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Peter J. Donaldson

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A Mother's Day Gift

Posted: 05/08/2012 2:25 pm

More than 360,000 women will give birth this Mother's Day -- 90 percent of them in developing countries. One thousand of these women will die while becoming mothers. Nearly 300 of them didn't plan or want to be pregnant, yet they will lose their lives. In early April, Melinda Gates demonstrated her commitment to these women in a remarkable, heartfelt but little-noticed speech delivered at a TEDxChange conference in Berlin.

Melinda argued that greater use of family planning could save women's lives and advance their own and their children's health. Her message was simple: Trust women to decide on the number and spacing of their children -- as she and Bill had -- and give them the means to do so. Melinda used her speech to launch a major Gates Foundation initiative to promote family planning in developing countries, providing a Mother's Day gift to poor women throughout the developing world.

Melinda's speech was an effective argument for the benefits of family planning. She discussed the epidemiology of pregnancy and childbirth in poor countries and described how the global trends are reflected in the lives of individual women and their partners. She noted that more than 200 million women who want to prevent pregnancy lack access to modern contraception. If this need were met, 23 million unintended pregnancies, more than 140,000 maternal deaths, and more than a million infant deaths could be prevented every year. Averting these pregnancies and the mortality associated with them would also bring substantial health and economic benefits. Melinda concluded that when women have access to family planning, everyone wins. Women and children are healthier; and families and communities can invest more in education and health care.


Melinda's speech and the Gates Foundation's commitment to strengthening family planning programs in developing countries are very welcome. For at least the past 20 years, family planning has occupied a back seat on the global development agenda. Economists had decided that high fertility and maternal mortality were not significant barriers to economic advancement, and women's health advocates had become deeply suspicious of government-sponsored family planning because of coercive programs in China and India. As a consequence, support for family planning declined, while funding for HIV prevention and treatment and for a host of other programs increased, especially in Africa where family planning's life-saving potential could have the greatest impact.

Of course, more than modern contraceptives are needed to make motherhood safer. We must pursue long-term strategies that raise the status of women and strengthen national health infrastructure. But while doing this, we can ensure that more women have the tools to plan their families. A recently completed Population Council project in Pakistan illustrates how much can be done to increased contraceptive use, improve health, and respect human rights even in difficult circumstances.

Today, less than 20 percent of the women in Pakistan use a modern contraceptive method. Just 16 percent of the poorest women give birth assisted by a skilled attendant. Infant mortality is among the highest in Asia -- second only to Afghanistan. In the past, family planning was promoted as a way to control fertility and lower population growth. But the Population Council, funded by the U.S. Agency for International Development, and assisted by Pakistani and international partners, promoted family planning as a means of ensuring healthy birth spacing to protect women and infants. The Falah or "prosperity" project changed the way people thought about family planning. In less than four years, contraceptive use increased dramatically -- by an average of nine percentage points -- in 14 districts across Pakistan. The greatest increase occurred among those with the most need: poor, rural, and young couples.

The experience in Pakistan is not unique. Similar transitions have taken place in other countries from Bangladesh to Colombia and Ethiopia when high-quality family services were made easily available. When women have access to family planning, they can space their pregnancies at healthier intervals. They have fewer children. There are fewer unsafe abortions. And maternal and infant death rates decline.

So this Mother's Day, visit your mother, send a card, thank her for her favors, and forgive her faults. But in addition, honor your mother by doing something for mothers less fortunate than your own. Make Melinda's priority your own. Make a contribution to one of the groups that work to expand access to family planning around the world. Write your members of Congress urging more funds for family planning foreign assistance; demand they pay more attention to the needs of poor women. Tell them that family planning saves lives.

This post has been updated from a previously published version.

 
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