No Woman Left Behind

This spring, I was invited to an environmental conference, where a cadre of population actors joined the reflection around what it means for the world to pass the threshold of 7 billion people this year.

At this conference, the UN’s latest planetary demographic projections were the background to the discussion: are we headed to 9 billion by century’s end, or 10 billion, or even more? Despite disagreements on projections, one thing was clear – the answer depends on what happens to women’s fertility among the less than 20 percent of the world’s population living in countries where the demographic curve shows no sign of peaking throughout this century (areas of the world like Afghanistan, Niger, Pakistan, Yemen and countries of the Sahel).

PSI is helping women and families plan their pregnancies and reduce unintended pregnancy in some of these places, though not all. And it is sobering that this “demographic driver” geography includes some of the toughest-to-govern parts of the planet.

From Malthus well more than 200 years ago to our more modern efforts to grapple with the planet’s capacity, our responses to the population challenge have veered between the extremes of “population control” with its whiff of coercion and violations of rights, and at times a general unwillingness to talk about the issue at all. No effective policies come from either extreme.

Instead, the practical reality of dealing with population pressures finds its best approach in a dignified and simple strategy: help women who want to limit their fertility with modern contraception to do so.
There are at least 215 million of them, WHO tells us. PSI’s experience in countries such as the Democratic Republic of Congo, where for decades the unmet need for family planning has left women with a sixth, seventh or eighth pregnancy, or a dangerous and unsafe abortion, provides countless individual examples of women who want only to take care of the children they already have. Nothing more. Yet, the world cannot yet organize itself to meet this fundamental need, which would have so many positive results for women, families, countries and the planet as a whole.

Seven billion humans on the planet. Many of them will be born into a global economy where they will live better lives than their parents; many will emerge from poverty. In this sense, we can take joy from the fulfillment of so many aspirations. But leaving so many of our mothers, wives, sisters and partners behind in a high-fertility cycle they want desperately to escape is unworthy of us.