Birth Control in Afghanistan
The underlying idea that lowering Afghanistan’s fertility rate would help it develop economically makes a lot of sense. Especially in an overwhelmingly rural country, the tendency is for a rapid increase in population to lead to falling living standards.
That said, the specific method of trying to do this by talking to male religious leaders about birth control seems to me to be at odds with most of what we know about this subject. As a recent Economist story on fertility trends emphasized, women in the developing world generally have more children than they want to. When we see falling fertility rates, it’s normally a result of women being empowered to make more decisions about their own lives:
A surprising amount is known about how many children parents want, thanks to a series of surveys by the Demographic and Health Surveys programme. The picture it paints is of huge numbers of unplanned pregnancies. In Brazil, for example, the wanted fertility rate in 1996 (the most recent year available) was 1.8; the actual fertility rate then was 2.5. In India the wanted rate in 2006 was 1.9, the actual one, 2.7. In Ghana the figures for 2003 were 3.7 and 4.4. The rule seems to be that women want one child fewer than they are having (except in some rich countries, where they say they want more). [...]
That points to another big reason why fertility is falling: the spread of female education. Go back to the countries where fertility has fallen fastest and you will find remarkable literacy programmes. As early as 1962, for example, 80% of young women in Mauritius could read and write. In Iran in 1976, only 10% of rural women aged 20 to 24 were literate. Now that share is 91%, and Iran not only has one of the best-educated populations in the Middle East but the one in which men and women have the most equal educational chances. Iranian girls aged 15-19 have roughly the same number of years of schooling as boys do. Educated women are more likely to go out to work, more likely to demand contraception and less likely to want large families.
Of course, the case of China and the one-child policy does show that massive coercion works as well. But the problem in Afghanistan is almost certainly the view that how many children a woman should have is a decision that should be made by men. Just talking to men about making that decision in a different way is unlikely to address the issue. Of course, sending girls to school is a controversial issue in Afghanistan, but if the Islamic Republic of Iran was capable of overseeing a massive increase in women’s educational opportunities, then such things can’t be inconsistent with culturally conservative Islamism in any particularly straightforward sense.
30 Responses to “Birth Control in Afghanistan”
Register
RSSLogin
Topic Cloud
ArchivesBlog RollAbout Matt YglesiasContact Me
Donate
November 15th, 2009 at 11:46 am
Isn’t this exactly backwards? The graph doesn’t show that a decline in fertility rate leads to increasing living standards, it shows that increasing living standards leads to a decline in fertility rate.
November 15th, 2009 at 11:58 am
First, how about getting any significant number of American male religious leaders on board with birth control.
November 15th, 2009 at 12:01 pm
I have the sense that the people in China understand the problem of overpopulation and that is why they are willing to put up with the one child policy (which doesn’t apply to ethnic minorities).
I have not been to Afghanistan but I wonder if in a place where there is a lot of isolation (because of lack of roads, mountainous terrain, etc.) if it is so self-evident, as it is in China, that there are too many people and not enough resources.
November 15th, 2009 at 12:13 pm
“Of course, the case of China and the one-child policy does show that massive coercion works as well.” It doesn’t show anything of the kind. Look at the graph. China is a bit of an outlier, but not much. Chinese fertility is only slightly lower than that of the average country with its per capita income. Once you account for China’s income distribution being more equal than the average country with its income, and Chinese female schooling being better than expected for a country with its income, China’s fertility rate is not significantly lower than expected. Coercion isn’t adding anything significant. It’s not just a brutal policy. It’s a redundant brutal policy.
November 15th, 2009 at 12:28 pm
We’re a little like lemmings growth until it’s unsustainable. In Bangladesh which is reported to have a fairly reasonable fertility rate at present it took a near doubling of population to around 150 million people over the last 20 years to achieve some control. FYI Bangladesh is about the size of Wisconsin.
Hardly a poster country for economic development and population control as for the huge majority there has been virtually no improvement in quality of life and income.
November 15th, 2009 at 12:44 pm
Which is why, incidentally, progressives should not favor wealth destroying measures like the climate bill. By reducing wealth across the world, what exactly do you think will happen, given the data above?
