Tafelberg Short: The Politics of Pregnancy. Rhoda Kadalie
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The Politics of Pregnancy
from ‘Population Control’ to Women in Control
Rhoda Kadalie and Julia Pollak
Tafelberg
Introduction: Pregnant teenagers and falling fertility
When it comes to demography and fertility, South Africa is an outlier. Fertility rates tend to fall as countries get richer. But South Africa saw dramatic fertility declines among all racial groups far earlier than is usual in developing countries, and far earlier than its sub-Saharan neighbours, despite persistently high levels of poverty. Even today, South Africa’s fertility levels and population growth rate are remarkably low, compared to the rest of the region.
The Apartheid government’s family planning policies are partly responsible. But South Africa’s demographic ‘exceptionalism’ is also largely an accident of history – a by-product of the devastation Apartheid wrought on black and coloured families before 1994 and the impact of HIV/Aids on families since then. Sadly, this cannot accurately be accredited to the success of our reproductive health programmes and services, or to the empowerment of women, where we continue to fall short.
Over the coming decades, South Africa can expect its population growth rate to slow down even further thanks to a combination of continued fertility declines and mortality increases. According to a study by the South African Institute of Race Relations, birth rates have decreased from about 26 births per 1 000 people in 1996 to 21 in 2011. They are expected to drop yet further to 18 by 2025, according to the Actuarial Society of South Africa.
Meanwhile, the Institute for Futures Research at the University of Stellenbosch reports that the death rate has doubled since 1985 and is projected to increase by a further 17% between now and 2040. HIV/Aids is the main culprit, and its related deaths are mostly among women of child-bearing age.
Despite South Africa’s relatively low fertility rates, there are still alarmingly high rates of teenage and unwanted pregnancy. These threaten the status of women and compound the problem of female poverty by restricting women’s education and career prospects. A staggering 40% of all pregnancies in South Africa each year are among teenage girls, for example.
There is a long list of reasons: the lack of access to contraceptives; the lack of sex education; high rates of alcoholism and drug use, which dispose people to risky behaviour; the stigma contraceptives carry in traditional communities; men’s aversion to condom use; and the high rates of sexual violence and rape. Inadequate and mismanaged health-care services, brutish attitudes of men towards women, and a poverty culture of short-sighted and self-destructive behaviour remain indelible obstacles to the advancement of women’s health and reproductive freedom.
Many of the South African government’s efforts to date have had only minimal effects on contraceptive use and on the rates of teenage and unwanted pregnancy. There are some glimmers of hope, but achieving better outcomes will require government and civil society organisations to mount a herculean and multi-faceted effort. This will have to be aimed not only at improving women’s sexual and reproductive health, but also at expanding economic opportunity, improving the rule of law, and tackling the sensitive areas of tradition and culture.
‘Population bomb’? Policy in other countries
Governments have been trying to influence fertility and population growth rates since before Thomas Malthus started publishing his ‘Essay on the Principle of Population’ in 1798. Malthus worried that population growth would outpace the earth’s ability to produce resources for human survival and recommended that governments find ways to repress it. His followers circulated illegal manuals on birth control in the early 19th century.
Population control campaigners got a boost in the early 20th century due to the rise of eugenics movements, which were widely popular before becoming tarnished by their association with Nazi Germany. Birth control activists and eugenicists formed an uncomfortable alliance in their quest to influence fertility rates. American feminist Margaret Sanger, for example, teamed up with eugenics organisations such as the American Eugenics Society in her quest to promote birth control, even though she disagreed with many of their positions.
The 1968 best-selling book, The Population Bomb by Paul Ehrlich, argued that the world could not feed itself. It revived the population control movement. Population-bomb hysteria took root in much of the world between the 1970s and 1980s. Again, the obsession made strange bedfellows of the political left and the right. The left worried that the world would be doomed because of overpopulation in general. The right in South Africa and prejudiced elites in other countries worried about the overpopulation of black people, or poor people, or other ‘undesirable groups’, in particular.
In many countries, ruling elites imposed coercive population control policies designed to cut birth rates, especially among the poor. India forcibly sterilised millions during the Indian emergency of 1975–77, often under threat of violence or destruction to their homes. In 1978 China established its one-child policy, which continues to inflict draconian punishments on families with more than one child to this day.
Often the policies were (and, in cases such as China, still are) enforced with little regard for differences in individual preferences. An Indian official is reported to have said population control was a necessity for the masses, adding that ‘it is not what they want, but what is good for them’. An official in French Indochina said the problem with the natives was that ‘they are born too much and they don’t die enough’.[1]
The perils of China’s one-child policy
Through its one-child policy, China decided to restrict married, urban couples to having only one child. The policy is officially enforced through fines and other disincentives. The fines – referred to as ‘social-maintenance fees’ – can be several times a city’s annual income. Second children are also often denied a household registration, a hukou, which entitles a person to basic rights such as education. When parents can’t afford to pay the fine, the government often resorts to grave measures, such as destroying people’s homes or forcing women to undergo abortions and sterilisation.
One particularly violent and horrific case made international headlines early in 2012 after a leaked photograph went viral. The graphic image showed a 27-year-old woman, Feng Jianmei, lying exhausted next to her dead seven-month-old foetus after Chinese officials kidnapped, drugged and forced her to have an abortion. The photo sparked widespread outrage and protests. Several Chinese organisations are now lobbying the government to replace the one-child policy with a two-child policy.
Many people have had their houses torn down and their belongings ransacked for breaching the policy. Others have had their children confiscated and sent to orphanages. Government bureaucrats have learned that foreigners will pay thousands to adopt Chinese babies, and they’re happy to cash in on the process.
Despite all the attention China has received for the grave human rights violations associated with the policy, Chinese officials are adamant that China still has too many people, and that the policy continues to be necessary. They credit it with averting some 400 million births. But that is a wild exaggeration. As in most of the rest of the world, fertility was declining before the programme was introduced, and it would have continued to decline in response to economic growth and the increased availability of contraception.
China’s policy has also had many tragic unintended consequences. A typical Chinese family today consists of four grandparents,