A New and Improved Population Control Policy?

Author(s): Asoka Bandarage
Date Published: July 15, 2006
Source: Political Environments #1, Spring 1994

Malthusianism is one of the most pervasive, if not the dominant response to the current global political and economic crisis. It derives its name from the doctrine articulated by English clergyman turned economist, Thomas Malthus in 1798. Malthusianism sees the numerical increase of the human population as the root cause of natural resource depletion, poverty and social unrest and population control as the primary solution.

As global problems worsen and policy makers are pressured to find quick solutions, Malthusianism is resurging in many overt and covert forms today. Many leading scientific bodies, environmental organizations and United Nations agencies have been issuing warnings and declarations to the effect that if population growth in the Third World, which accounts for 95% of current global population growth, is not controlled quickly, the planet itself is doomed to extinction.

A joint statement issued by the U.S. National Academy of Sciences and the Royal Society of London in 1992 claims that if current rates of population growth continue, "science and technology may not be able to prevent either irrerversible degradation of the environment or continued poverty for much of the world". More than seventy leading population and environment agencies also signed a "Priority Statement" in 1991 arguing that "there is no issue of greater concern to the world's future than the rise in human population" and that the "the United States and all nations of the world must make issues of human population growth a priority in this decade".

At the International Forum on Population held in Amsterdam in 1989, policy makers set targets for fertility reduction for the first time in many years arguing that it is an essential development strategy for the 1990s. The World Bank has also been increasingly demanding that Third World countries accept stringent population control programs as a condition for receiving World Bank loans. Many Third World governments have adopted strong family planning programs pursuing fertility reduction through extensive use of targets and economic incentives. In the U.S. too, the calls for an official population control policy and plans to introduce economic incentives and new, long acting contraceptives have been growing in recent years.

Reversing the policy of the previous Reagan-Bush administration against funding for abortion, the Clinton administration is vigorously re-asserting U.S. leadership in international family planning. USAID is working closely with the corporations, multilateral organizations, media, academia as well as other industrialized nations, particularly Japan, in forging a consensus on the urgency for global population stabilization. As the world population conference to be held in Cairo in September 1994 draws near, a vast lobbying and media effort is underway to increase the "emotional edge" to the population question among the U.S. public and to raise funds for more effective methods of population control for the Third World as well as urban areas in the United States.

Since the time of Malthus, population control ideology and policy making have evolved in many directions ranging from open support for eugenics and coercion to reproductive choice as a basic human right of women. Demographers Bernard Berelson and Stanley Lieberson, for instance, called for a "stepladder approach" to population ethics arguing that population control programs should begin with less severe methods and ascend to harsher methods as the situations warrant them. At the time they put forward their theory in the 1970s, they hoped that a "disaster ethic" requiring measures such as "randomizing medical care" may not arise since the "disease" of overpopulation would be cured in the years ahead.

Today, however, many environmentalists in the North have accepted the "disaster ethic" as inevitable and are advocating coercion as a necessary evil in the race to stabilize global population. Maurice King, Professor of Public Health at Leeds University, for example, has called for a removal of oral rehydration and other human life sustaining methods from public health programs in the Third World as a means to control population growth and ensure environmental "sustainability". If the environmental movement and policy planning move increasingly in a Malthusian direction, we are likely to see more and more triage policies that sacrifice human rights of poor people in the name of environmental sustainability.

However, most official population policies being drawn up now in preparation for the Cairo conference claim "opposition to coercion" and attempt to present population control within a more humane framework calling for women's reproductive choice, health and human rights. They emphasize family planning as a pre-condition for gender equality and women's empowerment and advocate expansion of reproductive health interventions beyond fertility control to include maternal and child health, prevention of STDs (sexually transmitted diseases), HIV/AIDs and so on.

The "New" Reproductive Rights Agenda

The new emphasis on women's reproductive rights influenced by feminism is an improvement on the earlier U.S. and international population policies which paid scant attention to women's needs. Indeed, when compared with right wing fundamentalist opposition to abortion and women's reproductive freedom, this neo-Malthusian family planning position seems liberal and consonant with feminist struggles for reproductive choice and human rights for women.

However, the assumption that the goals of population control and women's rights are inherently compatible is mistaken and, in fact, dangerous to the interests of poor women who are the targets of population control. The distinction between population control and birth control must be emphasized here: population control involves external domination over people's reproductive lives whereas birth control involves individual autonomy and empowerment.

