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Jodi Jacobson

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In Absurd Move, Canada Drops Family Planning from Maternal Health Plan

Posted: 03/17/10 06:00 PM ET

In an act that appears to reflect a global epidemic of political absurdity, aversion to evidence, and "un-reality" show searches for "common ground" efforts that do not address the core problems we face, the Canadian government has decided to exclude support for contraceptive programs, supplies, and information from its initiative to save the lives and improve the health of mothers in poor countries.

There's only one small problem: You can't "save the lives and improve the health of mothers" without family planning.

The Globe and Mail reports today that "in no uncertain terms, Foreign Minister Lawrence Cannon yesterday ruled out any kind of family-planning programs being included in Canada's "signature" initiative at June's G8 summit -- a strategy to improve the health of mothers and young children in poor countries."

The Conservative government has offered an explanation for why it will exclude contraception from its initiative to improve the health of mothers in poor countries: Birth control doesn't fit with saving lives.

"It does not deal in any way, shape or form with family planning. Indeed, the purpose of this is to be able to save lives," Mr. Cannon told the Foreign Affairs committee.

Really?  Are they kidding?

Nearly 600,000 women die each year worldwide from complications related to pregnancy, labor, childbirth, and unsafe abortion. Many times that number suffer illness and disability from unresolved complications, like prolapsed uterus, vaginal tearing, infection or uterine scarring from self-induced abortion. Many of these problems are caused by too many pregnancies, too close together, or occurring too early in a girl's life or too late in a woman's reproductive life. Family planning is the key preventive intervention in a broader effort to reduce maternal illness and death. Programs to reduce maternal mortality and morbidity that do not include family planning will therefore be as effective as plans to reduce motor vehicle mortality by abolishing seat belts, to reduce diabetes by force-feeding corn syrup to diabetics, and reduce dental decay by forbidding the sale of toothpaste.

Such programs will be about as successful in reducing maternal deaths--the leading cause of death among poor women ages 15 to 49 in most countries worldwide--as the no-condoms-for-youth policies and the abstinence-only-until-marriage programs of the Bush administration were in stopping the spread of HIV among women and girls in Africa.  Which is to say: A stupendous failure.

The Globe and Mail reports that "maternal-health advocates worry that the government's desire to steer clear of the abortion issue - and therefore not upset part of its political base - is also pushing it to rule out all other family-planning programs, like distributing contraceptives."

"This is really playing to the base in tractor-loads rather than with shovels," Katherine McDonald, executive director of Action Canada for Population and Development, told the Globe and Mail.

She argues that no maternal-health policy can be effective without providing ways for women to space out pregnancies, because many childbirth deaths are caused by complications from having too many pregnancies too quickly or from unsafe abortions.

Yet, conservatives in Canada as elsewhere, appear unable to face the fact that women are people who engage in sexual activity; that pregnancy often results from said activity; and that milions of women today throughout the world experience unintended and unwanted pregnancies--and consequently have more children than they desire--due to lack of real and consistent access to the most basic contraceptive information and supplies.

They likewise appear unable to understand that due to early marriage, lack of economic alternatives, social pressure, high rates of gender-based violence or all of the above, women may have little control over whether, when and to whom they get married and whether, when and with whom they have sex; that millions of these women worry endlessly about how they will care for existing children and families and how to avoid another pregnancy; and that those same women name access to basic contraceptive supplies and family planning programs as an urgent priority.  Their priority.

Moreover, even in the best of marital or partnership situations, women and couples want to plan their families....or Canada itself would have a far higher total fertility rate than it does today.

Finally, conservatives--and increasingly it appears some international women's groups and some liberals cowed by the ultra-right's obsession with controlling women's lives and sex and reproduction--also clearly are unable to face the reality that in response to unintended and unwanted pregnancy, women turn to abortion.  Some 75,000 women die each year and many times that number face disabling health consequences as a result of unsafe abortion, in their desperation not to bear yet another child for which they can not care and which they can not feed.

By reducing unintended pregnancies, basic family planning programs allow women to take control of some aspect of their lives, to plan ahead, and to care for their families.  Such programs are proven to save lives.  By preventing and reducing the number of unintended pregnancies, contraceptives reduce the need for abortion.  They allow women to space pregnancies.  They enable women with conditions like vesico-vaginal fistula, high blood pressure, uterine prolapse and other dangerous conditions to avoid high-risk pregnancies.  They save the lives of women.

They also save the lives of children. In high ferility socieities, voluntary family planning programs increase infant birthweight, and reduce neo-natal and infant mortality.  Moreover, because children ages 0 to 5 are more likely to die if their mothers have died, reducing maternal mortality through family planning has enormous impacts on the health and survival of families.

It is true without question that women also need access to trained birth attendants, to good pre- and post-natal care, to good nutrition and to emergency obstetric care.  And yes, to safe abortion services, without which again addressing maternal mortality is futile. But contrary to the new common ground fad, these are not part of a buffet plan where you pick and choose what is important, just as an internist doesn't decide he or she will take blood pressure but doesn't like doing EKGs. They are part of a continuum that starts with enabling women to choose whether and when to be pregnant in the first place, and that starts with family planning information and supplies.

To hear that the Canadian government now can say with a straight face that family planning programs are not part of a program of "saving lives" of women and infants is so absurd that I am at a complete loss of confidence about rational thinking in the world today, leading me to ask how Canadians voted the current government into power.  But then of course, I have to remind myself I live in the United States, the center of the anti-choice, anti-fact universe and that U.S. politicians now in or running for office actually brag about their efforts to strip women of all their rights.

Canada has already taken such steps by denying funding to the very organizations that reach the greatest number of poor women:

The International Planned Parenthood Federation used to receive funding from the Canadian International Development Agency, but its nine-month-old request for a renewal of its $6-million-a-year grant has so far gone unanswered and funding stopped in December.

Folks...we have a pack of elephants in our collective living room.  One is called sex, the other is called power, the third is called reproduction. These elephants have been trying to tell us--indeed they have been virtually screaming--for some time that if we don't pay attention to both the immediate needs of women for access to contraception, HIV prevention (and the two go hand-in-hand), unwanted pregnancy, healthy wanted pregnancies, and safe abortion services, we are not dealing in reality.  We will not solve the maternal health crisis. And, if we are more concerned with our pseudo-anti-fact reality, or our conservative base, or our own re-election, or all of the above, then we are ignoring reality, and we are in turn responsible for, in so many words, telling women to go jump off a cliff. 

Let's not pretend otherwise through statements that not only evade the truth, but instead foster lies.

If you are not willing to address these issues, you don't care about women and girls and maternal illness and death.  You are instead using this issue for your own political gain.  I know is not "politic" to say but it really is as simple as that.  And it is a "dying" shame.

 

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