October 20, 1999

Putting Fertility First


There are now six billion people on the planet, we are told, and many characterize humanity's arrival at this milestone as a catastrophe. Family-planning activists responded to it with calls for more financing to address the "unmet needs" of hundreds of millions of women.

According to many of these groups, supplying contraception to third world women will provide the key to reducing the rate of growth. Yet the population controllers' central premise -- the malleable concept of "unmet need" -- is fundamentally flawed, and their estimates of 150 million to 500 million women of reproductive age who do not immediately desire another child are wildly off base.

In much of the third world, contraceptives are readily accessible, yet fertility rates remain high. According to the United Nations family planning agency's 1999 report, 99 percent of Costa Rica's population has access to contraception, along with 96 percent of Haiti's, 93 percent of Zimbabwe's and 89 percent of Peru's. Yet all of these countries have fertility rates well above the level needed to replace those who die. In the early 1990's, demographic surveys in Kenya revealed that at least 90 percent of the population knew where to obtain contraceptives, but only one-third of the population chose to use them.

Donald Warwick noted in his 1982 book "Bitter Pills" that administrators of family planning programs in developing countries were often satisfied if 10 percent of the eligible population accepted the help during the first year; they were delighted with a rate of 20 percent.

Even when contraceptives are used, there appears to be only a loose correlation with overall fertility. In 1989, World Bank estimates indicated that 56 percent of Japanese women used modern contraceptives and that the total fertility rate for Japan was 1.5 births per woman. Meanwhile, in Turkey, contraceptive use was 63 percent but total fertility was estimated at 3.4.

The key to understanding these statistics lies in something that population controllers have long ignored: the desires of parents for large families. In a 1994 study published in Population and Development Review, Lant Pritchett, a senior World Bank economist, and Lawrence Summers, then director of research at the World Bank (and now Treasury Secretary), found that women's preferences about the numbers of children they will have account for up to 90 percent of differences in fertility across countries.

In many countries, helping parents achieve their desired family size would result in higher birth rates.

For better or worse, the status of women in many societies still rests on their success in childbearing. In Zimbabwe, the larger number of children a woman has, the higher the status she enjoys. In Nigeria, traditional celebrations are held for a woman on the birth of her 10th child. Among the semi-nomadic Pokot tribe in western Kenya, women with many children are honored after death with ritual burial, while the bodies of barren women are left out for the hyenas and vultures. In India, there have been reports of wives burned to death when they failed to produce sons.

If fertility levels in developing countries rest first and foremost on the number of children desired by parents, then the population control movement faces a wrenching dilemma. Purely voluntary programs will do little to reduce fertility; only those population programs that override parental preferences through bribes, bullying, threats or outright coercion will lower birth rates significantly.

The six billionth human being has arrived, and population controllers must decide whether their desired end -- reducing fertility in the third world -- justifies the coercion that would be required.

Mary Ann Glendon, a law professor at Harvard University, and Mary Haynes are writing a book on population control.

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