Contraception as a end to poverty for the world's women? Don't forget education.

Nicholas Kristoff wrote an op ed earlier this week about contraception as a tool to end poverty for many of the world's women and families.  He also wrote a follow up piece on the challenge of building consensus on this issue.

His main point is that women in many parts of the world lack knowledge of and access to effective and safe birth control methods.  Some of the barriers are due to culture and religion.  Children are valued as signs of virility, wealth and health.  Women are expected to produce children for their husbands, at least one every few years.

We have proven that education is its own special kind of contraception.  Where girls and young women are educated, they delay motherhood and have fewer children.  Why is this?  Because they are empowered members of society and the workforce (in many cases).  They do not have to rely on a husband to take care of them, and so can make decisions about when to have children and how many to have.   Children who have educated mothers (often employed mothers) are more likely to go to school and delay their own motherhood.  Poverty and ignorance breed more poverty and ignorance. 

If you keep a girl in school, you help her change the course of her life, that of her future family, and an entire nation....It’s a simple and well-documented fact. A girl who goes to school and stays there is much more likely to postpone marriage and childbirth. Those decisions have a dramatic ripple effect. Later childbirth results in lowering the overall fertility rate, which means higher per capita income and the increased ability of a woman to earn a living for herself and her family. And educated women provide better health care for themselves and their children, meaning lower maternal and infant mortality rates. In fact, a country's investment in education leads to a whole host of results that promote economic and social development. 

- Cokie Roberts (in Save the Children's The State of the World's Mothers 2005)

 
Simply handing out condoms and birth control pills will not change the fate of women and children in this world.  For one thing, men are in control of when and with whom they use condoms.  Many women in the world, from any walk of life or continent, do not have the power to negotiate condoms use with their partners.  Just look at the numbers of women with HIV/AIDS for evidence of this.

From The Body (for women in the U.S.):

Today, women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. In 2004 (the most recent year for which data are available), HIV infection was

• the leading cause of death for black women (including African American women) aged 25-34 years.
• the 3rd leading cause of death for black women aged 35-44 years.
• the 4th leading cause of death for black women aged 45-54 years.
• the 4th leading cause of death for Hispanic women aged 35-44 years.

From Avert: 

At the end of 2008 it was estimated that out of the 31.3 million adults worldwide living with HIV and AIDS, around half are women.¹ It is suggested that 98 percent of these women live in developing countries.² The AIDS epidemic has had a unique impact on women, which has been exacerbated by their role within society and their biological vulnerability to HIV infection.
Generally women are at a greater risk of heterosexual transmission of HIV. Biologically women are twice more likely to become infected with HIV through unprotected heterosexual intercourse than men. In many countries women are less likely to be able to negotiate condom use and are more likely to be subjected to non-consensual sex.^3 4

So the issues are more complicated than simply trying to prevent pregnancy for women who either cannot provide for a child or do not desire to have any/more children.  It is about controlling and ending a pandemic that has infected millions.  It is about saving millions of children from a life of poverty and lack of education or opportunity.  It is about decreasing maternal and infant mortality, which is a significant problem in the developing world, due to many factors, including lack of access to prenatal care and properly trained health care providers and necessary resources.  So yes, we need more contraception and family planning in the world, but we also need schools and the political will to make sure the world's girls get the education they deserve.