October 20, 1999
Putting Fertility First
By MARY ANN GLENDON
here 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
Mary Ann Glendon, a law professor at Harvard University, and Mary Haynes are writing a book on population control.