World attitudes changing; When women want fewer children

Ten years ago Ama Serwa gazed out into brushlands beyond the huts of her shanty village in central Ghana, dreaming of the day her 10th child would be born and her family receive the customary tribute from the village elders -- a live sheep.

Now -- six children and many talks with family planners later -- she and her husband are leaving old dreams behind.

No more babies. They will pay more attention to the children they already have. "We didn't know before of any alternative, or that too many children in Ghana might make it impossible for some children to go to school," Ama Serwa explains to her family planner.

A decision that will change the world?

Some population experts think so. And they are saying that there are far more "Amas" in the world than anyone had expected. It's a development, they say , with far-reaching implications for a world sagging under the pressures of astronomical population growth.

New evidence, for example, was reported in London this summer by the World Fertility Survey (WFS) showing that in many poor countries a majority of women of child-bearing age -- most of whom have no access to family planning services -- want no more children.

The percentages run as high as 72 percent in South Korea and 60 percent in Peru, Panama, Colombia, Sri Lanka, and Bangladesh.

The desire to bear fewer children may largely reflect the suffering women experience from giving birth to unwanted babies in exhaustingly large numbers. Last year an estimated half million women in Africa and Asia died and another 25 million worldwide suffered complications from pregnancy and childbirth.

But WFS researchers, who have completed 19 out of 41 planned studies of developing countries, see women's desire for fewer children as a plea for more international efforts to make family planning services available, especially in remote rural areas. It is a view vigorously challenged by religious groups fighting against chemical forms of birth control.

The desire for smaller families encourages hopes that the awesome population problem can be eased. But how reasonable are such hopes? The answer is hotly debated.

To be sure, changing attitudes about family size -- and the extent of that change is controversial because statistics are difficult to evaluate -- could mean the couples will more actively seek out family planning services in their countries.

Those services are available in almost every country, though to different extents. Eight out of 10 developing countries have government programs to slow the rate of population increase.

"This availability in itself is an epochal change," asserts Reimert Ravenholt of the US Agency for International Development, which has taken a strong interest in promoting family planning for the past decade. "From the end of the 19th century -- when there was nothing in the way of birth control -- to the end of the 20th century, we may well have achieved access for almost everyone."

Yet the experts are quick to admit that they do not know whether families will translate new attitudes about family size into action.

For a variety of reasons many women refuse to use services available to them. In the Philippines, for example, family planning services -- and awareness of them -- are widespread. But their use is minimal.

"People in my country cannot plead ignorance," says Dr. Mercedes Concepcion, the head of the Population Institute at the University of the Philippines. "They know about birth control and many can cite everything available, incuding the modern methods. But when interviewed, often they say they do not intend to use the services. There is a lack of motivation."

Also, reaching people with family planning services is no mean feat in the world's remoter regions. In Kenya, where women have an average of eight children each, some women have to walk 25 miles to reach the nearest family planning center, and even then may not find it open or supplied.

And distribution of wealth in some countries is so uneven that families feel compelledm to have many children as an insurance policy -- a trend likely to continue.

"When I was in Nepal recenty," says population analyst Kingsley Davis at the University of Southern California, "children were perceived very much as a net economic advantage from age 7 onward. They make it possible for a farmer to maximize his use of land, they work long hours and for free."

So a widespread trend toward smaller families seems unlikely unless smallness is widely perceived as an economic and social step forward. How, and if, that perception comes about, each country must decide.

For all the unknowns about the ideal family size, analysts are cheered that overall world birthrates have declined in recent years -- from 34 per thousand persons in 1965 to 29 in 1977. IThs the first time in modern history, and perhaps in all human history, that this has happened for reasons other than disaster, according to Nick Eberstadt, a visiting population analyst at the Rockefeller Foundation.

Life expectancy and literacy are on the rise in developing countries throughout the world, he says.

There are also a growing number of stunningly successful experiments in curbing a nation's birthrate -- in China, Indonesia, South Korea, Thailand, Singapore, Chile, Colombia, and Costa Rica, to name a few.

China, the world's giant with an estimated 1 billion people, appears to have achieved the most successful -- if Draconian -- population control of all time. In the last decade its growth rate fell from 2.3 percent to just over 1 percent, according to the commission on the future of North-South relatins headed by Willy Brandt. The aim: zero growth by AD 2000 and a one-child family ideal.

China's plan included a massive network of paramedics or "barefoot doctors" providing family planning services across the country; contraceptives, sterilization, and abortion available free of charge; improved education and status for women; a well-enforced living code urging late marriage and plenty of work, sports, and study. And the stick is never far behind the carrot: no extra rations for a family's third child, no additional living space or job preference.

Successes are not related to any one plan, points out Charles Gallagher of the American Universities Field Staff (AUFS).

Overcrowded Singapore and Hong Kong, for example, have radically reduced fertility, but with totally different methods. The government of Singapore offers what may be the world's most vigorous economic and social incentives for limiting family size, according to Mr. Gallagher, writing in an AUFS report. In Hong Kong, the government has noninterference approach, although it provides family planning services.

Concern -- and controversy -- is also very much alive in the industrialized nations. Some 40 of them commit moneys for world family planning efforts. International Planned Parenthood Federation, with its associated private organizations in 130 industrial and developing countries, provides education on balancing regional population and resources.

In the US organizations like the Population Action Council in Washington hope to arouse private interest and national legislation to support world family planning efforts. At the time of this writing a proposed $230 million population bill before Congress was meeting vehement opposition from religious groups that don't want the money to be used for abortion or for chemical birth control.

But more important than simply limiting numbers, the population problem ultimately concerns the qualitym of life earth's inhabitants can achieve.

The experts realize that reducing population in needy countries will not necessarily result in higher living standards.In fact, even with declining world growth rates, many millions are expected to face great obstacles to adequate food, shelter, education, and jobs by the year 2000.

"Recent slowing of birth rates and changing aspirations about family size are certainly important," reflects Gary Lewis, who conducts population surveys around the world for Westinghouse Health Systems.

"Yet much of this is only a relative gain. Instead of six children, say, a family will have four. But even then few families will have enough resources to provide for their children. Thus the population tidal wave, instead of being 210 feet high, will perhaps be 190 feet.

"But thaths still a tidal wave to be figilantly watched for its effects or resources and quality of life."

Faced with this wave, the Brandt commission insists that family planning must be balanced with community development, education, health care, higher status for women, and economic advances that make smaller family size more tangibly rewarding.

It's that kind of benefit that may ultimately sway the world's "Amas."