Contraception as a Global Issue

Worldwide contraceptive use has increased dramatically in the last several decades: An estimated 63% of partnered women of reproductive age practice contraception. Unfortunately, the use of modern contraceptives by the poorest of the world’s poor in developing countries remains low. For example, only 6% of married women in Nigeria, compared to more than 70% in the United States and China, use birth control. About 215 million women across the globe are not using effective contraception (Reading,

2012) . Tragically, millions of women and couples around the world are unable to exer­cise their right to decide freely and responsibly whether and when to have children. Each year in sub-Saharan Africa, South Central Asia, and Southeast Asia, 49 million married and unmarried women have unintended pregnancies (Darroch et al., 2011). Further, in these countries, a woman’s chance of dying from complications of preg­nancy, childbirth, and abortion averages 1 in 65. Africa’s poorest nation, Sierra Leone, has the worst rate: 1 in 8 mothers there dies in childbirth. In contrast, women in the United States have a 1 in 4,800 chance of suffering the same fate (Anghelescu, 2008b).

For many years, the United States has contributed less of its gross national income than European countries to help fund international contraceptive and reproductive health services (Barot, 2009). However, following President Obama’s election in 2008, his administration expanded funding and the scope of services supported by the United States by 40% from the level a year earlier at the end of the Bush administration (Cohen, 2010). Services expanded to include comprehensive contraceptive and sex education instead of abstinence-only programs, including a crucial shift to a broader view encom­passing the impact of poverty, the rights of individuals, and gender equality, with an emphasis on the interaction between these issues (Fritz & Speroff, 2010).

Making contraceptives available to the men and women throughout the world who desire to use them will enhance the quality of their lives and help alleviate overpopulation. At the end of the 20th century, worldwide population stood at 6.5 billion, compared with less than half that number—2.3 billion—in 1950. The United Nations projects an increase to 8.9 billion by 2050. Of that growth, 95% is expected to occur in poorer, developing countries whose populations already exceed the availability of bare necessities: housing, food, and fuel. When impoverished families have many children, they cannot secure adequate food, health care, and education for each child. Moreover, overpopulation (and overconsumption of the world’s resources by developed countries) poses a dire threat to the earth’s environment.

An essential factor in controlling population levels is to expand women’s access to education and economic opportu­nity (Douglas, 2006). Throughout the world, women with higher levels of education have fewer children and are more likely to use contraception (Saleem & Pasha, 2008).

Although the vast majority of U. S. citizens have a favorable view of modern birth control methods, much of the pro-life religious right opposes all contraceptive methods. anti­contraception religious groups do not see contraceptives as a means of preventing abortion. Rather, they believe that birth control itself is abortion or a gateway to abortion. "abortion will never end as long as society accepts the use of contraception" (American Life League, 2011a, p. 1). Far-right politicians and groups have attempted to estab­lish "personhood" amendments in the state constitutions of Colorado and Mississippi. These amendments define a "person" as every human being from the moment of fertilization. Under such amendments it could be possible to make some con­traceptives illegal (Khan, 2011;

Sheppard, 2011).

False claims about how methods work appear to be a thin veneer on pro-lifers’ over­all opposition to birth control.

Even methods like condoms, spermicides, and diaphragms that prevent the egg and sperm from reaching one another are believed to offend God because they prevent the conception of a human being: "[A]ny act of sex­ual intercourse must occur within marriage and be open to. . . procreative purposes" (Ameri­can Life League, 2004, p. 3). In spite of the enormous personal and public health benefits of condoms, anti-contraception abstinence-only groups — including Pro-Life America,

United for Life, Physicians for Life, American Life League, and the Vatican — have been engaged in a well-financed anti-contraception campaign. Many individuals and groups who oppose contraceptive use embrace the traditional role of women staying at home and raising children as an ideal. Therefore, they view access to contraception, with its potential to help women expand their roles beyond obliga­tory reproduction into traditional male realms of work and politics, as a threat that they must combat (Quindlen, 2005; Scheidler, 2006).

The political influence of anti-contraception groups increased during the administration of George W. Bush. Bush
appointed anti-birth control individuals to key reproductive health, judicial, and scientific positions in the government, and in attempting to achieve the goals of his far-right sup­porters, his administration implemented many restrictive policies and laws concerning reproductive health (Tummino,

2006) . For example, anti-contraception forces succeeded in reducing federal and state funding for contraceptive services (Stevens, 2008). By 2006, funding for community clinics that provide free or affordable birth control had declined

significantly, leaving several million low-income women without access to contraception, in spite of the fact that 73% of Americans believe that access to birth control should not be limited by inability to pay for it (Har­ris Poll, 2006).

During the recent economic downturn, federally funded family planning and Planned Parent­hood clinics have experienced an increased demand for services due to the increase in uninsured clients and a decrease in clients who are able to pay the full fee (National Campaign, 2011). Beginning in 2009, funding for public family planning services increased under the Obama administration as part of its "abortion reduction" strat­egy (Gold et al., 2009). Increased federal funding for contracep­tive services did decrease rates of unplanned pregnancies (Kost et al., 2012). However, since then antichoice activists and politicians have attempted to block federal funding for contraceptive services. This effort failed on the federal level, but several state legislatures passed laws that severely limited or com­pletely eliminated funding for family planning and Planned Parenthood clinics, which has resulted in increased rates of unintended pregnancies (Ertelt, 2011; Gibbons, 2011; Kost et al., 2012; Simon, 2012). The sex-negative motivation behind these kinds of activism was expressed by Rick Santorum during his bid to become the 2012 Republican presidential candidate (Bettelheim, 2012; Volsky, 2011). He pledged to repeal all federal funding for contraception, claiming that birth control devalues sexual union: "It’s a license to do things in a sexual realm that is counter to how things are supposed to be" (Begala, 2012).