Revisit the Real Pioneers of Family Planning History

June 24th, 2017

    

Although I am not much of a historian, I have followed the history of family planning and of the concern about human population growth—and was surprised to learn that two commonly held beliefs are not correct.
Thanks for reading!
Richard

Revise your Ideas of Family Planning History

Malthus was the first person to make the connection between increasing human population causing problems, correct? And, of course, Margaret Sanger was the first to teach poor women about family planning.

Both of these notions about the history of family planning are wrong. These two firsts actually belong to people who have almost been lost to history.

Hong Liangji was a minor governmental official who lived in the Yangzi Valley of China in the 18th and early 19th centuries. He wrote several essays about politics and other subjects. In an essay from 1793 titled “On Governance and Well-being of the Empire” he voiced his view that increasing population would interfere with peaceful rule. Apparently he felt that it was his duty as a Confucian to criticize the emperor. The emperor did not receive this well; he ordered that Hong be decapitated. Fortunately the sentence was reduced to banishment to a minor post.

The background to Hong’s writing was that highly productive new crops allowed China’s population to grow rapidly. This was welcomed by the government, but was recognized by a few as being potentially problematic.

“But in the matter of population, it may be noted that today’s population is… not less than twenty times as large as that one hundred years ago.” Hong wrote. A twenty-fold increase may have been an exaggeration, but his was definitely a time of very rapid population growth.

Hong illustrated his concern with an example. If a family that started with a large home and 3 children on a fair sized farm, at the end of a century they could end up with as many as 100 people (including servants) living in the same house and farming the same area of land. He wrote that the emperor could not stop the people from reproducing, but that harmony could be destroyed by the rapid growth. He observed: “… the resources with which Heaven-and-earth nourish the people are finite.“ He ended this essay on population “The food for one person is inadequate for 10 persons; how could it be adequate for a hundred persons? This is why I am worried about peaceful rule.”

Five years after Hong, Malthus published: “An Essay on the Principle of Population” in 1798. It is no wonder that we usually give Malthus credit for being the first to raise the alarm about population, however, because Hong wrote in Chinese (which few westerners understand), and he ended up in obscurity.

The first person to advocate for family planning was British. In 1823, more than half a century before Sanger was born, Francis Place published pamphlets about family planning for poor women. He taught two methods of birth control, withdrawal and use of a vaginal barrier. Here is a quote he wrote about the latter: “A piece of soft sponge about the size of a small ball attached to a very narrow ribbon and slightly moistened (when convenient) is introduced previous to sexual intercourse and is afterwards withdrawn, and thus by an easy, simple, cleanly and non-indelicate method, in no way injurious to health, not only may much unhappiness and many miseries be prevented, but benefits of an incalculable amount be conferred on society.”

Apparently many rich women knew about “pessaries” to prevent pregnancy, similar to what Place described. However he was the first person to pass this information on to “…the socially less privileged.” One of his pamphlets was named “To the Married of Both Sexes of the Working People and Similarly the Married Sexes in Genteel Life. The pamphlets were distributed widely throughout England, but the establishment called them “diabolical handbills”.

Place’s personal life is interesting, if perhaps antithetical to his later interest in family planning. He came from a poor family, married at age 19 (his wife was just 17) and they had 15 children! of whom 5 died young. Place educated himself by reading voraciously. He started a successful business that he turned over to his children so he could be politically active. Place’s goal was to improve the lives of the poor. He collaborated with some well-known friends, including Jeremy Bentham and John Stuart Mill.

Large families and rapid population growth affect both society and the individual. Hong wrote about the former; I have not been able to find out much about his personal life. Place was concerned about both later in life. His only book: “Illustrations and Proofs of the Principles of Population” was inspired by Malthus.

© Richard Grossman MD, 2017

 

 

Keep Public Lands Public

May 30th, 2017

 

Preserve public lands for children yet to come

 We are fortunate to live in a beautiful part of the world, and also fortunate to have parts of the land preserved as national monuments. Several of these are under review, and it is concerning that the national parks and other protected areas may also be in political jeopardy. Protect them so our children can enjoy them.
Richard

Rio Grande Gorge by Daniel Schwen

You have fished for the trophy trout in the Rio Grande in the Rio Grande del Norte National Monument. Or perhaps you’ve hiked Sand Canyon, a bit west of Cortez, and enjoyed the wonderful walking, spring flowers and ancestral Puebloan ruins.

You can kiss these amazing places goodbye if some of today’s politicians have their way. Both the above public lands are controlled by the federal government, as is much of the land in the West. The feds don’t do a perfect job of stewardship, but at least a certain minimum standard of protection is enforced. National monuments restrict and control grazing and extractive industries.

When he was campaigning, Donald Trump pledged to keep public lands under federal control. Unfortunately, ! he is reneging on those promises.

Trump has asked Ryan Zinke, secretary of the Interior, to review 27 of the largest and most recently designated monuments. The idea would be to either abolish these monuments or to decrease their size. It appears that Trump’s motivation is to alter the special monument status for commercial reasons. Yet it is essential that humanity not lose our connection to our land and to our past.

In addition, there are threats to turn control of monuments over to state authorities. At first glance, local control sounds as though it might be a good idea. There would be local or state governments controlling these beautiful parts of our wonderful country. Furthermore, the responsible people wouldn’t need to contact Washington every time they need to buy a new pencil sharpener.

