a review of
Reproductive Rights and Wrongs by Betsy Hartmann, Harper & Row, New York, 1987; paper $10.95.
This impassioned enquiry is both important and timely. It is important because it synthesizes valuable research to reveal the interlocking connections between world population growth and the related questions of hunger, ecological devastation, political economy, human health and human rights. It is timely because it adds a much-needed dimension to the critique of the Maithusian orthodoxy that overpopulation is the underlying cause of hunger and that population control is the solution. It focuses on the social relations that underlie both the population explosion and the global strategies to confront it, and ties together the discussions of world ecological crisis, the contemporary battle over reproductive rights (including abortion), the question of population control And human rights in the Third World. Much of this is addressed in Lappe and Collins’ book Food First, but by exploring the area of population control, and women’s reproductive and total human rights, Hartmann adds much to the entire discussion.
The book reflects what Hartmann describes as “an ongoing process” of thinking about the population question, and is based on several years of research as well as direct experience living in a rural village in Bangladesh during the mid-1970s. It is a valuable contribution to what should be an ongoing process of enquiry for us all. Her message is that the way out of the current impasse and drift towards greater catastrophe, the way towards stable population levels and ecological and human well being, is the same. Furthermore, it is distinctly liberatory, centering as it does on the rights of women not only to their own reproductive destiny, but to participate fully in society. Thus it moves dramatically away from an authoritarian, bureaucratic-technological domain towards a participatory, liberatory vision of human empowerment and health.
That the liberation of women is the key to the crisis is an important and compelling insight, and suggests very strongly the connection between empire, the destruction of the natural world, the human/nature split, and the original emergence of institutions of domination over women. Such a discussion affirms the anarchist and eco-feminist perspectives that the fundamental causes of our present crisis in nature and culture lie in the origins and consolidation of the institutions of human (particularly male) domination; and the way out of the crisis also lies in the practical opening towards freedom of self-expression and selfhood for women, which is the key to the destruction of hierarchy, the re-empowerment of human communities, access to and proper relations with the land, and human health.
This very clear picture elaborates a tragically obscured dimension: how exactly “The needs of the planet are the needs of the person,” and “The rights of the person are the rights of the planet,” to use Theodore Roszak’s excellent formulation. The salvation of the marvelous green planet, our Mother Earth, depends on the liberation of women—and children, and men—from social domination, exploitation and hierarchy. They must go together. Neither a radical political vision nor a profound ecological vision can exist without this fundamental dimension.
The Two Sides of Birth Control
Hartmann’s book is refreshing in that instead of going into a long description of population growth itself, she provides a history of fertility control. Many traditions, such as abstinence and withdrawal, and techniques, such as abortion and barrier methods of contraception (like a cervical sponge or diaphragm), are thousands of years old. Some 400 species of flowering plants grown in 111 countries have been used traditionally for fertility control. Condoms, too, are quite old, and by the 1800s the process of vulcanization made possible much-improved condoms and diaphragms.
Fertility control hardly starts with Malthus, who in fact, had opposed contraception as immoral, preferring to let the poor starve as a method of keeping numbers down, as a “natural” preventive check. Only misery, poverty, famine, disease and war would keep population from expanding beyond the carrying capacity of the land.
Many working class radicals accepted the logic that excessive numbers were what kept the poor in their misery, and during the nineteenth century there were courageous attempts to disseminate birth control information both to promote lower population and to make it possible for women to control their own reproductivity and escape male domination. Birth control was the province of feminism, radical socialism and anarchism; Emma Goldman, for example, was arrested and jailed for distributing a pamphlet, Why and How the Poor Should Not Have Many Children, which described condoms, cervical caps, and diaphragms. Birth control clinics were opened by socialists in Europe, and in Germany female members forced the Social Democratic Party to reverse its opposition to birth control. In the United States, a young social activist, Margaret Sanger, founded The Woman Rebel, a paper with a socialist-feminist and pro-reproductive choice perspective, which was shut down by the Post Office. Sanger had to flee to Europe after being indicted on two counts of obscenity. Later the charges were dropped, but she was arrested for opening a birth control clinic in Brooklyn.