November 15th, 2009 at 12:56 pm
1. The Afghan and Iranian strains of conservatism are completely different animals. Each use Islam to justify their cultural prejudices. For example, despite the high population of Afghan refugees in Iran, they maintain their cultural traditions (marriage of girls at a young age, low education rates among women) despite living in a country that creates more opportunities for women than their native homeland. The Iranian government didn’t help by limiting access of Afghans to higher education.
2. In a conservative culture like Afghanistan, without the clergy and male elders buying into the notion of lower birth rates, there is no way that women would have the autonomy to control their reproductive rights. In Iran at the beginning of the revolution, having lots of children was a religious duty to fight the imperialists (hence the large population of young Iranians). By the mid-80s, the population explosion and providing for them was such that they had to change their views out of pragmatism. Again, it was the government–and Khomeini himself–who started openly talking about family planning and promoting it, going so far as advertising the virtues of small families openly (street signs, tv and radio advertising, etc). Last I heard from my family, young couples are taught about family planning before their marriage is made legal. Even in remote villages, clinics and hospitals hand out free condoms without question to anyone who asks for it. I say all of this to highlight the fact that it is not just female education that would help this along, but a specific cultural shift and religious sanction that would actively promote this change.
November 15th, 2009 at 12:57 pm
Re: First, how about getting any significant number of American male religious leaders on board with birth control.
Two separate issues here. Some Protestant denominations (Latter Day Saints and I think a few evangelicals) disapprove in principle of all efforts to have small families. Which is, to be charitable, pretty dumb. The Catholic church, by contrast, doesn’t object to the goal of smaller families, but it does object to artificial contraception (as do, I think, the Russian Orthodox, but not all Orthodox churches). They encourage natural family planning (which can be a good option for many people, particularly when the woman’s cycle is regular). It has a very low failure rate when used perfectly (that said, it’s quite difficult to use perfectly) and is the method of choice in Poland, which has a below-replacement TFR.
Personally I support chemical contraception (and am hopeful that some work in India and other places may produce a male contraceptive treatment fairly soon), and think that the Pill, and also any male equivalents when they become scientifically tested and commercially avialable, should be made widely available. (I think barrier methods more problematic- and of course I thoroughly oppose abortion). That said, I think we should give the Catholic Church and NFP its due as well.
BTW, I’m pretty sure that Islam does not, in principle, forbid either natural or artificial family planning, so talking to Afghan religious leaders may be beside the point. The disapproval of birth control in many Middle East countries is a social problem more then a religious one.
Re: Coercion isn’t adding anything significant. It’s not just a brutal policy. It’s a redundant brutal policy.
Excellent point. I used to think that the Chinese policy was at least effective, if cruel, but then I looked at the rapidly declining fertility rates across the developing world and realized that it had been not only tragic but tragically unecessary. I disagree with political liberalism in many, many regards, but the regulation of family size is really one of those decisions so intimate that it should- for the good of the mother, the child, and society as a whole- be left up to the parents. The state and the church can (and should) exhort, advocate and educate, but they should not coerce in the matter of family size.
November 15th, 2009 at 1:00 pm
By the way, I think it’s incorrect to say “replacement level fertility is 2.1″. It’s 2.1 in developed countries, but my understanding is that it’s closer to 2.5 in poorer countries, and somewhere around 2.3 on a global level. Which means that Brazil, for one, is already below replacement level fertility, and that India is not that far away.
November 15th, 2009 at 1:06 pm
I’m just writing to confirm what PGS said (although I don’t know about the free condoms in rural areas – I’m guessing men would have much easier access to that than women). Iran does actually require engaged couples to take contraceptive classes before marriage. And yeah, the population boom was probably mostly because of the specter of Iraq attacking and taking over Iran, not because the Shah had somehow forced women to have less children and the Islamists had reversed that trend.
November 15th, 2009 at 1:31 pm
I agree with PGS and Persian, I don’t think Iran is very similar to Afghanistan, aside from belonging to the Muslim world. Most obviously Iran is Persian, not arab, and has always had a high regard for learning -going back as far as the Zoroastrians. Also Shiism, and Sunnism do have significant differences, this kinda like lumping Catholics, and Protestants into the same mental grouping.
November 15th, 2009 at 1:33 pm
James Robertson @6: wealth destroying measures like the climate bill
I guess it’s my turn to bang my head against the wall of James’s incomprehension of common goods. Something can be valuable and thus contribute to “wealth” even if it is unowned. An atmosphere with less GHGs in it is such an unowned common good. Common goods that are unowned (or are owned but the use of which is not controlled or priced by its owner) are overused and can be depleted.
