Today's Choices, Tomorrow's Population

The rate of world population growth is already declining, but the number of people could still double or even triple from today's 5.8 billion before stabilizing a century or more from now. Women in most countries are still having more than the two-child average consistent with a stable population size. Moreover, so many young people are now entering or moving through their childbearing years that even a two-child average would still boost population size for a few decades until the momentum of past growth subsides. Yet there is reason for optimism. The combination of access to family planning and other reproductive health services, education for girls and economic opportunity for women could lower birthrates enough to stabilize world population well before a doubling of today's total.

At the 1994 International Conference on Population and Development in Cairo, 180 nations reached a historic consensus on both the need and the means to slow population growth and eventually stabilize human numbers. The strategy is grounded in the recognition that couples have the right to make their own decisions about childbearing. Among the most important needs is universal access to the information and means to plan families. The availability of a variety of contraceptive options helps women plan their families and avoid the health risks of unwanted pregnancies. Child spacing also makes it more likely that children will survive their births and early years.

In the long term, access to contraception helps reduce reliance on abortion, to which many women without access to effective contraception turn. Both the ongoing decline in desired family size and the annual addition of 24 million more women in their childbearing years argue for dramatic expansion of international family planning and related health services in the coming years. Sharing U.S. expertise in contraception and family planning service delivery is consistent with our history, our culture and our ideals. American innovations in aviation, automobiles, televisions and computers are rapidly transforming the developing world, for good or ill. American expertise in public health, medicine and in providing clean water helped produce the unprecedented worldwide declines in death rates after World War II, the decisive factor in post-war population growth. Finally, the United States increasingly is exporting its culture to poorer countries in the form of popular entertainment and advertising. We have an obligation to share as well our technological advantages in contraception and reproductive health care. These are not affordable by most couples in developing countries without help from governments–their own and ours.

International family planning assistance represents a success story of historic proportions, and the United States deserves credit as a long-time leader in this field. In the 30 years since the U.S. government began helping other countries provide their citizens with family planning services, the number of couples using contraception in developing countries has multiplied tenfold and the average number of children per woman has declined from nearly six to fewer than four. Population growth has slowed impressively, and it continues to slow. The U.S. contribution to this success story has cost less than 4 cents out of every $100 raised in taxes.

We can also help slow population growth by helping other countries improve the lives of women and girls in ways that go beyond providing access to family planning and related reproductive health care. Greater access to schooling‹especially beyond the early grades‹for girls and young women leads to lower birthrates in almost all countries and cultures. Access to secondary school education correlates with later marriage, knowledge and use of contraception and small family size. Secondary schooling also increases the likelihood that women will take paying jobs or launch small businesses and otherwise contribute more to their families, to their communities and to national economies. In addition, education for girls and women improves the survival rates of mothers and children, as parents' knowledge about preventive care is one of the most important contributors to family health.

In Peru, a woman who has completed 10 years of education typically has two or three children. A woman who has never seen a classroom has seven or eight. In 23 developing nations, the average woman with a secondary school education has her first child three and a half years later in life than a woman with no schooling. Like smaller families, such delays in first births exert a powerful brake on population momentum by lengthening the time span between generations.1 Average family size and child death rates are lowest in countries such as South Korea and Sri Lanka that combine high levels of education for women with strong family planning and health programs.2 Providing opportunities for women to gain income for their work enhances women¹s status and well-being, and early evidence suggest that this, too, may encourage the use of family planning and thus contribute to slower population growth.3 Banks in Asia and Latin America that target small loans for women¹s enterprises find that women taking advantage of such programs tend to have fewer children on average. (They also have much better repayment rates than men.) The World Bank, known more for the large development projects it helps sponsor than for its social spending, recently announced that it will lead a drive to raise $200 million to provide small-scale loans to help low-income people start their own businesses, in part because the impacts of such loans on women¹s lives appears to be so positive. 4

Family planning and related health services, education for girls and economic opportunity for women all work best when they work together, and each strategy deserves attention and financial resources. The U.S. contribution has been historically strongest in areas related to family planning delivery. We need to continue and strengthen that contribution, and we need to expand it to encourage better access to reproductive health, education and economic opportunities for girls and women worldwide.

A FINAL WORD

Population matters‹to those who want their children to live long and healthy lives, to those who value a clean and secure environment, to those who want to help others take responsibility for their own lives, to those who ask that jobs be available for all, and to those who work for a more peaceful world. Slowing world population growth is important to all Americans). The 30-year U.S. effort to make contraception and related health and education services available worldwide is a success story. Today that success is threatened as never before by misunderstanding and misinformation. By informing yourself and communicating your views to legislators, the White House and the news media, you can make a difference.