Commentary: Family planning should mean choice, not control

Jennie Bristow, editor of Abortion Review, reports on the ‘morally uncomfortable’ questions raised by a recent conference examining the alleged connection between population dynamics, reproductive health and rights, and climate change.

Following the Copenhagan Climate Conference in December 2009, the issue of the effect of global population levels upon climate change has been placed high on the political agenda. Discussions about how nation states can reduce the ‘carbon footprint’ left by their citizens have led some protagonists in this debate to voice concerns about the number of such footprints caused by a growing world population, and to suggest ways in which these footprints could be reduced.

In other words, a familiar concern about ‘overpopulation’ has now become linked to the agenda of reducing climate change. Some campaigners, academics, and advocates for reproductive health and rights perceive the issue of global warming as adding a sense of urgency and purchase to the cause of allowing women the right and means to limit the size of their families. In this view, access to contraception and abortion is not only something that women want and need, but something that will benefit the environment by reducing the increase in carbon emissions caused by a growing population.

These issues were addressed at a recent conference held at the British Medical Association (BMA) in London (1). The conference aimed to examine ‘the connection between population dynamics, reproductive health and rights, and climate change’. Speakers included climate change campaigners, reproductive health advocates, scientists, members of the medical profession, British Members of Parliament and African Ministers of State. Presentations discussed the alleged moral and scientific links between population levels and climate change, social programmes focused on helping communities to ‘adapt’ to the effect of climate change, and political options for taking the agenda forward in the developed and developing world.

As I have previously noted on Abortion Review (2), political arguments that link population levels to global warming provide a number of difficulties for those committed to the cause of reproductive choice. The greatest of these is the assumption that, in order to tackle climate change, population growth should be reduced, through measures designed to coerce or cajole women into limiting the size of their families. This assumption implies that concepts such as ‘family planning’ or ‘reproductive choice’ only work in one way – through enabling women to have fewer children.

At the BMA conference, Ann Furedi, chief executive of BPAS, challenged this point from the floor. A movement genuinely committed to reproductive choice, she argued, would be as committed to helping women have more children as well as less. Mentioning BPAS’ ambition to pioneer not-for-profit fertility treatment services alongside its abortion and contraception work, Furedi pointed to the danger of mixing up the cause of women’s reproductive choice, which may mean campaigning for access to contraception and abortion where this is denied, with the cause of reducing global warming, which assumes that people should have fewer children for the sake of the environment. 

The question of how far ‘choice’ can be genuinely considered important within the climate change agenda formed the basis of a recurrent theme throughout the BMA conference. The first speaker, Jonathon Porritt, trustee of the population-reduction campaign Optimum Population Trust and former chair of the UK government’s Sustainable Development Commission, talked about the ‘moral mandate’ of linking population and climate change in relation to what he perceives as a reluctance to engage with these issues. This reluctance is the product of ‘misrepresentation’ and ‘crass idiocy’ on the part of those who perceive discussions about world population and possible reduction strategies as a form of ‘racism’.

Noting that a more significant cause of global warming than absolute numbers of people is widely understood to be over-consumption in the Western world, Porritt cautioned that we should not fall into an ‘either/or trap’ – we should seek to address overconsumption and overpopulation at the same time. He noted that there are continuing sensitivities around coercion, and used the example of the unpopularity of China’s one-child policy. However, he noted, this policy has ‘averted’ 400 million births and brought a ‘reduction’ of 1.5billion tonnes of carbon emissions.

In recognising that population reduction arguments are ‘uncomfortable, morally’, Porritt’s presentation provided a good example of exactly why such arguments are uncomfortable. While many of those who worry about the growing world population are not motivated by racism, it is the case that the world’s population is growing in the developing world and not in richer nations. Discussions about population reduction inevitably take the form of focusing on the developing world, and discussing the problem of an ‘unmet need’ for contraception and abortion.

Professor Anthony Costello of University College London, and chair of the Lancet Commission on Managing the Health Effects of Climate Change, at this conference claimed that 23% of women in the developing world have an unmet need for family planning. But these assertions raise questions about how it is possible to measure such ‘unmet need’, and what it means to ‘meet these needs’ through programmes that are often funded by western governments or international agencies. To what extent can such programmes can genuinely promote individual women’s choice, when they are motivated by wider concerns over family planning as a means to reducing global warming? 

Another morally uncomfortable aspect of the population and climate change debate is the way in which it tends to speak of babies in terms of ‘carbon footprints’, and contraception and abortion in terms of a reduction in ‘carbon emissions’. This language has been taken on board by some reproductive health organisations, including Marie Stopes International, which has claimed that its work over 2009 ‘prevented over four million ecological footprints’ (3).

For people in the developing world as much as the developed world, children are not perceived or experienced as ‘carbon footprints’ but as creative human beings. It is well known that one of the reasons why women in the developing world tend to have larger families than those in industrialised countries is that children contribute physically and financially to the household – often, for example, becoming a much-needed source of labour on a subsistence farm. The presentation of children as a burden, as in discussions of ‘carbon footprints’, ignores this reality as well as the emotional benefits that babies can bring to people throughout the world.

When women use contraception or have abortions, they are not ridding themselves of an ecological toxin, but making a decision about pregnancy in the context of their own lives, relationships, health and circumstances.