A cap-and-trade regime effectively divvies up the atmosphere among GHG emissions permit holders. A carbon tax assumes public ownership of the atmosphere and charges users of its lower levels of GHGs (that is, people who increase the levels of its GHGs).
The consensus of scientists who study AGW and its economic (and, more importantly, human) costs is that mitigation will be cheaper than adaptation. Which is to say, depleting the wealth that is a low-GHG atmosphere so that we can make cars and buildings and whatnot more cheaply will lead to more wealth destruction in the long run than preserving the wealth that is a low-GHG atmosphere.
November 15th, 2009 at 1:35 pm
Right Jim-Bob, we don’t need “wealth destroying measures” what we need are measures to slaughter innocents wholesale as revenge for acts committed 70 years before.
It’s always good to see what kind of fucking monsters the right-wing hatemongers produce.
November 15th, 2009 at 2:35 pm
Most obviously Iran is Persian, not arab,
Just to nitpick, neither is Afghanistan. There’s also quite a bit of Persian cultural influence in the background from centuries of being neighbors and/or co-residents in a given empire. (Most obviously, Dari being the dominant language of the elites and the lingua franca of the rest of the country)
The anti-education sentiment is one part Taliban legacy and one part being so much more rural than most of the rest of the world (developed or developing).
There’s a little under 100K high school graduating high school in the past year in Afghanistan. In 2013 at current trends(which by no coincidence would be 12 years after the Taliban regime ended) there will be about 500K. Two years after that, 1 million.
And about 1/4 are women, and is expected to rise to 1/3 in that time frame.
November 15th, 2009 at 2:36 pm
It has a very low failure rate when used perfectly (that said, it’s quite difficult to use perfectly)
Of course, from the Catholic point of view if it fails, you are pretty much stuck, since Catholics say Abortion Is Murder™.
I always thought the Catholic fetish for “natural” family planning came from the fact that the sworn-to-celibacy clergy gets their jollies by preventing other people from having sex when they want, which “natural” family planning does a lot of.
BTW, I agree with Matt’s point that it’d be futile to try to lower fertility by convincing a collection of graybearded extremist misogynists to relent on their oppression of females. Taliban or Catholic, you’re not going to budge them.
November 15th, 2009 at 4:42 pm
Re: (as do, I think, the Russian Orthodox, but not all Orthodox churches
Orthodox opinion is all over the map on birth control, but an outright ban is a decidedly minority position. And it is not the doctrinal position of any individual Orthodox jurisdiction.
As far as the LDS goes, I don’t think they ban birth control either. My older step-sister, and my niece (her daughter), are Mormons. My niece is an only child; and she just had a child herself in April. It was difficult birth, and future births will be equally difficult for her. She has openly declared that she wants one more child, but probably no more after that. I have to assume her church has no problem with this, as she is otherwise quite obedient to LDS moral strictures right down to the no-coffee and coca-cola rule.
November 15th, 2009 at 5:26 pm
…but if the Islamic Republic of Iran was capable of overseeing a massive increase in women’s educational opportunities, then such things can’t be inconsistent with culturally conservative Islamism in any particularly straightforward sense.
Hopefully this was MY’s intention, but the above statement of his is evidence of the idiocy of reducing our understanding of the culture of all Middle Eastern countries to “conservative Islamism”.
November 15th, 2009 at 6:09 pm
Right. It’s like saying “If Massachusetts, with its powerful Catholic Church, can have sensible abortion laws, surely so can Oklahoma.” It totally ignores the fact that Iran is a sophisticated, ancient, and cosmopolitan culture, whether it’s being run by prime ministers, shahs, or mullahs. And Afghanistan is, by and large, the sticks.
November 15th, 2009 at 7:07 pm
Re: And it is not the doctrinal position of any individual Orthodox jurisdiction.
JonF,
Thanks for your comment. I have seen statements harshly condemning birth control from the Patriarch of Moscow, though. I’m not sure if those statements count as authoritative doctrine or just as pastoral guidance.
