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Philippa Taylor

The ‘unmet need’ for contraception and abortion in the developing world

Philippa Taylor is Head of Public Policy at CMF. She has an MA in Bioethics from St Mary’s University College and a background in policy work on bioethics and family issues.
The views expressed do not necessarily reflect those of CMF.

This summer, Theresa May committed to spend £200 million on ‘family planning’ in Africa and Asia.

More accurately, I should say ‘another’ £200 million, because the UK Government has already given vast sums of foreign development money to abortion giant Marie Stopes International (MSI): £163 million in UK taxpayer money. And it is not just for contraception provision but abortion provision, including helping to liberalise laws on abortion in developing countries (see my blog here).

This money will mainly target Africa, particularly women and girls in the poorest communities. We do not know exactly how much of this allotted money will go towards paying directly for abortions, because our Government doesn’t know! (although there is no denial that the money will be used for abortions):

Minister of State for International Development: ‘As the Women’s Integrated Sexual Health programme will deliver integrated sexual and reproductive services, we cannot provide a figure for the number of safe abortions which will be supported.’

…we cannot provide a specific figure for the amount of funding that will be spent on comprehensive and safe abortion care. WISH will operate in 24 African and 3 Asian Countries’:

There are no surprises as to which organisations stand to benefit from this most recent largesse: ‘Marie Stopes International have been awarded a contract for £77 million and International Planned Parenthood Federation have been awarded a contract for £135 million.

No other country has given as much money to MSI as ours, via the Department for International Development (DFID). The next two big spenders on MSI are the US Agency for International Development (USAID), followed by the Bill and Melinda Gates Foundation – also known supporters of abortion in developing countries (although they prefer the term ‘reproductive rights’.) This is despite a ComRes poll showing that 65% of the public oppose UK taxpayer money being spent on abortions overseas.

MSI is not just about contraception ‘services’. They ‘provided or supported more than 4.1 million safe abortion and post-abortion care services in 2017, a 12% increase on the previous year’.

However we should look at the need for contraception in Africa, the place where most of this new UK money will be directed. It is argued that this funding is needed to help women stop having unwanted children and unsafe births.

However the Guttmacher Institute (another known abortion and sexual rights campaigning organisation) in its own research found that: ‘Women with unmet need for contraception rarely say that they are unaware of contraception, that they do not have access to a source or supply, or that it costs too much.’ Even going back to 1995–2005 they note that women rarely cited a lack of access or cost as a reason for not using a contraceptive method.

Instead, they report that women express concerns about the side effects and health risks associated with modern contraceptive methods and ‘In Africa, opposition to contraception is somewhat more frequently cited as a reason for non-use than in earlier years.’

This is important. The issue here is not about access and availability but about women not wanting to use contraception.

Family planning organisations naturally have a vested interest in this business, so their answer is to ‘educate’ women. So poor and uneducated African women need, they say: ‘…broader educational programs designed to address opposition to family planning.’

Obianuju Ekeocha of Culture of Life Africa says that this is simply a new form of neo-colonialism and imperialism. It certainly reeks of ‘we know better than you’ as the UK imposes its own Western-cantered ideological values on other nations. Evidence, it seems, is not allowed to stand in the way of ideology.

Do African countries want our money? They want our aid but this is aid with strings attached. It is humanitarian aid tied to population control measures. In the last two decades the developed world has sent $106 billion to the developing world to slow its population growth. In 2014 the UK targeted 43% of its African aid to population control.

Interestingly this September, after Theresa May’s announcement made from neighbouring Kenya, President Magufuli of Tanzania suspended all family planning advertisements funded by USAID, while the donor is reviewed for its populations control motives. In front of the United Nations Population Fund (UNFPA) representative the President questioned the merits of family planning and expressed concern over low birth rates experienced by many countries: ‘I have travelled to Europe and elsewhere and have seen the harmful effects of birth control. Some countries are now facing declining population growth. They are short on manpower.’

Added to this, Ekeocha comments in her book ‘Target Africa’ that the staggering prevalence of corruption makes one wonder why donors keep giving money to African leaders, knowing full well that they will line their pockets with it.

Africans, as a generalisation, tend to value larger families, hold to more religious and ‘traditional’ views of sex and relationships, and see children as a blessing, not a cost. They are also wary of the costs and side effects of contraception and attach greater value and importance to unborn human life than we in the ‘West’.

What about the UK paying for abortions for African women, and using the money to try to liberalise abortion laws?

Almost 80% of African countries have some sort of law prohibiting or restricting abortion, predicated on the widely held belief that unborn babies have a right to life and deserve to be protected by the law.

And the concern about ‘unsafe abortions’ is disingenuous. Abortion, spontaneous and induced, accounts for less than 5% of maternal mortality in resource poor countries, according to the WHO. Moreover, as proven in many resource rich countries, abortion incidence markedly increases with legalisation, and that increase is accompanied by an absolute increase in mortality and morbidity.

(see this blog too).

I look at maternal mortality rates here in more detail. Research in Mexico, where abortion legislation varies from State to State (and thus provides a unique scenario to test its effects), found that:

  • Permissive state abortion laws do not reduce maternal mortality and morbidity
  • States with restrictive abortion laws have lower maternal mortality and morbidity rates

South Africa has one of the most liberal abortion laws in the world, freely provided in public healthcare facilities, yet they have a very high maternal mortality rate (higher than neighbouring Botswana with no legal abortion). They also have high numbers of illegal abortions – despite offering legal abortions for free.

If the UK government really wants to reduce maternal mortality they need to provide resources targeting the causes of 90% of maternal mortality: literacy, maternal health care, trained birth attendants, obstetric care, sanitation and clean water.  It is medically and morally unacceptable to divert resources from interventions that are proven to reduce maternal mortality to the provision of abortion, under the guise of ‘decreasing unsafe abortion’.

Before I end this, I need to just mention MSI’s record of illegal abortion practice.  The documentary, Killing Africa, uncovers evidence of shocking practices, including illegal abortions, by MSI in Uganda, and an upcoming film, Strings Attached, will expose how the millions pledged by Western nations on ‘sexual and reproductive health and rights’ is really being spent.

The tables need to be turned the other way. What makes us think we in the West, with our culturally biased views, our high abortion rates, high family breakdown rates and shrivelling community values, know what is best for Africa? It should be the other way around. As Ekeocha says in ‘Target Africa’: ‘The most precious gift that Africans can give to the world right now is our inherent culture of life.’

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