New Internationalist

Keynote

Issue 176

new internationalist
issue 176 - October 1987

Keynote

[image, unknown] Families to order
Population and human rights
Debbie Taylor argues that women know best
about the number of children they need.

Forget statistics and projections. Forget creeping deserts and deforestation. Forget the five billionth baby (apparently born in July this year). Forget food crises and debt crises and put aside, if you can, your suspicions that China's coercive one-child policy is justified. For however long it takes you to read this article, I would like you to look at population from a different point of view - that of poor women in poor countries.

I hope those women will forgive my attempt to step inside their shoes (many do not even have shoes). They would be right to be suspicious of yet another self-styled expert purporting to represent their wants and needs. I cannot even plead that I have their best interests at heart - how many times have they heard that before? But if they (and you) will suspend scepticism and bear with me - here goes.

Let's call her Mosadi, which means 'woman' in drought-cursed Botswana. But her name could be Maya - one of 190 million Indian women; or Zhou - one of 260 million women in China; or Lucha - one of 34 million women in Mexico.

NATASHA, USSR
[image, unknown]
Interview by Chris Sheppard

The problem is that the pills are of very low quality and you have to pay maybe two roubles ($3) a month. And they do not advertise contraception so many people don't know It's available. People are very embarrassed talking about sex. There is education for pregnant women about how to have a child, but not about how not to have a child. It's a very big problem.

I have had about nine abortions, but that's exceptionally high. Maybe I was supposed to have a lot of children. Most women only have two or three abortions because they don't have much sex - perhaps just once a month. They are so overworked, you see. The men are tired too, it's not because they can't have sex, it's because they don't want to.

Abortion is very easy. You just go to the hospital for your pregnancy teat and arrange a date for the abortion at the same time. It's quite normal - more serious than having your tooth pulled out, but not much more. They do the abortions in the mornings and the other operations In the afternoons and you can choose what kind of anaesthetic you want.

Normally people have two children. Three is unusual. And 99 per cent of women have jobs, even if they have children, because one salary is not enough to support the family. Even with two children life is very hard. You cease to be human. You finish your work and you want to relax, but you can't, because you have to queue for tomatoes or meat and you can't find it in this shop, or that, and you have to walk around and spend hours on shopping, then cook and clean and wash clothes and look after the children.

In theory the government wants women to have more children, but in practice they discourage it because our living conditions are so terrible. There are some privileges - families with eight or ten children get free kindergarten places - but that is nothing compared to the low salaries and high prices. A woman has the right to stop work until her child is three and gets a third of her salary for the first 18 months. Then she leaves her child with grandparents or at kindergarten. Kindergarten's very cheap -only three or four roubles a month. The problems come if the one near you is full and you have to travel miles to one with a vacancy.

The divorce rate is very high because women are more independent than in the West. if your husband doesn't earn enough money and he doesn't help around the house, what is he for? You get more support from a boyfriend than from a husband who doesn't help you with anything.

Last week I went to a fortune teller and she told me I would have another child even though I don't want to. She's right. I really don't want to.

Mosadi wants children, that is certain. Though she knows many women die in childbirth (well over half a million a year worldwide)1, the thought of life without children is, well, simply unthinkable. For a start her husband might take another wife or divorce her and throw her off his land; she might be branded a witch and shunned, even by her own kin; her status among her in-laws would remain as lowly as a servant's, just as it was when she first arrived as a nervous young bride. She knows the fate of the childless woman - in Zimbabwe she is buried with a mealie cob in her vagina and a rat in her arms to still the restlessness of her unhappy spirit. In some parts of Africa up to 70 per cent of women are infertile.2 Just one child would release her from that fate.

Mosadi is anxious; her new husband is anxious. They make love as often as they can. Her mother-in-law watches her like a hawk for the first signs of pregnancy. Six months pass; ten; twelve. She conceives, then miscarries (half of all pregnancies are blighted, end in miscarriage or stillbirth3); she conceives then miscarries again. A sister-in-law confides that this happened to her too, but Mosadi begs money from her husband and visits the traditional healer just to be sure.

