Proponents of family planning services say each year, nearly 360,000 women die from pregnancy-related causes, most of them in Africa. The former president of Ireland, Mary Robinson, is helping lead a campaign for greater access to those services in developing countries. Robinson is now chair of the Aspen Institute?s Global Leaders Council for Reproductive Health.
?It means that you have healthy families. You have more possibilities that children, both boys and girls, will go to school because the mother will have time or motivation to make sure they have the best chances, which is what every mother wants for their children if they?re not absolutely exhausted and overcome by the problems of too many with too little food,? she said.
In the long run, she said, reproductive health will mean greater productivity.
From bad to worse
The Aspen Institute said Somalia is an example of a country in which the lack of family planning services has made a terrible situation worse. Somalia has the eighth highest birthrate in the world and has an average family size of seven children. Its population is expected to increase from around 10 million today to more than 13 million by 2025.
Some 19 years ago, Robinson visited Somalia in the days when warlords battled for control of the country, while people starved. She recently returned and found things had deteriorated further.
?There had been no functioning government for the 19 years. Instead of warlords, we have al Shabab linked to al Qaida. Food prices are at an all-time high and famine was declared in July. And finally, the Horn of Africa has had the eight hottest years ever in succession. So climate is beginning to impact,? she said.
Robinson saw the toll that has taken on many Somali women.
?I met emaciated women with their children with the glassy eyed (look), near starvation. And it?s a way of talking to women to say how many children do you have? And not a single mother said to me that she had less than six. So, Somalia is actually the worst case, where women have to have as many children as possible so that at least one or two may survive,? she said.
Kenya and Ethiopia
The former U.N. High Commissioner for Human Rights also visited the Dadaab refugee camp. Hundreds of thousands of Somalis have sought refuge there to escape conflict, drought and famine.
?I was in Dadaab in Kenya, the largest refugee camp in the world now, and I was looking at a project that Save the Children had of child brides. These were under 18- year- olds, who were already mothers and some of them had been raped on the journey from parts of Somalia, then across the border into Kenya, and became pregnant because of rape,? she said.
Robinson also visited the Amhara region of Ethiopia with some of the group known as The Elders, including Archbishop Desmond Tutu. She says often girls there get married at age 12. Many lose children during pregnancy because their bodies are just too young. Families may have as many as nine children.
She said, ?I talked to a 16 year old who?d been married for a year. So she was married at 15. And I wanted to sort of have a friendly conversation with her. And I said tell me about your wedding day. And she looked at me with the saddest eyes and she said I had to drop out of school. So, one day she was at school and the next day her family said to her you are marrying this man. And she moved into his household. And you can just imagine what her life was like.?
Family planning critics
The former president of Ireland said family planning services must be culturally sensitive and cannot be imposed on a community. She says the women should be educated about what those services entail and must want to use them. Robinson said the controversial issue of abortion often clouds the overall picture of the importance of reproductive health.
?I wish that those who took a strong ideological stand on abortion would realize how worrying it is when you cut off all access to reproductive health and family planning and women are forced into illegal and botched abortions, which are a huge source of maternal deaths in many countries. It?s a tragedy,? she said.
Religious and conservative groups in the United States and abroad have often opposed funding for international family planning services. They cite moral and ethical reasons and say the services must not be imposed on women. Many consider abortion comparable to murder.
Recently, the Global Leaders Council on Reproductive Health called on the international community to double funding for family planning to $6.7 billion.
Robinson has also founded the Mary Robinson Foundation. Its stated goal is to seek justice ?for the many victims of climate change who are usually forgotten - the poor, the disempowered and the marginalized.?