Tuesday, April 13, 2010

Development is the best contraceptive

I've spoken of my suspicions of the population control arguments put forward in support of increasing use of hormonal birth control methods before. In response to the question of the Pill's potential side effects, it is often said that preventing women in developing countries having too many children overrides such concerns. This motivation translates into the myopic view of contraception in the Western world that is backed by a dogged desire to prevent unwanted pregnancy above all else.

As Laura Wershler said in a recent interview I conducted with her, and posted on the Bitch magazine site - unwanted pregnancy is the only acknowledged sign of health in young women.

Not Just Another Choice: Interview with Laura Wershler

As long as a young woman avoids unintended pregnancy, all is well. Although I'd suspected, and read a little, about how poverty has very little to do with population and a whole lot more to do with distribution of resources - I'd not quite got my head around the topic. So when I came across Betsy Hartmann's book Reproductive Rights and Wrongs: The Global Politics Of Population Control I was happy to see my unformed thoughts given some real substance.

She argues that it is not overpopulation that causes poverty, but a coupling of the subordination of women and the monopolization of too many resources by very few people. The belief that overpopulation is the source of the problem has what is described in this book as a 'boomerang' effect on developed countries attitude toward contraceptive research and distribution. The drive of reducing birth rates quickly and effectively dominates programs in developing countries, the US and across Europe. Health and safety concerns are swept aside in favour of high rates of success in preventing unwanted pregnancy. Hence the pushing of the Pill and now long-acting hormonal methods.

In developing countries women are oppressed - Hartmann thinks that if you reduce the system of patriachical power in a country, then you reduce the birth rate consequentially. If women are provided with support, opportunities to earn, independence and decision-making power then population can be stabilized. I've thought before how strange it was for feminists to bring out the population control argument in response to criticism of the Pill and whole-heartedly advocate the importance of preventing women in the Third World having children as it seemed to me to legitimise, or at least show an uncaring attitude toward, the unequal relationship between men and women in those countries. It seemed a bit to me like saying all American teenage girls should be put on the Pill because they might get raped by teenage boys, and preventing them having the resulting pregnancy is more important than dealing with the fact they're getting raped to such a degree that we need a blanket application of hormonal contraceptives.

If there is a high infant mortality rate then women will have more children with the knowledge that many of them may well die before they become adults. Women in poverty also need children to help them survive - to work, to take care of them as they grow older or if they become ill. I have never heard anyone suggest that these women may need, want or just plain have to have children and not want to use hormonal contraception to prevent this happening. Blaming their poverty and hunger on overpopulation allows for social injustice, allows for the oppression of women. So rattling out this argument, as many feminists did when I discussed this in terms of Depo Provera on my Bitch blog, is actually allowing for the oppression of women, and assuming their oppression in an inevitability.

The Rebranding of Birth Control

Hartmann calls population control a 'substitute' for social justice that holds back the emancipation of women. This is interesting to me, as I have said before the Pill could be seen as a substitute for real change in the Western world - changing women as it did, rather than changing society. The Pill only helped women to be assimilated into the male-created, masculinized social structure and allowed for the continued development of the consumer economy. It usefully blotted out long-held, and still held, concerns about women's bodies and reproductive abilities. It didn't address real issues between men and women, but compounded in a way their alienation from each other in order to progress a capitalistic society. I've wound around this all previously. It's like how sexual freedom is now used to show how free and independent women are, and is focussed on above all other areas of women's lives - as Ariel Levy talks about in Female Chauvanist Pigs or Natasha Walter in her new book Living Dolls - except without the Pill part of the discussion.

The Malthusian outlook that backs the population control argument denies that the rich play any part at all in keeping the poor, poor. Basically, it is just thought that the poor should stop being born. But there is no evidence to show population density causes a lack of resources and poverty. Hartmann points out that corporations that own much land in developing countries do push populations into unsuitable areas for farming and living in order to take advantage of better areas and make a profit. Plus governments in developing countries have different priorities to what they should, preventing change.

The emphasis on the most effective methods of contraception and not the safest or best for individual women that is produced by population control programs ensures that many women, once put on hormonal contraception, will experience side effects and soon stop taking the Pill or returning for their injection. If one woman has an adverse experience she will tell many more. Women in developing countries do not get told what to expect - then again, neither do most women in developed countries - and so when they experience problems they will just stop using that method. The inserts in Pill packets contain far less, and often no, information.

The linking argument here that is frequently used both for population control purposes and here in the US and Europe is that hormonal birth control is much less risky to a woman's health than pregnancy - an argument that has a lot of holes - but Hartmann suggests that the Pill and long-acting methods could cause far more health problems for women in the Third World. If a woman has low body weight, poor nutrition, poor sanitation and is not given any health screening prior to being put on the Pill she is far more likely to suffer side effects. In fact, considering how the Pill impacts on the metabolic system, preventing proper absorption of vitamins and promoting vitamin deficiency - this drug could actually be directly weakining women further and preventing them more so from having healthy children. Depo Provera, Hartmann notes, can cause continuous bleeding for some women - and women living in poverty cannot afford to loose the blood or the iron it contains.

In conclusion she argues that, as I have, the dominance of hormonal methods of contraception prevents the development of other methods and research into improvements or even new possibilities. Barrier methods are rarely improved upon and barely advertised in the US and Europe. I had much discussion at Bitch regarding negative attitudes towards condoms. Attitudes that could be turned around if the material used to make condoms was developed to produce a better feel and experience. I notice at my current cashiering day job people mostly buy novelty-type condoms with design additions supposed to improve the experience, so the market is there for a wholesale upgrade. Barrier methods are not considered for third world countries as a viable, effective option because it is understood that women would need the cooperation of men and with developing countries male/female relations as they are this would be difficult. Rather than addressing the root - that the oppression of women prevents the use of barrier methods - and therefore, importantly, increases the spread of HIV - it is thought better to push the Pill and injection on them.

Hartmann believes real reproductive choice relies on women having control over their lives and equal power to men.

I have just found out she is a professor at Hampshire College in Massachusetts, a school right near Mt Holyoke, where I studied for a year. Mt Holyoke is an all-girls place, and very political. At the time I took a lot of fun in sending up and skewering the feminist-like activism that went on and wrote essays about the plight of the American male as seen in Michael Douglas movies and Jackass. I guess all that influence filtered through over time, or fermented, or something, and here I am now writing this.

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