Spotlights on Health and Rights

Key topics in the Heilbrunn Department of Population and Family Health

Human Rights

Reproductive Health and Human Rights

The following section is adapted from PW Eager, "From population control to reproductive rights: understanding normative change in global population policy (1965-1994)," Global Society 18(2):145-73, 2004. Among other things, it shows that UN conferences such as those in Cairo (1994) and Beijing (1995) have been important in expanding the reach of human rights language and norms related to health.

A historical perspective on human rights thinking and reproductive health

Throughout human history, it has been generally accepted that a growing population is vital to a society's military and economic strength. However, by the mid-1960s, the problem of rapid population growth, especially in the "Third World," began to affect global society. A new norm was propagated that population growth negatively affected state strength and developmental prospects. Concern about a "population explosion" in the developing world soon became a fear. Prior to the mid-1960s, the United States was adamantly opposed to becoming involved in the business of birth control within the US, let alone in the developing world. However, in President Lyndon Johnson's 1965 State of the Union address, he stated "The US will seek new ways to use our knowledge to help with the explosion in world population and the growing scarcity of world resources." Between 1965 and 1980, the US contributed more than half of all international assistance for population and family planning and underwrote numerous Third World family planning programs.

In the early years, population programs were designed, for the most part, by white, Western men who were part of a tight-knit "population control movement," which included links among experts working for USAID [the US Agency for International Development, the US government's foreign assistance agency], the Ford Foundation, the Population Council and demography centers at major universities. Obviously, many in the developing world agreed that population growth was too high, especially since countries like India had embarked upon population control measures well before 1965. However, the causal relationship between population and development was called into question at the 1974 World Population Conference in Bucharest.

The American delegation to the Bucharest Conference anticipated that the conference would be an opportunity to express what it viewed as "a nearly complete consensus regarding the dangers of rapid population growth and the advantages of countries adopting population growth reduction targets". But they did not foresee the active participation of the "Group of 77" (G-77) countries, which included developing countries and constituted a majority among UN member states. The G-77 challenged the Malthusian idea of growing population clashing with limited resources and instead argued that development is the best contraceptive and reversed the neo-Malthusian causal analysis. In other words, they argued that fertility increase was a consequence rather than a cause of underdevelopment whereas experts from the developed world, especially the US, had argued the opposite. This point of view was reflected in the Bucharest declaration, as was concern about the use of coercion in population control programs. The term "reproductive rights" was not used, but ground-breaking human rights language in the declaration stated that "all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and have the information, education and means to do so." Even so, the US continued to be committed to population control.

From 1975 to 1985, a network of women's rights activists evolved and drew attention to women's reproductive rights issues, including but not limited to human rights abuses in population control programs, safety concerns about contraceptive methods, and the role of women in many societies. The majority of feminists did not want to see women's access to family planning services eliminated; instead, they wanted to ground family planning in a more explicit health and human rights rationale as opposed to the demographic rationale propagated by neo-Malthusian population control advocates. For feminist health and rights advocates, women's ability to choose whether or not to use contraceptives was vital to their personal autonomy.

In 1984, the World Population Conference was held in Mexico City. The US delegation sent by the Reagan administration, which was concerned about liberalizing abortion in the context of growing reproductive health programs, announced that the US government would no longer fund NGOs that performed or actively promoted abortion as a method of family planning. (The so-called Mexico City policy or "global gag rule" would become a political football over the years as Presidents Carter, Clinton and Obama rescinded it while they were in office, and President George W. Bush reinstituted it.) Nonetheless, the Mexico City declaration reiterated the "basic human right" to decide the number and spacing of their children and underscored the need to ensure that population policies "enhance the status and role of women." Women's groups increasingly framed reproductive autonomy as an inalienable and indispensable right necessary for women to live a dignified life.

The International Conference on Population and Development (ICPD) in Cairo in 1994 saw the emergence of the strong voice of women's networks from the Global South, even as the Vatican and like-minded actors worked in earnest to block the creation of what they viewed as an attempt by women's groups to secure an international right to abortion. The Vatican and its allies blocked all references to "reproductive rights" in the draft declaration. In the end the compromise language of the declaration committed each country to implement the ICPD Program of Action "with full respect for the various religious and ethical values and culture backgrounds of its people, and in conformity with universally recognized international human rights."

The ICPD was nonetheless a benchmark in the sense that it defined new norms that ought to guide global population policy. First, women should be treated as individuals and not as an aggregate group. Second, women had a right not to have their bodily integrity violated. Third, women had the right to choose voluntarily whether or not to use a contraceptive method, and the method they chose should be safe, effective, affordable and accessible. Fourth, women had a role to play in the design, implementation and evaluation of reproductive health programs.

Question for Thought

Could the neo-Malthusian view of population control be consistent with the rights of women? Why or why not?