The medicine is bitter, but the next foetus holds fast in her womb and a child is born - Mosetsana, a daughter. All at once Mosadi's life is transformed. She has a child. with a soft smudge of black hair, dimpled brown limbs and a smile that melts the heart. Mosetsana, that sweet heavy weight in her arms, is her first sure ally in the demanding household of her in-laws and her passport to join the envied society of mothers.

Mosadi relaxes a little. One young woman tells her about the contraceptive pills some women in the next village are taking: 'They say they're good because they make you put on weight; but they can give you headaches and make you barren, and the clinic often runs out of supplies. There is an injection too. That's better, even though it makes you bleed so much - because you can keep it secret from your husband.' The older women shake their heads disapprovingly and tell her that in the past you wouldn't need to use such things: no man would have sex with his wife until his child was weaned at two years of age. Ah, but few men keep to the traditions nowadays, they grumble, and they warn her not to conceive too soon - 'or your eldest child will suffer'.

But little Mosetsana is already suffering. And her illness - diarrhoea, which accounts for half of all Third World infant deaths4 - banishes all thought of contraception from Mosadi's mind. If the baby dies, Mosadi will be back where she started. How could she dare tempt the evil spirits by tampering with her fertility now? Besides, even if her daughter lives, she will soon be a nervous young bride in her own right, far away in a neighbouring village; no longer able to help with the transplanting in the paddy fields, the weeding of the maize, the endless sweeping and washing and grinding and winnowing. Only a son stays with his mother and makes sure she has food to eat - even when she has no teeth to eat it with and her sinewy old arms can no longer lift a hoe to her shoulder. In Ghana a widow without a son may lose her right to farm her husband's land5. In China, where couples are only allowed one child, parents may resort to killing their daughter so that they can try again for a son. In one village alone 40 baby girls were drowned in one year6.

Mosetsana lives, but the seeds of uncertainty are sown. The previous month the village echoed with wailing as women mourned the funeral of a neighbour's child, one of 40,000 under-fives who die each day in the villages and shanties of the Third World7. Mosadi clutches her daughter tighter in her arms and conceives again as soon as she can.

This time it's a son - Mosimane: a tiny baby born two months premature with a red and wrinkled old-man's face. Her husband whoops with delight and raises the baby above his head, like a footballer brandishing a trophy. But Mosadi's exhausted after the birth. She has a fever too, and a foul-smelling vaginal infection that makes her cringe in shame from her own body.

Though still weak and feverish, she hoists Mosimane onto her back and sets off to walk to the clinic. In Kenya that journey would typically take around six hours; in Nepal, Bangladesh and Rwanda it could take even longer. She arrives in the middle of a great commotion. A man in a white coat is sticking posters up on the clinic wall which say 'A two-child family is a happy family - sign up for family planning'. One shows a couple standing proudly behind two plump smiling children in pristine school uniforms.

The baby wriggles and whines as Mosadi stands in the line to see the nurse. Staring at the boy on the poster, with his glowing skin and bright eyes, she offers Mosimane her breast. He sucks hungrily, flailing his skinny arms. The nurse is preoccupied when Mosadi reaches the front of the line and barely glances at the baby, let alone weighing him as Mosadi had expected or inspecting his umbilicus. Instead she glances uneasily at the white-coated man hovering nearby as Mosadi explains, in a quiet voice, about her infection. 'How many children do you have?' the nurse asks loudly, shaking antibiotics into an envelope, then: 'Isn't it time you used family planning? How can you look after more children when you are sick like this?'

The white-coated man nods approvingly, then frowns as Mosadi says she had heard that the pill and the injection can make you sick or barren. 'That's nonsense,' he says. 'You shouldn't listen to old wives' tales. It's having too many children that makes you sick. It can make the children sick too if there are too many for you to feed and provide for.'

