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Family Planning, a Gender-just Solution to Promote Planetary Health

By Sabine Baunach

Ever year on 11th July we celebrate world population day. Looking at figures and global trends of the world population in the Anthropocene I don’t feel like celebrating. Globally, population growth is one of the main drivers in a complex planetary system effecting human health, climate change and biodiversity.

Since 1950, human population has increased almost 200%; fossil fuel consumption by over 500%; atmospheric carbon dioxide levels by about 24%, nearly 50% of temperate and tropical forests have been cleared, we use nearly half of accessible freshwater every year and half of the planet’s surface to feed ourselves. What is called the Great Acceleration defines an era in which human action is pushing hard against the planetary boundaries, such as land degradation, ocean acidification, climate change- a ticking time bomb!

There are currently more than seven and a half billion people on Earth, with the UN projecting that number will hit 10 billion by 2056. Just in terms of food production, this is more than three times the human load considered sustainable. Unprecedented anthropogenic land-use change and carbon hungry economies in the developed world are driving growing climate emergencies globally. However, it is the Global South that suffers the most. On average, carbon emissions per capita in the developed world are about five times those in developing countries. But negative contributions of developing countries have been growing recently. Between 1980 and 2006, per capita carbon emissions declined slightly in developed countries (or have been exported), but they doubled in developing countries as a group, and nearly tripled in China. Some reports state that India's greenhouse gas emissions will more than triple over the next two decades.

Don’t get me wrong. This blog is not influenced by a radical antinatalist opinion.

The solution cannot be to eradicate humanity or forcing Chinese-style One-Child-Policies on ever nation on the planet. Rather, we need to find a balanced way of living on this “shared home” in tune with nature and other species, if we don’t want to destroy the Earth system and with it our every own existence.

So let us take a look at contraception, which I consider a gender-just solution to improve health, well-being and address all sustainable development goals. Globally, more than 200 million women and girls do not have access to contraceptive services or even information on how to prevent, delay or stop childbearing despite. Experts call this unmet need for contraception, meaning these women want children by choice (voluntarily!), but don’t have access to contraception. A problem, existing mainly in the Global South, resulting in high fertility rates, high maternal and child mortality rates, poverty and hunger; 200 Million women! I wonder if they are in the mood for celebration world population day while being stigmatized for a teenage pregnancy, are expecting a child following rape or in the mid of a war zone, during displacement or are facing life threatening complication due to a maternal medical condition.

All these are very good reasons to make contraceptive services universally accessible. The list is much longer; the individual reasons are personal. However, the decisions and policies to provide contraceptive services are very political and often the result of conservative societies dominated by gender inequity and inequality.

Regardless of the location, contextual circumstances, age or socio-economic status of a woman, contraception along with other sexual and reproductive health services are a human right, a right to sexual health. To make this very clear: It is each and every woman’s right to decide on her own body, conceive the number of children she desires and have children by choice, or not to have any at all. There is no controversy, period! But in too many places around the world this right is not granted to us women.

Often, I wonder what our world would look like if men would be the ones conceiving and delivering our babies. Would they want to have access to contraception?

But as a matter of fact, it is us women in charge of reproduction, and it is us women lacking the power to decide for themselves and do not sit at the table when policies are made. The evidence base is clear: Healthy timing and spacing of birth improve health outcomes for mothers and babies. In fact, they are lifesaving health interventions that should be available everywhere to avoid unplanned pregnancies, resulting complications and unsafe abortion that lead to ill-health, suffering and death. Having the power to choose when and how many children to have gives women the opportunity to improve their own lives and the lives of their children, e.g. finishing her own education to improve a socio-economic status, send kids to school, assure family health and nutrition, etc. At national level the use of effective contraception could reduce unintended pregnancy and public health care costs.

For example, if all women in the U.S. had access to effective contraception $12 billion in public health care costs could be saved each year.

Contraception is a mean to female empowerment helping women to unlock their potential and build a meaningful future. But despite the ecological collapse within sight, parenting is still viewed as a moral imperative. In recent years awareness has been rising to integrate family planning into holistic approaches to address the planetary emergency. Research suggest that one of the high impact actions by individuals to fight climate crisis is to reduce family size by one child equating to a reduction of 58t of CO2 for each year of a parent’s life.

Individuals but also organizations (e.g. Population Matters) promote the ecological advantages of smaller family sizes. As Sir David Attenborough states: ‘All our environmental problems become easier to solve with fewer people, and harder- and ultimately impossible- to solve with ever more people’. NGOs like Blue Venture or Population Matter recognize inextricable links between poor health, unmet family planning needs, food insecurity, environmental degradation and vulnerability to climate change and promoting planetary health concepts targeting the unmet need for family planning and the negative consequences of human population growth. As Project Drowdown states: when levels of education rise (in particular for girls and young women), access to reproductive healthcare improves, and women’s political, social, and economic empowerment expand, fertility typically falls. Across the world and over time, this impacts population.

To sum it up, contraception is a human right, it is a tool to empower women, to support us to self-determine our life, speak up, sit at the table when decisions are made and address the planetary emergency to build a better future for us and our children. Contraception has to be made available and accessible to each and every woman to allow her to have children by choice, not by chance! This will certainly promote planetary health.

About the author: Dr. Sabine Baunach is a senior associate at the Women Leaders for Planetary Health. She is an International Health Expert for Sexual and Reproductive Health and Rights and Planetary Health experienced in technical assistance, strategy and policy development, training and designing and implementing health programs in international aid. 

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