Re: Of course, from the Catholic point of view if it fails, you are pretty much stuck,
From my point of view, too (I’m Anglo-Catholic, not RC, for what it’s worth). By all means, be a responsible citizen and take all due precautions to avoid the risk of pregnancy, but do be aware that even when used correctly most methods have a (small) failure risk. If you’re not willing to accept the small risk of contraceptive failure (or NFP failure, whatever), then don’t have sex. Abortion (which has been considered a form of homicide for all of Christian history, and well prior to that among Jews and Zoroastrians) is not an acceptable solution, except on grounds of serious health risk to the mother.
Re: It totally ignores the fact that Iran is a sophisticated, ancient, and cosmopolitan culture, whether it’s being run by prime ministers, shahs, or mullahs.
True. Lebanon and Turkey, which are the other two Middle East countries with below replacement fertility rates, are also ’sophisticated, ancient, and cosmopolitan cultures’ par excellence, in their pagan, Hellenistic, Christian, and Muslim periods.
On an international level, at least for the last half-century, religion doesn’t appear to have much impact on birth rates- the more important determinants are women’s education and more generally the social and economic power available to women. It’s quite possible for Muslim societies to achieve low birth rates, particularly since Islam, unlike Christianity, has never had a dogmatic position against contraception.
November 15th, 2009 at 10:54 pm
BTW, I agree with Matt’s point that it’d be futile to try to lower fertility by convincing a collection of graybearded extremist misogynists to relent on their oppression of females. Taliban or Catholic, you’re not going to budge them.
Only if you assume that large family sizes are a sine qua non of female oppression. The “graybearded misogynists” might be able to be convinced that men should have the goal of having a replacement-level-sized family and that the husband should force this upon the wife. I don’t see why controlling women necessarily requires forcing them to have large families. Which is not to say that the Taliban attitude is good, but I’m not certain that changing their attitudes toward population control requires changing that aspect of their culture.
Personally I support chemical contraception (and am hopeful that some work in India and other places may produce a male contraceptive treatment fairly soon), and think that the Pill, and also any male equivalents when they become scientifically tested and commercially avialable, should be made widely available. (I think barrier methods more problematic- and of course I thoroughly oppose abortion).
Why are barrier methods more problematic? I can see why post-fertilization methods (e.g. IUDs) might be, but I would think that condoms would be less, not more, problematic than hormonal methods due to the lack of concern about possible post-fertilization action.
November 15th, 2009 at 11:17 pm
I assume the Economist was just simplifying for graphic effect, but 2.1 is not necessarily the replacement rate. It’s actually calculated by dividing 1 by the percentage of women to reach average age of the mother when giving birth times the percentage of the population born female: 1/ (percent survival to child birthing age * percent born female).
A higher child mortality rate or a skewed gender selection at birth (parts of China and India, for example) will push it higher.
November 16th, 2009 at 12:14 am
A point that hasn’t been made is that Islam permits birth control but requires that both parties consent to its use. Both spouses have a right to children from each other, as they have a right to sex (and sexual pleasure) from each other. So I as a Muslim woman can’t use birth control without my graybearded elder husband agreeing to it too, and similarly he can’t “force it on me” as someone upthread suggested.
November 16th, 2009 at 1:39 am
I don’t see why controlling women necessarily requires forcing them to have large families.
Huh? Making women to carry to term pregnancies they’d rather not have had (but were forced to have because you forbidden them from using effective contraception) isn’t controlling them?
And if you’re going to claim that the women could have avoided the pregnancies by abstaining, recall that these are patriarchal cultures where women may have little practical leverage if they try denying their husbands.
November 16th, 2009 at 4:11 am
What does Greta Garbo say in “Ninotchka”?
“After the Purge Trials, there will be fewer but better Russians.”
“Fewer but better” at least sounds like something we’re otherwise missing for Afghanistan: a plan.
November 16th, 2009 at 5:30 am
As others have suggested, Iran and Afghanistan share quite a bit of common history and culture. So does Appalachia and SoHo, but there isnʻt really a US example than can compare to the gulf between the first two. By and large, modern Irani culture is hell and gone from what the shit-kickers in most of Afghanistan call civilization.
By-the-by, Islamic jurisprudence in general doesnʻt seem to have a problem with contraception, with the exception of a minor school of imams who feel that sperm is predestined to fertilize an ovum, and it is therefore wrong to subvert the Lordʻs blueprint. Unfortunately, Wahhabi imams have the treasury of SA to stand on, so their POV has been getting a lot more play than it would IF WEʻD GET OFF THE FREAKING PETROL.
