Family Planning, New Contraceptive Technology, and the Lives of Poor Women

In a recent New York Times op-ed piece, Nicholas D. Kristof outlined a number of novel contraception methods set to hit the United States and the developing world in the coming decade. Among them were an easily inserted vaginal ring that lasts one year, a small hormone-releasing skin implant, a reversible sterilization injection, and a “sperm cooking” male undergarment. Hailing the new technologies as tools for fighting global poverty, Kristof writes that the next generation of contraceptive products will be “cheaper, more effective and easier to use – they could be to today’s condoms and diaphragms what a smartphone is to the bricklike cellphones of 20 years ago.”

While this may be true, it is important to consider these advancements bearing in mind the ways in which subtle population control, or population “stabilization” ideology emphasizes reducing the fertility of women in developing nations as a means of slowing population growth, rather than broad reproductive healthcare with the goal of increasing women’s autonomy and access. One of the main tenants of population control philosophy is the idea that birth control can be “delivered” to Third World women in the absence of basic health care programs, with a stronger emphasis on preventing pregnancy than addressing health and safety concerns.

Hormonal contraceptives and the IUD, often presented as liberating technologies, also pose various risks which women in developing nations are often denied vital information about, even as they also tend not to receive consistent medical screening or follow-up care during use. Clinical trials of new contraceptive methods tend to take place in the Third World, where controlling or “stabilizing” population is seen as a key issue by many people in power. Kristof frequently utilizes the term “family planning,” but the prevailing model often places more emphasis on lowering birth rates in poor regions and communities than improving women’s health and expanding their control over reproduction. Some family planning programs in the Third World promote riskier methods of contraception such as hormonal technologies and sterilization over barrier methods, or don’t fully disclose potentially adverse effects to patients. Even the Pill is seen as ineffective by some programs because of the potential for “user failure” – based on an elitist assumption that certain women are incapable of remembering to take a pill each day.

Kristof points out that the new birth control ring is an improvement over the older, similar NuvaRing in that the woman herself can insert and remove it, giving her greater control over her reproductive health and safety if she notices adverse effects and knows to connect them to the device. The rings are also likely to be less expensive – $5 to $10 for one year of contraception – and last for a year, much longer than the NuvaRing’s month. As a hormonal method of contraception, the ring’s focus is on preventing pregnancy, not reducing the risk of contracting HIV, sexually transmitted infections or cancer-causing HPV, but Kristof reports that ongoing research is testing the rings with medication cocktails aimed at preventing these.

As technological strides are made in the world of contraception research, it is imperative that we consider who these advancements truly benefit, and look critically to their ability to expand reproductive freedom and comprehensive health care for poor women. A truly advantageous system of family planning is one which offers a wide array of both male and female contraception methods, safe abortion, full disclosure on benefits and risks, good screening and medical follow-up. Before we get excited about developments in contraceptive technology we must first take a stand against programs that sacrifice women’s health and safety in the name of lowering birthrates.

Senti Sojwal works with PopDev as a research and writing assistant. She is a second year student at Hampshire College where she is concentrating on creative writing and race and gender studies. A native New Yorker, Senti is a voracious lover of literature and hopes to someday travel the world in search of light and laughter.

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