Coalition building and alliances among different social change movements is essential for finding effective, long term solutions to the complex problems facing the world. Yet, it is important to bear in mind that ruling interests tend to confuse and coopt social movements that challenge them by manipulating progressive terminologies, offering funds and other tactics. There are many historical precedents to the cooptation of liberal feminist birth control struggles by population control interests, especially in the United States.

During the early decades of this century, the birth control pioneer, Margaret Sanger, who started out campaigning for working class and women's rights, capitulated to the eugenicist efforts to control the numbers of the poor, the working class, minorities and new immigrants. This happened when Sanger came under the financial and political influence and the openly eugenicist ideology of the population control movement at the time. Later, in the 1970s, liberal feminist organizations such as NOW (National Organization of Women and NARAL National Abortion and Reproductive Rights Action League, leaders in the abortion rights campaign in the U.S., refused to join the struggle for stricter federal regulations of sterilization. They did so because sterilization abuse was not a major concern of white middle class women and because they did not want to lose the support of the population control organizations which were opposed to those reforms. But, in taking such a stance, the liberal feminist organizations distanced themselves from the interests of poor women in the U.S., particularly Black, Latina and Native American women who have suffered greatly from forced sterilization. Liberal feminist organizations have continued to take a narrow view on reproductive rights equating choice with abortion. They see the so-called pro-life movement as their enemy and the population control movement, despite its relative silence on abortion during the Reagan-Bush era, as largely their ally.

Many international women's reproductive rights organizations are now working together with population control organizations relying on the latter's monetary and political support. Some of the most influential women's health and development organizations have been established and are led by a few women in the North with close ties to major population control agencies. Many of these women's organizations define their work within the analytical framework of population stabilization.

As population control organizations adopt and adapt the language of women's rights, population control subsumes women's health concerns. As fertility control is presented increasingly as the means for women's empowerment, feminist criticisms of coercion and experimentation within family planning programs get softened; the resurgence of eugenics associated with the growth of new reproductive technologies gets overlooked; and the social structural roots of women's subordination and the global crisis tend to be forgotten.

The reproductive rights agenda that is now being put forward does not seek to decentralize the techno-bureaucratic command structure of population control or challenge its inherent authoritarianism. More women and "non-whites" have been integrated within its higher ranks in recent years. Yet, since its beginning after the second world war, population control has been a male dominant, eurocentric, numerically oriented enterprise emanating its financial and technological power from Washington, D.C. and New York to the far corners of the Third World. U.S. leadership in international population control was initiated largely as a national security concern by the likes of John D. Rockefeller and General Draper, an investment banker, railroad tycoon and U.S. Ambassador to NATO.

Today, the pharmaceutical companies selling contraceptives, medical and scientific community developing new technology, demographers producing the numbers, bureaucrats at USAID, the World Bank, UNFPA, WHO, IPPF, etc. designing programs, public relations experts marketing family planning and lobbyists raising funds are the leading actors in global population control and they all work closely together. Within individual countries too, the hierarchical population control establishment is reproduced with power spreading from elites in Third World capital cities to distant regions, communities, villages and individuals, mostly poor women, the ultimate targets of population control.

The "new" reproductive rights agenda does not seek to change its modes of operation either. For example, it does not call for the abolition of targets and economic incentives although the abuses associated with them have been widely documented. Targets and economic incentives are still routinely used in many family planning programs, especially those in Asia. Targets in themselves may not be wrong. But, the pressure put on family planning workers to meet targets, that is pre-determined numbers of "acceptors" for specific contraceptive methods, often results in violations of reproductive and human rights as well as corruption and fraud.

Studies from India and Bangladesh show that midwives anxious to meet their sterilization targets and increase their earnings often fail to offer non-terminal methods to their clients and to neglect their work in childbirthing. Doctors moved by their dedication to the cause of population control and pressure to meet their own targets and increase their earnings perform tubectomies with undue haste in the unhygienic environments of mass sterilization camps or refuse to take out IUDs and the hormonal implant, Norplant from women complaining of serious side-effects. In addition to health care workers, in many Asian countries, school teachers, shop keepers, village officials, military officials and others with social authority have also been integrated into population programs through targets and incentives. In Thailand, for example, in some cases the provision of basic social services like roads, transportation and latrines have been tied to the acceptance of contraception.