Mosadi ducks her head, embarrassed at being spoken to so directly by the strange man. Under his gaze, she accepts the three packets of pills proffered by the nurse, fumbles for coins in her blouse, and escapes as quickly as she can.

AMEERA, PAKISTAN
[image, unknown]
Interview by Maria del Nevo

I had my first child one year after I got married. Then I had a baby every year after that until I had five girls and three boys. My husband sells fruit on the streets of Lahore. I have no Idea what he earns, but he gives me about 1500 rupees ($86) a month to run the house. Two of my sons are working too and they bring in about 300 rupees a month each.

I wish I'd had fewer children - if I'd known the way prices would go up . it's so difficult to manage on what my husband and sons bring home. When they get married I'll tell them to use family planning because prices get higher every day and it's impossible to support a large family. Myself, I never thought about using birth control before because my mother-in-law would never allow it. She believes that children are a blessing from God and we shouldn't do anything to stop them. So when I did go it was in secret.

I found out about it from one of my neighbours. She was using condoms and advised me to do the about it. There are no health visitors in this area, so if my neighbour hadn't told me l still wouldn't know anything about it. I don't know whether my husband knew either. But when I asked him for permission he just agreed.

The doctor at the hospital told me about the pill, but said you have to take them regularly and if you forget even once, then you'll get pregnant. Anyway, I was sure my husband would forbid me to use the pill, and thought it was better to use condoms. They were five or ten rupees a packet and they hurt a lot and I had some internal injuries. So I went back to the lady doctor and she gave me a cream and some tablets.

My in-laws didn't know - I didn't tell them. But my mother-in-law was suspicious and asked us, some had to tell her we were using condoms. Then there was a big fight and she said I mustn't use them ever again. My husband was on my side - he wanted us to use family planning. But in the end it was all for nothing, because l got pregnant anyway. So then I went secretly to have an abortion, and my mother-in-law found out about that too. So there was another huge fight.

Recently I've heard that there have been advertisements on the television and people say the doctors give you 50 rupees if you go for the sterilization operation. I think it's a sort of a bribe they have to offer because otherwise the people won't go, and they want to control the population. That's why they give you the money instead of making you pay. Men have the operation too, but it's mostly the women. I've seen it with my own eyes. They do the operation and keep the woman there for about an hour then give her 50 rupees.

She walks home thoughtfully. Strange that they should say family planning prevents sickness and yet be so uninterested in examining Mosimane - in El Salvador, Indonesia, Bangladesh and India ordinary health services have been cut back to make way for a concerted family planning drive8. Strange they should dismiss her worries about side effects when so many women she knows have complained about them - side effects make between 40 and 70 per cent of women stop using the pill and TUD within the first two years9. Strange that they should say that two children is the ideal number when her own calculations tell her that to stop at two would be completely out of the question.

The clinic people must be lying, she reasons: lying or simply stupid. They claim to have her best interests at heart, yet they try to persuade her to do something she knows would be bad for her.

Mosetsana is still not completely well, and Mosimane has been sickly ever since he was born. Even if they both survive - which in her heart she doubts (in over 37 countries the average infant has only a 90 per cent chance of surviving its first year10), she will still need more than their two pairs of hands to manage her work in the fields. And what if her son should leave the village and try for a job in the city? Already her husband is talking of leaving. What if they both leave and never come back? One in three of Third World house-holds are managed by a woman without an adult male to help her11.

Mosadi fingers the three packets of pills in her pocket. Perhaps when I have four children, then I'll think of stopping, she says to herself: four might be enough - provided that two of them were sons (in Africa young women want an average of 6.6 children; in Asia and Latin America the figure is 3.3; in the Middle East 4.2 children is considered the ideal number12). Later her husband discovers the pills and beats her - for the first time in their marriage - accusing her of planning to deceive him, of wanting to have secret sex with another man. Afterwards they watch the plastic packets melt then burst into flames on the cooking fire.

