Can Melinda Gates move contraception beyond controversy?
After a 2012 news cycle dominated by debates in the United States over women’s reproductive lives --from the HHS showdown with the Catholic bishops to Susan G. Komen’s conflict with Planned Parenthood to claims about a “war on women”--the philanthropist and co-founder, along with her husband, of the Bill & Melinda Gates Foundation, is hosting an international family planning conference in London this week. And she’s proclaiming “there is no controversy in empowering women to decide if and when to have a child.”
Gates hopes to use the summit to put contraception back on the global development agenda in an effort to raise $4 billion for family planning initiatives in the developing world, “giving 120 million more women access to contraceptives by 2020.”
Working to re-frame the conversation on family planning, the foundation launched no-controversy.com, a Web site asserting that “contraceptives are not controversial”and encouraging people to share stories about how birth control has changed their life.
In an April TED talk, the Catholic-school educated Dallas native said that growing up, she questioned whether, as her church teaches, “birth control is really a sin.” Gates said that it is her Catholic commitment to social justice that drives her work for the foundation today, including her new family planning initiative. She also has been emphasizing areas of relative consensus on birth control, as in her TED talk:
“One of the reasons we have this huge discomfort talking about birth control is this lingering concern that if we separate sex from reproduction, we’re going to promote promiscuity. And I think it’s a reasonable question to be asked about contraception: ‘What is its impact on sexual morality?’ But like most women, my decision about birth control had nothing to do with promiscuity.”
Acknowledging cases of family planning policies gone wrong, such as the mass sterilization of hundreds of thousands of indigenous Peruvian women — and steering clear, the Seattle Times noted, of any talk of “overpopulation,” the mother of three has been working overtime in recent months to point the global discussion around family planning away from third-rail topics.
“We’re not talking about abortion,” Gates said in her talk. “We’re not talking about population control. What I’m talking about is giving women the power to save their lives, to save their children’s lives and to give their families the best possible future.”
Giving women, particularly in sub-Saharan Africa and in Southeast Asia, access to contraception, Gates contends, will save millions of lives by reducing maternal and infant mortality, improving child health, lowering abortion rates, and “helping countries reach their development goals.”
(Watch Gates’ full TED talk below.)
But when certain methods of birth control are condemned, particularly by religious conservatives, as abortifacients, and deep skepticism of international efforts to impact reproductive choices persist, can Gates navigate a morally and cultural complex terrain to make an international contraception effort truly non-controversial?
One group may show Gates the way. Among the participants in Wednesday’s conference is the Jesuit school Georgetown University’s Institute for Reproductive Health, which, funded primarily by USAID, researches and advocates for “Fertility Awareness Methods.’ It’s an approach to avoiding pregnancy that is in line with Catholic teaching, yet is also used by couples who are not Catholic but prefer a more natural approach.
Such approaches include, for example, the Standard Days Method, developed by Georgetown, that “identifies a fixed fertile window” during a woman’s menstrual cycle and asks her to avoid unprotected sex on those days.
Institute director Victoria Jennings occupies a sometimes-tense space between natural methods embraced by religious conservatives, and a family planning world that can see natural approaches as ineffective. Her organization’s approach is non-religious --no theology required-- but Jennings can have a tough sell when pitching Fertility Awareness Methods to the family planning world. She also anticipates push-back from religious conservatives to the conference’s goal of bringing tens of millions of women access to contraceptives.
“Because of the traditional conflict that has developed between the Catholic Church and other family planning and reproductive health organizations around the world, [Fertility Awareness Methods] are sometimes are viewed with some doubt and suspicion,” Jennings says. She adds that she sees participation in the conference as an opportunity “to reach new people in a way that really does work.”
In the family planning world, Jennings says, “there certainly is the perception... that a number of faith-based organizations that would otherwise be in a position to promote family planning as a social good and as a benefit to the family have in fact done just the opposite. . . .They tend to be some of the more conservative groups who are very much concerned about the preservation of traditional family values and see the whole idea of family planning as being very challenging to that.”
On the other hand, adds Jennings “there are others who are concerned about specific methods of family planning, perceiving them, generally inaccurately, to be in some way linked to abortion. The very unfortunate linkage of family planning and abortion has exacerbated the situation with some of the conservative, faith-based perspectives.”
Jennings promotes Fertility Awareness Method as a hormone-free approach that often brings women in developing countries to family planning for the first time. “It’s something that she doesn’t have to necessarily even engage with a health care provider around. This is something that is just something that is natural for her body.” Jennings also says that like condoms and pills, natural approaches “need to be used correctly” but calls them “very effective methods.”
As she approaches the conference Wednesday, Jennings sees an opportunity to bring an often-underground view to the family planning universe: “We know we need all hands on deck to do this. There are a variety of approaches and they need to be respected.”
Still, a $4 billion international family planning effort that includes methods that the the Catholic Church and conservative Christian churches find objectionable is likely to be viewed critically among those religious people and institutions. According to the Dallas Morning News, Bishop Kevin Farrell, who leads the Texas diocese in which Gates was raised, issued a statement in apparent response to the philanthropist’s framing of the initiative as a Catholic social justice issue, insisting “every Catholic has a serious responsibility to inform themselves about [church] teaching and to form their consciences in its light.” But Gates isn’t backing down from religious arguments either.
In her TED talk, Gates commented:
“Sex is absolutely sacred and it’s sacred in Germany and it’s sacred in the United States and it’s sacred in France and in so many places around the world. And the fact that 98 percent of women in my country who are sexually experienced say they use birth control doesn’t make sex any less sacred, it just means that they’re getting to make choices about their lives.”
Gates added: “I think in that choice, we’re also honoring the sacredness of the family and the sacredness of the mother’s life and the children’s lives by saving their lives. And to me, that’s incredibly sacred too.”