The breakdown in the alliance between radicals and the birth control movement towards the end of the second decade of the twentieth century reflects Hartmann’s comment that the birth control movement had “carried within it the seeds of birth control as a liberating force as well as a means of coercive population control.” Two other sources of the birth control movement had also emerged, the eugenics movement which argued for the “improvement of breeds” through genetic manipulation, and the desire by the professional medical establishment to bring birth control and reproductive decisions under its own supervision. As repression set in and the radical movement waned in the late ‘teens and early 1920s, Sanger herself moved to the right, seeking respectability and an alliance with elitist medical professionals. (Those readers familiar with Ivan Illich’s thoughtful descriptions of the professional monopolization and institutionalization of health and its subsequent destruction of human community, subsistence values, and the possibility for more liberatory modes of health, will recognize this process in the birth control movement’s evolution. See Medical Nemesis and Toward a History of Needs.)
With the hierarchicalization of birth control, and the retreat by anti-capitalist radicals from feminist issues, the movement became increasingly reactionary, with racist, nationalist and fascist elements creeping in. By 1919 Sanger was writing that the “degenerate” masses might destroy “our way of life,” and arguing “More children from the fit and less from the unfit—that is the chief issue of birth control.” By 1932 she was calling for sterilization and segregation by sex of the “dysgenic population,” a program which would soon be carried out with a vengeance by the Nazis, who in 1933 passed their first sterilization laws for people deemed “unfit.” This slippery slope ended in mass extermination practices and mass starvation of psychiatric inmates and others. Although the Nazis discredited eugenicist ideology in the U.S., Hartmann observes, “it never completely disappeared.”
With the New Deal and the reorganization of capital in the 1930s and 1940s, birth control was once more linked ideologically with social reform. Long time readers of the FE will recognize this period as the emergence of the real (as opposed to formal) domination of capital and the integration of proletarian movements and their program into the institutions of a modernized capitalist state. With World War II, the consolidation of what Lewis Mumford has described as the nuclear-cybernetic megamachine was complete; the nazi vision of the super-state had won the war, in the newly emerged garrison states that had defeated the Axis powers. For birth control, the same ambivalent character remained: Planned Parenthood made available contraceptive techniques for millions of women, and as a result capital was able to integrate women into industry and bring about further transformation of the proletariat for its own purposes of rationalization.
Population Control and the Cold War
Perhaps the most interesting section of this history is the origins of modern birth and population control as a component of the Cold War. The desire of the United States to “contain communism” and control the resources and political developments of the so-called “Grand Area” (essentially everywhere outside the Eastern Bloc), led to a perspective of population control to thwart nationalist revolt in the Third World. The Chinese and Vietnamese revolutions frightened U.S. ruling circles, as did Indian and Indonesian independence and non-alignment. The concern, of course, was the “security” of raw materials to feed the Garrison State. Governments in Iran, Guatemala, Indonesia and Brazil, among others, had to be overthrown to protect the “Grand Area” from “internal aggression” (that is, from their own populations), and lndochina was militarily attacked for several decades to stem the tide of nationalist revolt and war against the landlords and corporate puppets until the region was effectively shattered socially and ecologically.
Nationalist independence and realignment was seen by foreign policy circles as a direct result of population pressure as far back as the early 1950s, and therefore as a priority for the U.S. policy establishment. The 1957 Ad Hoc Committee report “depicted population growth as a major threat to political stability both at home and abroad,” writes Hartmann. By 1967, advertisements from the population control lobby (heavily financed and promoted by Dixie Cup magnate Hugh Moore), asserted, “The ever mounting tidal wave of humanity now challenges us to control it or be submerged along with all our civilized values,” and, “A world with mass starvation in underdeveloped countries will be a world of chaos, riots and war. And a perfect breeding ground for Communism…We cannot afford a half dozen Vietnams or even one more…Our own national interest demands that we go all out to help the underdeveloped countries control their population.”
