In Our Control (49 page)

The Road to Cairo: Feminism and the Transformation of International Family Planning

It wasn’t easy to be a woman in the population movement during those early decades. Adrienne Germain, a young graduate student who had moved to New York from California to be with her husband, applied to the Ford Foundation for a job doing research. She was well qualified for such a position, having been active in the Zero Population Growth movement during her years at Berkeley. Ford turned her down, noting that because she was married, she would most likely leave in a short space of time to have children. Two years later, after Germain had logged some important time with the Population Council, Ford reconsidered and offered her a job.

At the same time, an expatriate Englishwoman named Joan Dunlop endured five months of interviews to get a job working for John D. Rockefeller III. Rockefeller’s wife told Dunlop that she was delighted: “I’m very glad to see you here,” the older woman said. “I’ve wanted him to have a woman on his staff for many, many years, for a long time. But I want to say to you that you must tell him the truth. He’s not being told the truth.”
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The truths that women like Germain and Dunlop were being called on to tell were hard for many of the movement’s veterans to hear. First, international family planning groups had some serious image problems. Led nearly exclusively by Americans and Europeans, population control organizations were suspected in many parts of the world of being players in a larger colonial plan to prevent poorer nations from gaining power. In many cases, this was a difficult claim to dispute. Second, the sometimes well-meaning intentions of many in the movement were confounded by misplaced priorities. When it came to helping female patients, programs focused almost entirely on preventing births, ignoring other crucial aspects of women’s health. Particularly in populations where such clinics constituted the only available health care for many women, the fact that they would provide contraception, but not help with infertility, sexually transmitted infections, children’s health, and other serious problems seemed evidence of a lack of care for women’s total well-being and of an obsessive interest in controlling and limiting fertility at all costs. And
offering contraceptives with dubious health profiles, such as high-dose oral contraceptives and older IUDs, seemed like proof of disrespect for female lives.

What separated women like Germain and Dunlop from others in the population movement was their belief that the best way to achieve the goal of family limitation was through empowering women. They understood that instead of trying to force contraceptives down the throats of sometimes unwilling, often bewildered women, organizations should be working to provide women with options that extended beyond the home and childbed. If women were given greater knowledge of their bodies, better health care, and greater financial control over their lives, they would willingly
choose
to have smaller families. According to this way of seeing, overpopulation is evidence of women’s oppression, a sign that their rights are being undervalued. This combated the common perspective that overpopulation was a crisis of such proportions that the rights of individuals didn’t matter. As she set out to change people’s minds, Germain reckoned that there was a lot of work to be done in a field that frequently referred to women as “contraceptive acceptors” instead of people and that was headed by cavalier and often sexist leaders (one, Reimert Ravenholt of USAID, enraged an audience of feminists at a conference on abortion by suggesting that the proper anesthetic for a first trimester abortion was two martinis “because that’s the way she got pregnant in the first place”
¹⁰
).

In some ways, these women were gaming the system. While certainly concerned about population growth, Adrienne Germain had also realized early in her graduate work that the only health care monies reaching poor women were coming through population control channels. After six months in Peru, where Germain saw women beaten, raped by husbands, and subjected to botched abortions, she became convinced that getting resources to such women was necessary by any means. The only large-scale infrastructure for doing so at that time was family planning groups.

Shifting the focus from demographics to women’s rights and reproductive justice was an uphill battle, but Dunlop, Germain, and women like them had powerful friends. Foremost among them was John D. Rockefeller III, who laid out the new family planning agenda in his 1974 speech in Bucharest. At the same conference, activists from developing nations protested population programs arguing that “development was
the best contraceptive” and pointing out that “simply encouraging the use of birth control without taking any additional efforts to address problems with development was not a sufficient solution to the overpopulation problem.”
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The
New England Journal of Medicine
explains, “Western nations advocated the implementation of programs aimed at controlling the high rates of population growth then prevalent in resource-poor countries in Africa, Asia and Latin America. Most leaders from these countries, however, saw this as an inappropriate, imperialist goal … when the real problems were related to poverty.”
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Such critiques were similar to the feminist ones in that they spoke to a need to make international health care programs dynamic and to understand the problem of overpopulation as the product of complicated factors deserving of similarly sophisticated solutions. They were different in that they pointed away from women: If the real problem was development, then why throw money at female health? Wouldn’t it be better spent in economic initiatives? Such arguments appealed to conservative forces in the United States who were becoming increasingly wary of throwing government dollars into sexual health programs, particularly those that had any connection with abortion rights. Within a decade, many leaders in developing nations would change their minds, coming to the conclusion that indeed, high population growth was hindering economic progress, but by that time, representatives of the Reagan administration were using development arguments to try to defund and derail global women’s health programs.
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In 1981, Adrienne Germain put her precepts into practice, moving to Bangladesh to head the Ford Foundation’s office there. In addition to broadening health care funding away from the contraceptives-only model, she also worked to secure a huge grant for the Grameen Bank, a financial institution founded in part to increase the number of women participating in the financial system. Started at a time when women made up less than 1 percent of bank creditors, the Grameen Bank worked to extend resources to female clients. Muhammad Yunus, the Bangladeshi economist and Nobel Peace Prize–winner who created the bank, explains, “Once they have increased their incomes through self-employment, Grameen borrowers show remarkable determination to have fewer children, educate the ones they have, and participate actively in our democracy.”
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Even as women were transforming “population control” into “reproductive
rights,” controversy over abortion began to threaten their tenuous gains. For centuries, the distinction between contraception and abortion was semantic. Most women saw them as part of a common process, an effort to prevent a birth from happening. In the United States, the federal legalization of both birth control and pregnancy termination happened within ten years, although both had been gradually decriminalized
¹⁵
and eventually legalized in many states before becoming a part of national law. In 1965
Griswold v. Connecticut
made contraception legal everywhere in the United States. In 1973
Roe v. Wade
did the same thing for abortion. The relationship between the population control movement and the legalization of abortion in America is interactive: the effective activism of organizations such as Zero Population Growth convinced President Nixon to sign a program of contraceptive funding that included abortion with birth control as a population limitation strategy into law. Although Republican politicians and other conservatives would come to be associated with the anti-choice movement, in the 1970s there was nothing inconsistent in the president’s support of certain varieties of pregnancy termination. Historian Rickie Solinger explains that at that time, many “Republicans quite fervently supported legal abortion on a variety of grounds, from population control to women’s rights.” She adds, “Unquestionably, the population controllers helped cultivate the ground for
Roe v. Wade.
”
¹⁶