The downside of local control is that local people may! lose sight of the purpose of monuments; they might sell off rights during a time of economic difficulty. Furthermore, locals often don’t have the resources or expertise and would be unable to administer the monuments properly. Many states lack sufficient funds to run their state parks well, let alone take responsibility for national monuments!

National monuments come in all sizes, from a single historical house to the mammoth Papahanaumokuakea Marine National Monument. They were all created by decree by presidents of both parties, on territory that already belonged to the federal government. No president has ever ordered a review before.

Many of the 129 national monuments in the U.S. are of great aesthetic value. Their beauty attracts millions of visitors and is of great value to local economies. Exploration and drilling would spoil their bea! uty and trade short-run profit for long-run ruin.

Bears Ears National Monument was designated at the end of 2016 after years of consideration. It was established with the help of several Native American tribes, who are also involved in its administration. It is under intense scrutiny, probably because of a resolution passed by the Utah legislature “… urging the president to rescind the designation of Bears Ears National Monument designation.”

The response to Utah’s resolution was quick. Clothing giant Patagonia has moved the huge Outdoor Retailer trade show from Utah, where it has been held for 20 years. Other companies joined, and the trade show has announced that the next show will be in Denver. Conservation Colorado put advertisements in Utah papers saying, “We have stronger beer. We have taller peaks. We have higher recreation. But most of all we love our public la! nds.”

Establishing an! d protecting public lands (and oceans) became prudent as our population grew, and as we harvested increasing amounts of the bountiful resources. It is essential to have places for children to explore and for adults to reconnect to the land. In addition, some of the monuments memorialize cultural resources – for instance, Canyons of the Ancients protects more than 6,000 archaeological sites.

There are many good organizations that are monitoring and fighting the attempt to jeopardize public lands. I favor the San Juan Citizens Alliance (sanjuancitizens.org) and Conservation Colorado (conservationco.org). Both have information on their websites and advocate for public lands protection.

We are fortunate to live in a beautiful part of the world that also has copious resources. We should enjoy our surroundings and use the resources carefully but r! emember those who will come after us.

I would like my granddaughters to be able to fish the Rio Grande, hike Sand Canyon and camp in Bullet Canyon without the sounds of pump jacks and chainsaws.

Like you, I have explored parts of Cedar Mesa, which are now protected by Bears Ears National Monument – but perhaps we better hurry back while the monument is still undeveloped.

Or work harder now to preserve it.

© Richard Grossman MD, 2017

Look Where We Need Family Planning the Most

April 27th, 2017

“As we crawled through the city, we encountered a crowded slum area. The temperature was well over 100, and the air was a haze of dust and smoke. The streets seemed alive with people. People eating, people washing, people sleeping. People visiting, arguing, and screaming. People thrusting their hands through the taxi window, begging. People defecating and urinating. People clinging to buses. People herding animals. People, people, people, people.”   Ann and Paul Ehrlich in Population Bomb, 1968

Impact = Population x Affluence (consumption) x Technology

                                                Ehrlich and Holdren, 1971

 

Close your eyes for a moment and conjure up an image of overpopulation. Did you picture hundreds of people hanging off a train in India? or dark-skinned crowds in a street in a poor country?

Yes, family planning is important in those scenarios. Voluntary access to modern contraception is important for humanitarian reasons in the global south. You probably know the litany of its benefits: decreased maternal mortality, healthier children, economic savings, progress in standard of living and education, local environmental protection.

However, the need for effective, universal access to family planning and to safe, legal abortion is much more important in rich countries in the global north. This is because of the issue of consumption.

What! you might be asking. The average woman in many African countries has 5 or more children. Niger tops the list; the total fertility rate there is over 7! Surely the population explosion there must be causing problems. Yes, Niger is one of the lowest ranked countries in the UN’s Human Development Index. Repeated drought has caused famine; population pressure and overgrazing cause environmental degradation.

Let’s compare two countries in the Western Hemisphere—the USA and Haiti. They are, respectively, one of the richest and one of the poorest in the world. The carbon footprint of an average person in the USA is about 20 tons of CO2 per year, while that of a Haitian is 0.2 tons—one hundredth of ours! Thus it would take a hundred Haitians to equal the climate damage done by one of us.

Another way to compare the impact of a single person in the two countries is with Ecological Footprint. The ratio between the two countries is 16 to 1. Thus 16 kids of a really large Haitian family would have the same impact of a single-child family in the USA. I have to admit that there are several problems with this comparison: it doesn’t include the two parents, the average Haitian family size is just a little over 3 so I doubt that there are many as large as 16. The legacy of a large family grows over generations. In Niger, if each generation has 7 children, the number of grandchildren would be 49!

The two measures of impact are different. The carbon footprint is global, since carbon emissions into the atmosphere spread over the whole planet. The Ecological Footprint includes carbon emissions, but it also includes effects that are localized, such as damage to the local environment. In any case, the impact of a person in the USA is much greater than one in Haiti or Niger, and it is spread over the planet.

There is good news! The unintended pregnancy rate (this includes mistimed and unwanted pregnancies) has dropped significantly in the USA. Whereas this rate has hovered at about 50% for years, the latest information is that it has dropped to 45%. The news is especially good for young women, when an unintended pregnancy can be devastating. This decrease is due to increasing use of effective contraception. It is very concerning that the new administration threatens women’s reproductive health and may make contraception and abortion services either unaffordable or totally unavailable.© Richard Grossman MD, 2017

Creative Commons Attribution 3.0 United States
This work is licensed under a Creative Commons Attribution 3.0 United States.