Such control was always seen as a process of collaboration with local elites through military aid and the establishment of statified institutions for population control. In fact, the U.S. Agency for International Development (AID) is presently the largest single funder of population activities in the Third World. Local revolts, as in Central America, were and are consistently blamed on population pressure rather than class war and domination. This explains vividly the contemporary configuration of the population establishment and its technocratic vision of population control linked to industrial development, urbanization and the world commodity market, exemplified by technocrats like former U.S. Secretary of Defense and head of the World Bank Robert McNamara. It also aptly reveals how the Reaganite position against abortion rights in the Third World, based on the absurd “cornucopia thesis” of consultants like Herbert Kahn (that denies any necessary limitations to population growth), is only an aberration in an overall global strategy, a sop to Reagan’s right-wing, fundamentalist supporters inside the U.S. The anti-population control statement of the U.S. at the August 1984 Mexico City Conference on Population, in fact, was designed for domestic consumption, and “served to legitimize the position of the population establishment by casting them in the role of the defenders of reproductive rights,” and masking their real role as institutions of authoritarian-statist control.
Authoritarian and Technocratic
The contemporary population control establishment is, indeed, a component of the same forces of plunder and oppression that have brought the world to the brink of an ecological and social abyss. Its focus is authoritarian and technocratic. It follows a “machine model” perspective of human reproductive decision-making and has a high tech preference for sterilization, IUDs, the pill and other risky forms of fertility control over traditional methods and barrier techniques. It avoids any discussion of the social context within which reproductive decisions are made (or not made), defends the status quo of stratified, class societies and the capitalist market, and actually discourages an overall approach to women’s and children’s primary health as a central factor in population stabilization. Population bureaucrats deal with people in a purely instrumental fashion as statistics, and “incentive” programs are followed to sterilize as many people as possible, no matter what.
The ideology of population control is summed up by Hartmann as based on three tenets:
“1. Rapid population growth is a primary cause of the Third World’s development problems, notably hunger, environmental destruction, economic stagnation, and political instability.” Notice how for them, it is development itself (which means capital accumulation), and not environmental and human well being, which is the central concern. People are “units.”
“2. People must be persuaded—or forced, if necessary—to have fewer children without fundamentally improving the impoverished conditions in which they live.” To do so, of course, would demand agrarian and social revolution, which would undermine both the local elites and ultimately, perhaps, the entire development model of industrial-capitalist civilization.
“3. Given the right combination of finance, personnel, technology, and Western management techniques, birth control services can be ‘delivered’ to Third World women in a top-down fashion and in the absence of basic health care systems. In both the development and promotion of contraceptives, efficacy in preventing pregnancy should take precedence over health and safety concerns.” One can see the entire operationalism of mass technology and the disabling professions at work in this assumption.
Underlying the entire population control ideology is the Malthusian orthodoxy, which argues that the earth has reached the limits of its carrying capacity due to excessive human numbers using resources excessively. The image of a dark-skinned woman far along in her pregnancy is supposed to bring to mind the source of the world’s miseries. Hartmann does a good job of putting this orthodoxy into a proper perspective. Those who see the problem “as an inevitable race between man and nature” have a point, she writes. “No one wants a world of standing room only, where every bit of land, drop of water, and unit of energy is pressed into producing sustenance for an endlessly expanding human mass. Other species have a right to inhabit the earth, and our own quality of life is enhanced by respect for the natural environment. However, while limiting human numbers makes sense in the long run, it does not follow that in the short run overpopulation is the main cause of environmental depletion.”
Yet it is not so much the population growth that puts pressure on the earth as it is “the consumption explosion in the industrialized world,” she argues. “Moreover…many of the main ecological crimes being perpetrated on the earth” are caused by “unregulated and inappropriate patterns of technological development” rather than the population growth of peasants. Hartmann looks at the arguments of environmental destruction as an outcome of population pressure and finds them seriously flawed.
Malthusian Fatalism
One example is the serious problem of deforestation, which according to the official view of the Indian government, for example, was caused primarily by population pressure. Yet when the Center for Science and the Environment in New Delhi investigated deforestation there, where millions of hectares of forest are disappearing annually, it found that private companies had “illegally felled huge sections of India’s forests, at the same time as they were declared off limits to the local communities who have long depended on them for a livelihood. Meanwhile, ‘official’ forestry projects, aided by international agencies such as the World Bank, are encouraging the export of India’s hardwoods and the destruction of mixed, ecologically sound forests in favor of monoculture plantations of pine, eucalyptus, and teak.” The same process is going on throughout the Third World, as in Brazil, where corporations like Goodyear, Volkswagen, Nestle and Mitsubishi have stripped millions of acres of rainforest for lumber and cattle ranching. Dictator Ferdinand Marcos of the Philippines “gave illegal logging concessions worth over a billion dollars to relatives and political cronies, depleting the country’s forest reserves from 34.6 million acres in 1965, when Marcos took power, to only 5.4 million acres today.”