Economic incentives offered to poor people to accept sterilization, IUD insertions or hormonal contraceptives make genuine reproductive choice a fiction. How can the acceptance of sterilization or contraceptives in order to collect money to buy food constitute reproductive freedom? This question has applicability in the United States too where many state legislatures have put forward bills attempting to tie welfare payments to fertility control, particularly the use of Norplant. Norplant has also been used in a punitive way in the U.S. by judges who have made its acceptance a condition for probation for some poor women.

While family planning is increasingly promoted in the name of women's reproductive choice, rarely do family planning programs offer poor women a choice in the selection of birth control methods. This is why female sterilization continues to be the leading method of fertility control in the world. Where non-terminal methods are made available, long acting, hormonal methods are promoted over less invasive technologies. Despite the new rhetoric asserting the importance of women's health and empowerment and need for greater male participation in fertility control, the use of quick-fix, provider controlled, female contraceptive methods is currently being expanded, for example, in Africa. Women are seldom told of all the side effects and contraindications. Furthermore, poor women, whether they be in the South or the North, rarely have access to routine, quality health care essential for relatively safe use of high-tech methods such as Norplant and the hormonal injectible, Depo-Provera.

While leading population control organizations like USAID's Office of Population speak publicly of integrating family planning within a broader health care framework, in private correspondences officials argue that family planning should not be "held hostage" to strict health requirements and that "medical barriers" to contraceptive provision such as pap tests and breast exams be reduced. In other words, the position that maximum access to contraceptives should override safety and ethical concerns, continues unabated.

Starting with the birth control pill, modern methods have been experimented mostly on the bodies of poor women of color in the Third World as well as the United States, quite often, without informed consent. The dumping of the Dalkon Shield IUD in the Third World after it was taken off the market in the U.S. due to damage to women's health and the testing of Depo-Provera among tribal women in Thailand and African American women in Atlanta, Georgia, are a few examples. The latest "miracle" methods such as the anti-pregnancy vaccine being tested in India and elsewhere and the non-surgical female sterilization pellet, quinacrin, tested in Vietnam could have serious side effects on the health of women as well as their offspring.

Yet, the dominant policy alliance of population, reproductive rights and environmental groups is not questioning the potential long term effects of methods which alter hormonal and immune systems on the ecology of women's bodies and the sustainability of human reproduction. There does not seem to be a place for these concerns in the global consensus on population being declared "on the road to Cairo". Yet, many feminist groups in the South as well as a few international feminist networks based in the North continue to advocate the use of safer, low-tech, barrier methods with access to legal abortion as a back-up method. They point out that women's health and their ability to have control over their bodies must come before the goals of population control. They also emphasize the advantages of barrier methods for the prevention of STDs and of rapidly spreading HIV in the Third World. But, as the population control hysteria grows, feminist voices emphasizing safe methods and democratic processes over the goal of population stabilization are marginalized. Their challenge to the dominant forces of technical-scientific "progress" and bureaucratic authority is shunted aside as "extremist" and "radical".

The introduction of coercive and experimental fertility control methods in the context of deepening poverty and patriarchy can make family planning a force for women's victimization rather than liberation. Perhaps, the most extreme example is the spreading use of sex-selection tests such as amniocentesis in China and India as well as other countries. Population control pressure coupled with deep rooted preference for male children and the wide availability of modern sex determination technology have resulted in a situation where increasing numbers of female fetuses are being aborted. The sex ratios of many Asian countries are increasingly biased against women. Yet, no calls are being made against sex-selection in the new reproductive rights agenda being prepared for the Cairo Conference. The liberal tendency to see sex-selection as an issue of reproductive choice could help further the trend towards eugenics and genetic engineering, in this case against the interest of females.

In this context must also be noted the irony of demanding severe control of fertility in the South while pronatalist policies and new reproductive technologies for fertility enhancement such as IVF (in-vitro fertilization) are being promoted in the North. Just as the pressure on poor women of color not to bear children increases, the pressure on middle class women, especially white women, to bear children also increases. Yet, the population control organizations and the policies being prepared for the Cairo Conference do not address these contradictions of reproduction. The ethical and human rights involved in growing areas of international commerce and biotechnology such as the buying and selling of human bodily parts, of women and children, "surrogate mothering" and so on are wholly ignored.

The alarmist calls for fertility control also tend to overlook the fact that in all regions of the world birth rates are declining. Population is increasing not because of extremely high fertility as much as the exponential nature of growth and the high proportion of people already in the childbearing age. Given this reality, couples could be made to limit childbearing only with extreme coercion as exemplified in the case of China's one child family policy and its drastic consequences for women's reproductive and human rights.