Five years and three pregnancies later, Mosadi has four children. Mosimane died aged six months, but Mosetsana has battled through the gamut of childhood diseases and emerged a serious and sturdy seven year-old - already fetching water and firewood, able to cook and serve a simple meal on her own and to look after her little siblings while Mosadi works in the fields during the day.

They are allies in the battle for survival, looking after younger siblings while their parents are at work and, in due course, taking up the hoe in the fields beside them.
Photo: Julio Etchart

In those five years there have been many changes in the country. A combination of drought and inflation has forced many people to sell up their plots; others have been compulsorily purchased as big commercial plantations, with the blessing of the government, take over huge tracts of the most fertile land. Many families have decamped to the outskirts of the city, hoping to find some employment that pays better than the unreliable seasonal wages on big farms. Many others have hedged their bets, with some members staying on the land, others working the plantations or trying their luck in the city. In Bangladesh, the Philippines, Sri Lanka, Peru, El Salvador, Ecuador, Java, Bolivia and Guatemala over 75 per cent of the population are landless or near landless.

Mosadi and her husband are in debt and on the brink of selling up. Things seem to be getting harder and harder for them - not because of the children: they're still so small and eat so little and already Mosetsana is earning her keep - but because of things that seem to be outside their control: things that 'they' - the government, the bosses, the people in power - decide to do. 'They' set school fees so that people have to alter their whole lifestyle to get the cash to pay them; 'they' set the wages - and the prices for rice and beans and yams and mealie-meal; 'they' are in cahoots with the moneylenders and the landlords.

Now, Mosadi discovers, 'they' are trying to persuade people to be sterilised. She has gone to the clinic again - she is always going to the clinic with one or other of the children - and has managed to persuade her husband to allow her to get some contraceptive pills. 'Just while things are so uncertain,' she promises him, and he knows she is right. But it's a difficult decision for both of them. She needs to conserve her strength now, that's for sure - eight pregnancies in as many years have taken their toll. But what of the future? Yes, prices are rising, and the children may well cost more in the short term. But if prices continue to rise, it will be impossible to save and even two sons may not be able to support them in their old age.

'We do not use the pills any more,' say the people at the clinic. 'But if you have more than three children, it is time for you to be sterilized.' Mosadi is torn: part of her would love to release her battered body from the strains of childbearing, But another part looks at her smallest child - his little guts spasming in another bout of diarrhoea - and at the lorries roaring past, piled high with tobacco, coffee and sugar cane from the plantations; and at the doctor in his mask ushering shivering women in green gowns irritably into the makeshift operating room; and a deep, a very deep, feeling of distrust makes her turn and push her way out of the room.

1 Review and Appraisal: Health, official paper presented to the World Conference to Review and Appraise the Achievements of the United Nations Decade for Women (Nairobi, Kenya. July 1985).
2 Retel-Laurentin. A,, Tackling the Scourge of Infertility People, Volume 8,1981.
3 Report on the State of World Population 1980. United Nations Fund for Population Activities
4 State of the World's Children Report 1986, UNICEF.
5 Newland, K, Women, Men and the Division of Labour, Worldwatch Paper 37. Worldwatch Institute, 1980.
6 Croll, E, China's First-born Nightmare Returns, Guardian newspaper, 29 October 1983.
7 State of the World's Children Report 1986, UNICEF.
8 Harlmann, B, Reproductive Rights and Wrongs, Harper and Row, 1987.
9 Bruce, J., and Shearer, S. B,, Contraceptives in Developing Countries, paper at International Symposium of Research on the Regulation of Human Fertility, Stockholm 1983.
10 World Bank Development Report 1986.
11 Report on the State of the World's Women. DESI 1985.
12 World Fertility Survey.
13 See worth reading

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