Desertification, like deforestation, is largely a result of inequities on and exploitation of the land. A world land census in 1960 revealed that 2.5% of landowners controlled 75% of arable land in the world, and the top 0.23% control over half. And where starvation ravaged the poor, those regions, as in the famished Sahel of Africa, actually increased agricultural exports. In Burkina Faso (formerly Upper Volta) in West Africa, Hartmann reports that cotton production increased twenty times since 1961, while staple crops like millet and sorghum remain at 1960 levels. The same situation is occurring in El Salvador, where 77% of the land faces accelerated erosion; most of the poor are marginalized on higher slopes, causing ecological damage, and the good lands are monopolized by the death squad oligarchy to raise exports like cotton, coffee, sugar and cattle. “In such a situation,” she writes, “more people do mean more ecological destruction, since they are crowded into a limited land space. In this sense, rapid population growth is a factor in desertification, but to call it the primary cause is to simplify a much more complex process. El Salvador’s peasants are putting pressure on marginal lands because they themselves have been made marginal by an agricultural system controlled by the rich.”
She comes to the same conclusions as Lappe and Collins: “Despite the popular Western image of the Third World as a bottomless begging bowl,” she observes, “it today gives more to the industrialized world than it takes. Inflows of official ‘aid’ and private loans and investments are exceeded by outflows in the form of repatriated profits, interest payments, and private capital sent abroad by Third World elites.” According to one banking study, more than a third of the region’s increase in borrowing between 1978 and 1983 was “spirited away overseas” by rich Latin Americans.
Yet the Malthusians do not ask why people are going hungry, why they lack livelihoods, why they are driven from their land. They do not consider the questions of land ownership, the history of colonialism, where social power lies. So when the poor demand their rights, the Malthusians see “political instability” growing from population pressure. “Their ideological fervor masks a profound fatalism: the poor are born to their lot, and the only way out for them is to stop being born.” “Population control is substituted for social justice, and the problem is actually aggravated by the Malthusian ‘cure.'” Family planning and health are subordinated to coercive and repressive population control, and millions of women are negatively affected.
Both the failures and the “successes” of authoritarian population control are explored at length by Hartmann. In Bangladesh, for example, “Spending on population control now absorbs over one third of the country’s annual health budget, and its share is growing.” Health care for mothers and children is being slashed to pay for population programs. Population control efforts are being accelerated as the quality of life deteriorates—landlessness, plummeting wages, decreasing food consumption. More than 60% of the population now has an inadequate diet. Amazingly’, “Despite the millions of dollars flowing into the country for population control, women’s unmet need for contraception is still not being met…Whereas before village women were neglected by Bangladesh’s family planning program, now they are the targets of an aggressive sterilization drive that uses incentives and intimidation to produce results. Meanwhile, access to safe and reversible methods of fertility control is still very limited.” Sterilizations, for which a person might be paid a small sum and given some new clothes, “increase dramatically during the lean autumn months before the rice harvest, when many landless peasants are unemployed and destitute.” The sterilization methods themselves are brutal and impersonal, and frequently lead to complications, illness and even death, since follow-up medical aid is unavailable.
Population Control as Genocide
The genocidal character of population control is dizzying. Sterilization has been focused at India’s tribal minorities, though they are numerically small. In South Africa, population control is for blacks, while whites are rewarded for having children. The only free medical service for blacks is birth control. There, the argument is used widely that black “overpopulation” is putting pressure on the ecology of the region. In Puerto Rico, a U.S. colony ecologically devastated by U.S. corporate exploitation (and where mainland U.S. environmental laws do not apply), one third of the women were sterilized by 1968. Inside the U.S., Native American women have been the target of forced sterilization. China, which has recently been going through economic transformations along a Western development model, has implemented draconian anti-population measures, with forced abortions and sterilizations to impose a one-child-family policy. As new incentive programs along private capitalist lines have been implemented, Malthus has slipped in with them. Nevertheless, interestingly, China’s greatest strides in stabilizing population came before the one-child policy was instituted, according to Hartmann, and there has even been a slight population trend upward since the new policy, along with the privatization of lands, was implemented.