November 16th, 2009 at 7:33 am
Re: I have seen statements harshly condemning birth control from the Patriarch of Moscow, though.
I haven’t actually seen anything of that sort, but I have to wonder if these statements were couched in terms of moral philosophy, or were in terms of Russia’s demographic crisis. Some years ago the Russian Church put out a formal dictrine on morality for the modern world and it did not have a blanket condemnation of birth control, but did advise believers that marriage (not necessarily each sex act) must be open to children, and that married couples should consult each other and their spiritual elder in matters of family planning. In any event, a patriarch is not a pope; he cannot pronounce definitively on matters of doctrine only offer his opinion. (The patriarch is more like a prime minister serving at the discretion of the synod; he is not a monarch gifted with any special chrism of office).
November 16th, 2009 at 12:06 pm
Re: IF WEʻD GET OFF THE FREAKING PETROL.
Unfortuntely the United States cannot “get off the fr**king petrol” any time soon, any more than an alcoholic can “get off the fr**king vodka”, and for much the same reason.
JonF, thanks for your excellent comment on the Orthodox position, and on the difference between a patriarch and a pope. I had not been clear on the distinction.
Re: And if you’re going to claim that the women could have avoided the pregnancies by abstaining, recall that these are patriarchal cultures where women may have little practical leverage if they try denying their husbands
Good point. As I understand it, it’s much the same case in many African cultures (Christian, Muslim, and animist).
Re: It’s actually calculated by dividing 1 by the percentage of women to reach average age of the mother when giving birth times the percentage of the population born female: 1/ (percent survival to child birthing age * percent born female).
Yup, I made that point above. As does the Economist if you look at the text article, actually, they do acknowledge that on a global level the replacement rate is closer to 2.33 children per woman.
November 16th, 2009 at 2:53 pm
Re: Why are barrier methods more problematic? I can see why post-fertilization methods (e.g. IUDs) might be, but I would think that condoms would be less, not more, problematic than hormonal methods due to the lack of concern about possible post-fertilization action.
Glaivester,
There is absolutely _no_ evidence that hormonal birth control like the Pill has ever led to the abortion of a single embryo. The arguments to this effect are entirely speculative and have neither any scientific nor any moral weight. They’re interesting, but only in the same sense as the “Maybe human beings evolved in the water” type of arguments are interesting.
As for barrier methods, I’m concerned that they have greater potential for facilitating promiscuity, and also that they interfere with complete physical union and do not (unlike hormonal methods) attempt to mimic a natural process (the physiological changes associated with pregnancy). Nevertheless, I certainly think they should be _legally_ avialble for those who don’t share my concerns.
November 16th, 2009 at 6:33 pm
jimBOB (#23): Huh? Making women to carry to term pregnancies they’d rather not have had (but were forced to have because you forbidden them from using effective contraception) isn’t controlling them?
Read what I said more carefully next time. I never said that forcing a woman to have a large family doesn’t require controlling them. I said that one can be controlling without forcing them to have a large family. That is to say, just because the imams in Afghanistan want to control the women doesn’t necessarily mean that they have to favor large families.
There is absolutely _no_ evidence that hormonal birth control like the Pill has ever led to the abortion of a single embryo. The arguments to this effect are entirely speculative and have neither any scientific nor any moral weight.
If that is correct, then that is a huge burden off of my mind (although I’ve never actually ahd sex so it doesn’t matter personally, it makes the world a somewhat nicer place).
As for barrier methods, I’m concerned that they have greater potential for facilitating promiscuity,
Condoms maybe you can argue this, but most other barrier methods do not prevent the spread of STDs and so would not be seen as facilitating promiscuity any more than birth control does (assuming that this is what you meant).
On the other hand, there is the problem that non-condom barrier methods tend to have a relatively high failure rate (~10%-20%).
and also that they interfere with complete physical union and do not (unlike hormonal methods) attempt to mimic a natural process (the physiological changes associated with pregnancy).
That is a reasonable distinction to make (not saying I agree that barrier methods are problematic, but your reasoning is self-consistent).
Nevertheless, I certainly think they should be _legally_ avialble for those who don’t share my concerns.
I would tend to agree with you.
November 18th, 2009 at 3:52 am
[...] Matthew Yglesias writes about the current research on birth control and fertility rates (featured in The Economist recently) and how it applies to Afghanistan. [...]