Leslie on the Life-Changing Value of Contraception to the World's Poorest Women

THIS past Thursday, I “live tweeted” highlights from London’s Family Planning Summit, a joint enterprise of the Gates Foundation and the British government.

The best of the summit was rolled out for a Sydney conference room crowded with men and women whose tireless advocacy for family planning services in the developing world led to what all agree is a pivotal moment in international development.

That moment was sparked by the Bill and Melinda Gates Foundation pledge of $550 million to increase contraceptive access in the developing world. The investment will prevent 100 million unintended pregnancies, and 200 million maternal deaths from unsafe abortion and unsafe motherhood. Among those saved will be girls aged 15 to 19, for whom pregnancy is the biggest killer.

All of this is consistent with the mantra that women’s rights are human rights. Help a man, and he benefits. Aid a woman, and she will lift her children, her family and her community out of poverty. But only if she has access to birth control.

The story of Judith, a mother from Papua New Guinea, is typical. With three healthy children at school, Judith works a vegie patch – and her husband fishes – to support the family. In contrast, Judith’s neighbour suffers ill health from having 10 children close together, preventing her from working outside the home, and putting school fees out of reach.

The key difference between the two women is that Judith was only 25 when a mobile family planning clinic came to town and fitted her with an IUD – an intervention that came too late for her neighbour.

The influence of feminist ideals on the Gates Foundation is undeniable. Ditto for the governments and NGOs that, by the summit’s end, had brought the tally of what is claimed to be new financial commitments to international family planning efforts to a whopping $2030 million.

Brochures distributed at the breakfast waxed lyrical about female empowerment, female education and female earning power. Gates defends her dissent from the Vatican’s stance on modern contraception by affirming that women’s lives matter: ‘'I believe in not letting women die … we need to give a voice to women all over the planet. This will be my life’s work.’'

Great stuff, though it did make some of the tweets in response to my comments so odd. ‘'What about the millions of girls that will be killed instead through abortion?’‘ complained one follower. Offered another: ’‘But not if you continue to support the silent elimination of girls through abortion.’'

First, it’s important to realise that the Gates initiative is focused on preventing pregnancy through contraception, not ending it by abortion. Of course abortion comes up in discussions of family planning – mainly because reducing the rate of unplanned pregnancies is the most effective way to reduce the incidence of abortion – but surely those opposed to abortion can’t object to fewer of them?

Perhaps my tweeters have been infected by long-standing misinformation from the church about how modern and effective forms of contraception work. For years, some have wrongly claimed that the so-called ‘'morning-after pill’‘ prevents pregnancy by causing very early abortions. In fact, emergency contraception blocks fertilisation and so has nothing to do with abortion. We now know this is also true for daily oral contraception – which the church also opposes.

But even if the Gates initiative were about providing safe abortion, the ‘'loss of future’‘ women argument would fail. The World Health Organisation says that even if couples contracepted perfectly 100 per cent of the time, coerced sex and imperfect contraceptive technology mean there would still be 6 million accidental pregnancies every year.

The tweeters seem to be saying that a feminist response to that reality is to force couples to continue an unwanted pregnancy to protect the rights of an embryo that has only a 50 per cent chance – should it survive to birth – of being female.

In contrast, they see no gender equity issue arising with the state stripping half its actual female population of basic human rights to medical privacy and bodily autonomy, as well as the ability to fulfil maternal responsibilities to existing children, around half of whom are known to be female. The influence of conservative traditions and religions remains a key impediment to women’s empowerment and their very survival.

But the Gates initiative is a game changer. In 1994 in Cairo, the whole world agreed that family planning was a human right. Now, money where mouth is, the lives of the poorest women and girls around the globe may finally be set to change.

Publication history

Opening the Gates to a Better Deal for Women  The Age (Melbourne)