It should come as no surprise that this “profoundly technocratic exercise” should aggravate the problem and backfire. The notion that top-down techniques and “rational” education of the poor, administered by authoritarian, privileged elites over the “stupid peasants” who are their subjects, without reference to the social context of land ownership, social power, and health, is a scientistic and mechanistic fantasy. But it is the strategy followed by most Third World states and Western population and family planning agencies. Kenya is considered one of the worst failures of such policy, yet it was the first African nation south of the Sahara to implement an official population control program, in 1967. By ignoring social and economic conditions, and focusing on population control rather than family planning and health, it was resisted by the people and now Kenya has one of the highest birth rates in the world. None of the sources of high fertility—high infant mortality, landlessness, lack of power, patriarchal domination—were addressed. One of the largest causes of high dropout rates in family planning was contraceptive side effects, yet riskier high tech methods were favored, and local custom and health devalued, so women did not respond.
The “machine model of family planning,” based on efficiency models, incentives, and “target orientation,” ends in outright coercion. In Indonesia, which is ruled by a right-wing dictatorship, “women are dragooned towards contraception as once they were doomed to uncontrolled fertility.” Choice is actually limited to the worst techniques, and traditional methods And low tech methods demanding women’s empowerment and participation as well as a focus on their health, are actively discriminated against. Even the military authorities have been directly involved, forcing IUDs on villagers at gunpoint. “The top-down approach toward birth control means it is not popularly perceived as a tool of reproductive choice,” writes Hartmann almost euphemistically, “but as a means of social control.” One can see this process backfiring as it did in Kenya and may be starting to do in China. Yet, “Indonesia has become the family planning showcase of the Third World.”
Ironically, the women of the world want birth control. Hartmann discusses several studies, including a survey done in 27 Third World countries, that “found that almost half the married women questioned wanted no more children, and that younger women especially tended to desire a smaller family size.” Women actually lack access to birth control and information. The 30 to 50 million induced abortions done a year—one half of them illegal—also suggest that women want birth control. (In Latin America, up to one half of all maternal deaths are due to illegal abortions.)
An Expansion of Rights
Yet the Malthusians have the problem backwards, she argues. “The solution to the population problem lies not in the diminution of rights, but in their expansion. This is because the population problem is not really about a surplus of human numbers, but a lack of basic human rights.” One of the main reasons for high birthrates is a total lack of security, which means that people gamble on having large families, particularly sons, with their old age, illness, and economic dislocation in mind. High infant mortality rates are also a cause of high fertility. One would think, as do many contemporary Malthusians, “that reductions of infant mortality would actually increase the rate of population growth, since there would be more surviving children to grow up into fertile adults.” (One AID bureaucrat even argued that primary health care programs should be discouraged, since they might aggravate the population problem by lowering death rates.) “Experience has shown,” Hartmann asserts, “that once mortality rates fall to around 15 per 1000 people per year, the average for the Third World today, each further decline in the mortality rate is generally accompanied by an even greater decline in the birth rate, as people adjust their fertility to improved survival possibilities.” High birth rates flow directly from high infant mortality rates, and the latter are “primarily caused by poor nutrition, both of the mother and the child.” Nutrition is crucial, even more than primary health care itself, since it underlies the whole chain of causes of infant mortality, from unhealthy mothers to low birth weight to poor breast milk. Paradoxically, what one United Nations official has called a “survival revolution” halving the infant and child mortality rate and preventing the deaths of six or seven million infants each year by the end of the century, could also prevent between 12 and 20 million births annually.
Hartmann remarks, “To date no country has achieved a low birth rate as long as it has had a high infant mortality rate.” In countries like Sri Lanka, Cuba and the Indian state of Kerala, where the birth rates have been dramatically lowered, it is not so much that industrial development, measured in terms of increased energy consumption and personal income per capita, has improved the standard of living, but that basic nutrition and access to primary health care and reproductive choice have been emphasized. Ironically, if the Malthusians have their way and health and nutrition in the Third World are allowed to decline even further as the Malthusian “checks” take their toll, the population explosion will only be exacerbated. By ideologizing the population question to the detriment of social critique, they work to promote the very scenario they claim to fear most.
