The Means of Reproduction: Sex, Power, and the Future of the World (12 page)

“It is hardly a secret that Nixon is making an all-out effort this year to capture the normally Democratic Catholic vote,” wrote
Chicago Tribune
columnist Clayton Fritchey.
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Indeed, after rejecting his commission’s report, he wrote a letter to New York archbishop Terence Cardinal Cooke supporting the church’s efforts to repeal the state’s liberal abortion laws. Meanwhile, his supporters demonized George McGovern as the candidate of “acid, abortion, and amnesty,” in the words of Senate Republican minority leader Hugh Scott. One
Washington Post
columnist characterized the 1972 race as “the first time in U.S. history that an incumbent president would, on the one hand, be running against his own advisers, and his rival, on the other hand, would be defending them.”
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W
hile Nixon inveighed against abortion to garner votes, within USAID Ravenholt was pushing forward with new abortion methods. Besides spearheading the development of the menstrual regulation syringe, he poured around $10 million into research to try to find a “nontoxic and completely effective substance which, when self-administered on a single occasion, would insure the non-pregnant state at the completion of a monthly cycle.”
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Ideally, Ravenholt hoped to see the development of a single pill that a woman could take whenever her period was late.

But not long after
Roe v. Wade
was decided, all this work was shut down. The decision, rather than signaling a new consensus as Ravenholt had hoped, motivated an entirely new level of antiabortion activism. As would happen repeatedly in the future, antiabortion politicians, unable to do much at home, turned their attention overseas. That year Republican senator Jesse Helms succeeded in passing an amendment to the Foreign Assistance Act banning USAID from funding abortion “as a method of family planning.” Botched abortions would continue to strain hospital wards worldwide, but American family planning programs wouldn’t be able to do much about it.

Just before the Helms amendment went into effect, Ravenholt organized a conference on abortion in Hawaii, where he distributed crates of menstrual regulation kits, paid for by the U.S. government, to health workers from all over the world. Then he organized another meeting of population groups and philanthropists to find someone to take over the production and distribution of the kits. That job went to a newly formed Chapel Hill, North Carolina- based group called International Pregnancy Advisory Service, or Ipas, funded with a half million dollars from one of the Scaife family’s foundations. (While Richard Mellon Scaife is famous as the billionaire patron of the right wing, his more reclusive sister, Cordelia Scaife May, was a supporter of family planning and environmental causes.) Potts became Ipas’s president and CEO.

Potts has called the Helms amendment the beginning of a “counterreformation” in family planning.
⁹¹
“I think if we hadn’t had that, the world would literally look very different today,” he said. “Helms has probably killed more women than most other people.”

S
till, for most of the 1970s, religious opposition to abortion and family planning on the right was outweighed by fears about mushrooming populations of poor potential converts to anti-American causes. In 1974, Henry Kissinger signed a classified national security study memorandum calling for a report on the impact of population growth “on U.S. security and overseas interests.” The study, it said, “should focus on the international political and economic implications of population growth rather than its ecological, sociological or other aspects.”
⁹²
Eight months later the resulting document, also classified, was presented to President Gerald Ford, who had by then succeeded Nixon.

The study’s executive summary began by declaring, “World Population growth since World War II is quantitatively and qualitatively different from any previous epoch in human history.” The report’s authors warned that the political consequences of rapid growth, including famines, internal and foreign migration, stagnating living standards, and increased urbanization, “are damaging to the internal stability and international relations of countries in whose advancement the U.S. is interested, thus creating political or even national security problems for the U.S.”

“In a broader sense,” it said, “there is a major risk of severe damage to world economic, political, and ecological systems and, as these systems begin to fail, to our humanitarian values.”
⁹³

For the most part the report’s recommendations tracked with what Ravenholt was already doing. It prevailed on the administration to try to assure full availability of birth control all over the world by 1980, and called for a substantial budget increase for population programs. It also urged support for expanded education and employment for women, and greater collaboration with the UN.

That was all very good, but the report made clear that not everyone thought voluntary programs sufficient. Under the heading “An Alternative View,” the study explained the position, shared “by a growing number of experts . . . that the outlook is much harsher and far less tractable than commonly perceived.... The conclusion of this view is that mandatory programs may be needed and that we should be considering these possibilities now.”
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Ultimately, though, the study’s authors were aware that the perception of coercion would be harmful, and they recognized the danger that some developing country leaders would see pressure for family planning “as a form of economic or racial imperialism.”
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Indeed, to mollify world public opinion, it even recommended that the United States set an example and “announce a U.S. goal to maintain our present national average fertility no higher than replacement level and attain near stability by 2000.”
⁹⁶

D
espite this stance—and Ravenholt’s own opposition to coercion—the reality on the ground could be murky at best. Faced with fertility goals and targets set from above, family planning workers from India to Indonesia cajoled, bribed, and sometimes forced people into accepting birth control, and even sterilization. All over the world birth control clinics were upgraded while other health facilities languished, dirty and run-down.