After
Roe
, everything changed. Solinger notes, “As long as abortion was illegal, Americans did not protest against the vast number of abortion procedures carried out in the United States each year.”
¹⁷
Although the estimated number of terminations performed in the United States each year remained consistent before and after legalization, the case marked a momentous change in the political significance of ending a pregnancy in America. Coming as it did amid the political and social upheaval of the 1960s and 1970s, abortion rights became a tangible symbol of women’s shifting social power. For those who were mourning the loss of a more traditional way of life or who were scared and uncomfortable with the many fundamental social changes in the second half of the twentieth century, abortion was a concise symbol of multiple grievances. For the first time, women in America had the legal right to reject motherhood—the social role that had historically defined them. For people who wanted to go back to the “way things were,” this was an ideal place to begin.

Politicians who were comfortable with a nameless, faceless woman in a third-world country terminating a pregnancy in the name of saving public dollars were much less at home with the process when it involved affluent American women claiming the right to undergo the procedure.

By the time that Ronald Reagan was elected, in part due to the fierce support of anti-choice forces in the religious right, growing domestic controversy over both abortion and feminism was about to go global. Reagan wanted to appease abortion foes, but also to stop spending massive amounts of money on women’s reproductive health abroad. In addition to hostility toward abortion, the new administration targeted contraceptive funding. In a nod to powerful Catholic groups, in 1984 the government gave a million-dollar grant to the Family of the Americas Foundation (FAF), a group promoting natural family planning. FAF used the money to promote the Billings method (which monitors changes in cervical fluids to prevent pregnancy) internationally. In the same year, another United Nations conference on population took place, this time in Mexico City. Held just days before the Republican National Convention, the conference provided the Reagan administration with the perfect theater for introducing its new anti-abortion strategies and proving its credibility on the issue.

The global gag rule was certainly one of the most enduring policies from this agenda. In a reversal of former strategies, it was announced that the United States would cease to offer USAID monies to any organization that promoted or offered abortions alongside other family planning strategies. This meant that organizations couldn’t council patients about pregnancy termination and couldn’t perform the procedure even if they were relying on separate funds to do so. So an organization like Planned Parenthood, which was receiving one fourth of its monies ($11 million each year) from USAID, suddenly lost a significant part of its budget.
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The policy is, to this day, a piece of political table tennis. When Bill Clinton came to office in 1993, he reversed the policy, and George W. Bush reinstated it in 2001.
¹⁹
Both presidents issued the change on the anniversary of
Roe v. Wade.
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The other important precedent set at the Mexico City conference was the threat to withdraw or freeze American contributions to UNFPA if it was found to be bankrolling abortion or coercive reproductive policies.
Two years later, claiming that the organization was supporting coercive Chinese abortion policies, the administration made good on their promise and blocked promised monies. Like the gag rule, the UNFPA freeze was undone by Clinton and reaffirmed by George W. Bush.
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The UNFPA had, unfortunately, made itself an easy target. Michelle Goldberg explains that while the organization didn’t agree with China’s one-child policy, it had provided computers for tallying birth statistics. They also gave the architect of the policy, Qian Xinzhong, its first population award. Qian shared the honor with Indira Gandhi, the Indian prime minister who had initiated a campaign of forced sterilization during a time of martial law in the mid-1970s. These choices—both the cowardly (failing to stand up for Chinese women) and the stupid (prioritizing population issues over human rights)—provided the pretext for stripping UNFPA of tens of millions of dollars in American contributions each year.

The various batterings and bruisings that the population movement underwent in the 1980s created enough instability to allow women like Adrienne Germain and Joan Dunlop to finally wrestle control. When Bill Clinton came to the White House in 1993, the stage was set for another important period of international family planning, this time led by women.

The Unfinished Agenda: Cairo and Beijing

If 1974 marked the beginning of the transformation from population control to reproductive rights, 1994 announced the completion of this change and a new ambitious agenda for the revamped movement. While Rockefeller’s 1974 speech sent shock waves through the domestic community, the effect of the UN International Conference on Population and Development in Cairo was felt around the world. The most important result was the official acknowledgment by 179 countries that reproductive rights are human rights. As Adrienne Germain and Jennifer Kidwell would reflect in 2005, ten years after the historic meeting, the groundbreaking consensus statement “also recognized that the most pressing international problems—poverty, hunger, disease, environmental degradation and political instability—can be solved only by securing women’s sexual and reproductive
health and rights.”
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The idea that providing health care and education to women was the key to alleviating world poverty was no longer a fringe notion; it had become dogma.