The question, of course, goes beyond population control and family planning. Women’s reproductive choice depends on their role in society as a whole, and their lack of choice is directly linked to their lack of autonomy and personhood as well as to their economic domination. Women are invisible in official labor statistics, but research shows that “women produce almost half the food crops grown in the world: In Africa women contribute two thirds of all hours spent in traditional agriculture and three fifths of the time spent in marketing. In Asia, they constitute over half the agricultural labor force; in Latin America at least 40 per cent.” Modernization, of course, has worsened women’s lot. Commercial farming has favored men at every level, and industrialization only doubles women’s workload. Today 80 to 90% of low-skilled assembly jobs in the Third World are held by women.
Women’s freedom and well-being is at the center of the resolution to the population problem, and that can only be faced within the larger social context. Even health and family planning programs will not suffice if they are implemented from above and administered as a technological procedure. If primary health care is to be effectively used, it must take place within “fundamental power struggles,” which means real participation in social decision-making, real health concerns, access to land, and the overthrow of patriarchal domination. “There is no intrinsic reason why women’s health and safety have to be sacrificed to contraceptive efficacy or why freedom of choice has to be subordinated to population control,” writes Hartmann. “If there is to be a second contraceptive revolution, let it start with a revolution in values.”
Personal, Political, Planetary
What would be the focus of such values? Woman must be at the center of concern—her autonomy and her well-being and the well-being of her children, within the larger social context of access to land and participation in society. If the origins of hierarchy and domination as well as humanity’s anguished cleft with the natural world are to be found in woman’s primordial enslavement and the institutionalization of patriarchy, then the necessity of her liberation is an elegant testimonial to the working out of an historical dialectic, a return to origins, a completion of a cycle. This can only come about by abolishing the structures of domination which are globally undermining women’s freedom and health and leading the planet to catastrophe. The political, the personal and the planetary all find expression in this process of liberation.
Some criticisms can be made of Hartmann’s book. She appears at times to be impressed with industrial growth as a solution to the problem of domination and hunger. She is also too willing to make use of arguments against Malthusianism that depend on industrial and technological models of development that only beg the question of carrying capacity. One need not repeat the arguments of some historians that population growth is the cause of improvements in conditions; it only legitimates industrialism and its destruction of vernacular societies while evading the central question of massive population growth as a result of the disruption of traditional societies and natural economies. The discussion of Africa is an example, in which she argues that Africa was to some degree depopulated by the slave trade, and while it was 20% of the world’s population in the eighteenth century, by the year 2000 it will be less than 13%. These figures are meaningless. The slave trade had little or no effect at all on numbers in Africa, as any population atlas will attest, except to disrupt the local societies enough to cause further population growth. Africa is not in need of more hands to promote development. And Africa needs, for its long-term health and biotic diversity, to leave most of its uncultivated lands as they are. If the population question is an ongoing process of enquiry, Hartmann should go on to explore a critique of industrialism, technological development, the disempowerment and commoditization of human communities, and the creation of mass society. A revolution in values demands a critique of industrial civilization and an attempt to live in harmony with the natural integrity of the planet, not mass industrial complexes to build tractors or produce chemical fertilizers.
This is not the focus of Hartmann’s book; it is, rather, the question of women’s reproductive rights as a central factor in their human rights, as integral to the entire project of social transformation and human freedom. Her devastating critique of authoritarian, technocratic population control suggests a deeper critique of modern technological civilization, rationalization and modernization, even if it is beyond the scope of the book to explore those themes further. Perhaps it is beyond any single book to provide such a critique. Readers can do that on their own by sifting through a whole body of literature and personal experience. Nevertheless, Hartmann has made an extremely valuable contribution to the critique of Malthusian ideology and has added important insights by linking the resolution of the population problem and the ecological crisis to the project of human liberation—for that she deserves our praise and gratitude.
The pages concerning deep ecology and the population discussion were typeset, proofread and laid-out by our friend and collaborator in San Francisco, Freddie Baer, with assistance from Daniel G. Our thanks and admiration for their fine work, especially for Freddie’s creative and incisive selection and design of the graphics. Our SF collaborators can be contacted at P.O. Box 410151, SF CA 94141-0151.