“I would visit these rural maternity clinics that were crumbling,” recalled Sara Seims, who worked for USAID in Senegal. “And the only money I had was to refurbish one room for family planning. And the only medical personnel who had a nice clean uniform and equipment and electricity working was the family planning [practitioner].” The message to locals, she said, was that “the only thing we care about... is that you don’t have so many babies.”
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Seims saw how eager many women were for family planning. She’d ask some of them why they wanted to use birth control. “[A]lmost all of them said because they were tired,” she said. “And I remember one woman pointing to her worn-out sandals, and she said to me in French, ‘I feel like these shoes.’ ”
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Yet these women needed many other things as well, and programs that ignored those needs felt both callous and counterproductive. “[O]ne of the most important things I learned is, if you cared about women’s reproductive health, you had to recognize that women didn’t exist in a vacuum,” she said. “They existed in a culture. They had families. You also had to care about the health of their children. You had to care about the health of their husbands, because 8 percent of the women in the villages we saw had gonorrhea.”
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Excessive fertility was a problem for many, but others were plagued by infertility wrought by rampant venereal disease. How could you ethically address one while ignoring the other?

All over the world women working in population control programs were having similar insights, and soon they would radically transform the field into one that attempted to change power relations as well as demographics. For a while the fiercest fight in global reproductive health wasn’t between family planners and religious conservatives, but between those hewing to the population control paradigm and those for whom women’s rights were paramount. Then a tide of religious opposition would shock both factions and push them back into an uneasy alliance.

CHAPTER 3:
SISTERHOOD IS INTERNATIONAL

D
uring the sweltering summer of 1970 a young woman named Adrienne Germain moved from Berkeley, California, where she’d been working toward a Ph.D. in sociology, to join her then husband in New York. Needing a job, she landed interviews at the Ford Foundation and Rockefeller’s Population Council. At Ford she was told her marriage disqualified her. “You’ll just work with us for a year or two and then you’ll go and have babies,” her interviewer said.
¹
She had better luck at the Population Council, where she became a researcher in the field that she would eventually turn upside down.

Germain must have seemed like a natural fit for her new job. At Berkeley she’d been part of the Zero Population Growth movement, meeting at Stanford professor Paul Ehrlich’s home for strategy sessions and giving speeches at schools and community centers. But population control had never been the point for her. As an undergraduate at Wellesley, where she was a classmate of Hillary Clinton’s, Germain had spent six months working as a researcher on a study of urban growth in Lima, Peru. It was her first time out of the country, and it seared her. She’d rented a room in the house of a poor family whose father was so violent she had to barricade her door at night. The women she met in the country impressed her with their strength, but they were aged before their time, often subject to spousal rape and relentless battery. Many had suffered botched abortions. “[T]hey were going through the tortures of the damned as far as I could tell,” she said. “And they weren’t getting any family planning, that’s for sure. I mean, it was a very strict Roman Catholic country. What options did they have? They had no health care for themselves and almost none for their kids, and that was just not fair. They were doing whatever they could to earn what little income they had.”
²

When she moved to Berkeley for graduate school, she quickly learned that the main source of international aid that might reach women like her Peruvian friends was population money, so she joined the movement. But she was always more interested in women’s rights than in mere demographics, and at the Population Council she realized how much her agenda differed from that of her colleagues, who were almost all men. They never seemed to talk about women as people: They were always “contraceptive acceptors” or “postpartum cases.” Not trusting women to use birth control correctly, they stressed long-term methods like IUDs and sterilization that took day-to-day decision making out of the clients’ hands.

Other things angered her as well. There were good reasons for women in traditional societies to have lots of kids: They were sources of labor and insurance in old age. They could offer a woman pride and meaning, especially when nothing else did. Besides, even if women wanted smaller families—and some surely did, as evidenced by widespread illegal abortion—the ultimate decision often lay with their husbands. If they were going to control their fertility, they didn’t just need contraceptives. They needed power.

Germain worried about the side effects of the IUD and birth control pills, which then used much higher doses of hormones than they do today, and were given without much thought to follow-up care. She hated the fact that the programs by their very nature did nothing to help women who were unable to have children. Infertility, after all, is a soul-crushing malady in countries where women’s whole identity is bound up with motherhood, and one that is epidemic in some countries with poor health care and widespread sexually transmitted disease.

She also thought family planning programs should be offering access to safe abortion. “From my point of view,” she said, “how could we morally ask women to take the risk of using contraception, of having fewer children, when clearly their life circumstances demanded that they have as many children [as] they could bear, and not enable a woman who had an unwanted pregnancy to end it?”
³

H
er argument points to a complicated, contentious issue in family planning. In societies where childbearing has never been regarded as a choice, where procreation is something to be celebrated or fatalistically accepted—but not controlled—introducing contraception is more than just a technological intervention. To be successful it entails a giant paradigm shift, a whole new conception of both human agency and ideal family size.

Thus, population programs always aimed to change culture as well as demographics. They produced posters featuring well-fed, well-dressed two-child families alongside bigger clans of scrawny paupers. In 1967, Walt Disney made a ten-minute animated family planning cartoon for the Population Council featuring Donald Duck, cheerful orchestra music, and a calmly authoritative voice explaining that “modern science has given us a tool that makes possible a new kind of personal freedom: family planning!” Translated into twenty-five languages, it first showed a happy farming family of five with enough to eat “and even a little left over, to provide money for some comforts and modern conveniences,” symbolized by a picture of a radio. Then the same family appeared with six children, skinny and drawn, sitting miserably around a near empty bowl. The radio vanished from the screen. In such a family, said the narrator, “the children will be sickly and unhappy, with little hope for the future. And when the sons grow up the land will have to be divided into so many small pieces that no one will have enough.”
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