'Poverty & the Pill' or Gender and the Pill?

I know, my suggestion doesn't quite roll of the tongue as easily as the title of Kristof's article in the NY Times about the use of contraception in the Democratic Republic of Congo--but I think it might be a more precise identification of the core issue.

He talks about the "fixable" challenge of unavailable birth control in many poor countries. Referencing a report by the Guttmacher Institute, he writes that,"If contraception were broadly available in poor countries, the report said, more than 50 million unwanted pregnancies could be averted annually. One result would be 25 million fewer abortions per year. Another would be saving the lives of as many as 150,000 women who now die annually in childbirth." By all means, every woman who wants contraception should have access to it. But most interventions in this regard vastly overestimate women's freedom to make choices about birth control for themselves.

In my research I also ask women about how they make decisions around family planning. Most of them are familiar with the idea of "child spacing" and have various methods for achieving it, some of which are free--but the majority are denied the ability to make those decisions. If I ask who does, most respond: "my children's father." (and a few: "God") A number of the women who have reported sexual violence within their marriages said the man justified his actions in relation to having more children.

Poverty isn't the cause and money isn't the solution. Kristof does allude to the gender factor, for example, noting the practice of hospitals requiring women to bring their husbands with them so they know whether the man has agreed to using family planning methods and men's resistance to condom use--both of which are as relevant in Uganda as in the DRC. Though he raises a few of the challenges that make family planning "harder than it looks" the article misses the crux of the issue. Although I think I'd be all in favor of re-appropriating 2 weeks of military expenditure in Afghanistan to make contraception available "worldwide"--the real issue isn't unavailability--it's the relationships between men and women that are socially entrenched that prevent women from exercising power over their reproductive health.

I could link a photo to liven up the blog from his article--but instead of attaching the somewhat forlorn expression of a woman who almost died in childbirth--I share this one with you:

He is a beloved former colleague who confesses to having 28 children that he's aware of. How many does he think he actually has, "I don't know. Around 50 maybe?"