However, the small family norm and even childlessness can become voluntarily acceptable to many people with fundamental social transformations, particularly economic empowerment and social and psychological freedom for women. Although neo-Malthusians recognize the correlations between women's poverty, education and fertility, they make hardly any provisions for women's education and economic survival in their population programs and financial disbursements. The new reproductive rights agenda asserted by population control organizations, the United Nations and USAID position papers for the Cairo Conference do not address these concerns seriously or honestly. They fail to challenge economic policies coming from the North such as the IMF/World Bank Structural Adjustment Programs which are worsening poverty, especially women's poverty and as a result in some cases, contributing to their need for large families. By upholding corporate, "free trade", economic policies, the international agencies setting the new reproductive rights agenda fail to provide the economic and social security essential for reproductive freedom of women.

There is also a great irony in pursuing triage and military policies that increase mortality in the South while encouraging the prolongation of life through costly and questionable medical technologies and programs in the North. Malthusian triage policies are increasing although their underlying population control objectives are not openly acknowledged by policy makers. Population stabilization is not infrequently a reason for neglect of famine relief and public health, particularly HIV prevention in the Third World. The pushing back of Haitian refugees coming to the U.S. into the high seas, the neglect of extensive deaths in war-zones in the Third World and other places like Bosnia also have Malthusian implications.

The massive production and export of weapons around the world also constitute a policy of corporate profitability, military repression as well as population control. Poor youth do not have economic opportunities, yet they have easy access to guns. As a result, they are increasingly killing each other. As the largest arms producer and exporter, the United States bears primary responsibility for this situation. It is hypocritical for the U.S. government to talk of reproductive health, human rights and sustainable development while actively promoting U.S. arms sales around the world.

A Global Class Consensus

The liberal reproductive rights, population control and environmental groups constitute a global class alliance and consensus representing dominant economic and political interests. It seeks solutions to the global crisis within the confines of the twin forces of modern technology and capital -technocapitalism- and the Malthusian framework.

Most environmentalists now agree that population is not the only factor that has an impact upon the environment. In addition to population, the popular I=PAT equation identifies affluence and technology as having decisive impact upon the environment. Yet, when it comes to providing solutions, Malthusian environmentalists inevitably advocate population control over consumption control or the development of environmentally appropriate technologies. Thus, in the Population Explosion, Paul and Anne Ehrlich argue that ". . . because of time lags involved, first priority must be given to achieving population control (emphasis in original)". The joint statement by the U.S. National Academy of Sciences and the Royal Society of London mentioned earlier, also recognizes that conservation of resources and energy in the "developed world" are needed for environmental protection. But, it too claims that "unlike many other steps that could be taken to reduce the rate of environmental changes, reductions in rates of population growth can be accomplished through voluntary measures". Such arguments place the costs of environmental sustainability on the poor while denying that population control in the Third World has been and continues to involve coercion.

Despite their public criticisms of overconsumption of resources by the North, Third World governments and elites are pursuing the same model of technocapitalist growth and consumption as the North. Working in collusion with their Northern counterparts, they too are vigorously promoting population control in place of fundamental social transformations such as redistribution of wealth and resources and the adoption of appropriate technologies of production and reproduction.

The Malthusian analysis is narrow and superficial and its solutions elitist and ultimately ineffective. Since the time of Malthus himself, socialist, Marxist, Third World and feminist analysts and ecologists have been presenting alternative perspectives that place population and human reproduction within the context of economic production and gender, race and class dynamics. But, historically these perspectives have been either neglected or repressed by dominant class interests. In fact, the publication of Malthus' Essay on Population, in 1798 was an ideological response to the tumultuous events and the rise of utopian socialist thinking at the time. Malthus directed his ideas specifically against the philosophies of his contemporaries like William Godwin, Antoine Condorcet and Thomas Paine who were "intellectual devotees" of the French Revolution. While Malthus went on to win academic prestige, his publication contributed to the repression of revolutionary ideas. Critical thinkers like Godwin had to bear the brunt of that political and intellectual repression.

Progressive movements including feminist and environmental movements today must not be confused and side-tracked by the benevolent terminology of Malthusianism including its more liberal reproductive rights variant. Instead, we must look at the actual policies, their implementation and effects on poor women and their families and continue challenging the population control establishment. More importantly, we must strengthen political-economy analyses that go to the historical roots of the contemporary population explosion and global crisis and seek democratic and sustainable solutions to these problems.