The peasant woman had inquisitive eyes and a warm smile. She was more talkative than the other women we interviewed in Bolivia's high plains. She was learning how to read and write and wanted a loan to purchase a bull to plow the land. As we were about to leave the isolated village where she lived, she approached our vehicle and talked quietly to the health worker. She was likely pregnant, and could not afford another child.
Women in these rural communities have, on average, 6.4 children per woman. Save the Children, the American-supported voluntary agency, has provided women with access to contraceptives, as well as credit and literacy programs. She had used birth control, but stopped because her husband feared that using contraceptives could make women unfaithful. Her options were grim: carry the unwanted child to term or have an unsafe abortion, with health risks in either case.
Maternal mortality in the area is extremely high - 14 deaths per 1,000 live births. Bolivia, which is considered to have high maternal mortality, has a rate of six deaths per 1,000 births (compared to the United States, where the rate is 0.08 deaths per 1,000 births). Of course, Latin American mortality rates are still not as bad as in some parts of sub-Saharan Africa, where one woman dies for every 50 live births. At a total fertility rate of seven children or higher, statistics would indicate that 1 in 6 women in such parts of Africa does not survive her reproductive years.
While the motivations may be different, the US Congress is threatening poor women's ability to plan their families and their own future by drastically reducing the amount of foreign aid devoted to family-planning services overseas.
The 1997 foreign aid bill approved by the House of Representatives continues the legislative assault on international family-planning programs begun last year, when Congress effectively slashed population assistance for fiscal year 1996 by an alarming 86 percent. The House proposes even greater spending restrictions for FY 1997 and is locked in battle with the Senate and the White House on the issue. The outcome of the entire foreign operations bill awaits resolution of this question.
But the truth of these Draconian cuts is not told in the story of the torturous budget process - in appropriations, authorizations, restrictions, and requirements. It lies in the lives of women and children. With reduced access to contraceptives, women in poor countries everywhere will be at higher risk as a result of childbirth or botched abortions. The Alan Guttmacher Institute, in collaboration with several research organizations, conservatively estimates that US overseas aid reductions will mean that 7 million couples will lose access to modern contraceptives, causing 4 million unplanned pregnancies, 1.6 million abortions, the death of 8,000 more women in pregnancy and childbirth, and the death of an estimated 134,000 more infants.
Reaffirmation in Beijing
Population programs are often justified in terms of cold demographic projections and/or environmental threats. But the lives and dreams of women and their children are at their core. In the last two decades, much knowledge has been gained on the role of women in development, and many of us have devoted these decades to improving women's status in poor countries. Thousands of women gathered in Beijing one year ago at the UN's Fourth World Conference on Women to reaffirm our mission to empower women around the world.
Congress can help by restoring much-needed international family-planning funds. Family planning saves lives, prevents abortions, and improves the health and nutrition of women and children. How many peasant women with warm smiles and no futures will it take to bring rational argument back into the deliberations on family-planning programs overseas?
*Mayra Buvinic is president and a founding member of the International Center for Research on Women, in Washington.