A third significant aspect of the discussion at the BMA conference related the role of population reduction strategies within broader ideas and policies about social and economic development. Jonathon Porritt argued that the linkages between demographic trends and social and environmental problems were addressed by the 1994 International Conference on Population and Development in Cairo. It is true that Cairo was a significant event in promoting the cause of ‘sustainable development’ in the developing world: namely, gradual, small-scale development as a preferable option to rapid urbanisation and industrialisation.

Access to contraception and abortion in the developing world emerged at this conference as playing a key role in enabling the world’s poor to manage their immediate circumstances: the idea being that if families had fewer mouths to feed, they would have suffer less pressure on their own limited resources.

However, the development agenda promoted at Cairo was controversial, and the discussion led by African Ministers of State at the recent BMA conference indicates that there is less consensus about the sustainable development agenda than might at first appear. For example, Dr Paul Wilkinson, Reader in Environmental Epidemiology at the London School of Hygiene and Tropical Medicine, spoke of population being ‘one factor among many that contributes to total greenhouse gas emissions’, and it was recognised that some climate scientists do not think that population numbers have an effect on greenhouse gas emissions at all.

The complexity of climate science means that it should not simply be assumed that there is a direct link between global warming as phenomenon that may have arisen partly as a consequence of human activity in general, and the effect of numbers of people living in the world now. Furthermore, as the commentator Brendan O’Neill has argued, fears about overpopulation and the effects on natural resources have historically been raised, and historically have proved groundless (4).

The sustainable development agenda assumes that the best way forward for countries in the developing world is to work within the limits of their current resources, and to try and reduce pressure on those resources. This is one reason why contraceptive provision holds an attraction for many development agencies: as Professor Anthony Costello argued, ‘Family planning is low cost, and it works’.

A key theme of the BMA conference, which is echoed in the UNFPA publication State of the World Population 2009 (5), is that of ‘adaptation’ to the consequences of climate change, ‘now and for the duration’. Adaptation essentially means that resource-poor countries should focus on working within and around the limits given by resource depletion, natural disasters, and rises in temperature and sea level.

At the BMA conference, a presentation by Dr Vik Mohan on ‘Combining family planning with marine conservation in Madagascar’, provided an illuminating case study of this approach. Dr Mohan’s organisation Blue Ventures, which focuses on marine conservation expeditions, worked with people in a fishing community to highlight the links between a growing local population and the reduction of fish that they could catch, and promoted contraception on that basis. 

However, the assumptions behind the current focus on ‘adaptation’ were challenged by the Honourable Professor Ephraim Kamuntu, Minister of State for Finance / Planning in Uganda. Calling upon the conference to address ‘issues of realism’ in this debate, he noted that the majority of the population of his country do not have access to electricity, financial services, or any other security. In this context, ‘they will look to their children’ for security; and if infant mortality rates are high, women ‘will have more kids thinking that they are going to die’.

It is all very well providing people with condoms, argued Professor Kamuntu, but approximately 90% of the population of Uganda and Kenya do not have access to electricity. If people do not have electricity ‘they will go to bed when the lights go out. And a guy needs light to put a condom on’. In this way, he turned around the assumption that family planning is itself a development strategy. Rather, he spoke to the well-established historical view that economic and social development gradually encourages people to have smaller families, while contraceptive provision alone does not; and argued that the key issue for African states was the need for development.

Following this theme, the Honourable Professor Peter Anyang Nyong’o, Minister of Medical Services in Kenya, argued that there was a need for a ‘holistic approach’ to population, climate change and development, which required the recognition that the resource limitations would be most effectively addressed through urbanisation and the intensification of agricultural production. He put the case for ‘a more capital-based approach’ to farming, and for bringing the population out of the rural areas to live in urbanised clusters. That way, he suggested, it would be easier to spread the message of family planning – but more importantly, to give individuals more control over their lives.

There was much discussion at the conference about the need to ‘empower’ women through access to family planning, but as Professor Nyong’o suggested, individuals ‘cannot be empowered’ without the means to exercise some control over their lives. Development, and urbanisation, would help with this process.

Responding to the African Ministers of State, Andrew Stunnell, Liberal Democrat MP for Hazel Grove, stated that there was a ‘deep consensus’ in the UK for the need for the UK government to invest in overseas development. He also confessed that he had five children, two of whom are adopted, and said that in the area of how many children to have ‘we should be careful of setting standards for others’.

Andrew Mitchell, Conservative MP for Sutton Coldfield, stated that ‘a Conservative government would make population a very big item on the agenda’, because ‘giving choice to women in this area is absolutely vital’. He did not specify whether he was talking specifically about women in the developing world, or whether choice is considered ‘absolutely vital’ to women in the UK as well.

For more news and commentary on the population and climate change issue, see the ‘Population debate’ section of Abortion Review.

(1) International Policy Symposium on the Connection between Population Dynamics, Reproductive Health and Rights and Climate Change

(2) Commentary: Population, the environment, and a woman’s right to choose, by Jennie Bristow. Abortion Review, 3 October 2009

(3) MSI leads discussion on using family planning to combat climate change. Abortion Review, 27 November 2009

(4) Too many people? No, too many Malthusians, by Brendan O’Neill. spiked, 19 November 2009

(5) Facing a changing world: women, population and climate. UNFPA State of World Population 2009