on the streets, I can go to work and look after myself, my husband and my children.”

Yet 225 million women around the world who don’t want to get pregnant are not using any form of contraception, with some areas much worse affected than others. As a result, every day, around 800 women are dying from preventable causes related to pregnancy and childbirth. When a mother dies her children’s best hope for survival dies with her.

As someone who has lived and worked in clinics from Brixton to Accra, the main difference I see is that women in the UK are empowered. They can take control of what happens to their body and what they want from their futures. In countries such as Ghana and Kenya that agency is not there. But the women in Kenya and Ghana are brave because they are challenging the status quo. I meet girls with hope in their eyes and ambition in their voices, who give me the sense things can really change. They are challenging what their mother and grandmother, religious leader and husband tells them. Their husband may not be happy about their choices, he may even beat her until she’s black and blue but they are determined to create real change.

Women in the UK have such an advantage and they don’t even know it. They are far more educated about contraception and can make more informed choices. We need to make sure that girls the world over have the same opportunities.


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