Contraception Family Planning Population Reproductive Health

Reject these Old Memes—2-2014

Recently a friend introduced me to the word “meme”. Now I run across this concept frequently.
The word “meme” is analogous to “gene”, but it is information in our culture rather than in our DNA. A meme is a building block upon which our way of life is built. One definition is: “an idea, belief or belief system, or pattern of behavior that spreads throughout a culture”.
An old example is the Pythagorean theorem—the square of the hypotenuse of a right triangle is equal to the sum of the squares of the other two sides. This meme is ancient.
One accidental meme is changing lives in Brazil. The average family size has dropped rapidly. In 1954, when I visited as a child, women had an average of over 6 children. Now the average is 1.8—less than replacement. This big change is largely because of TV telenovelas, where middle class families are all small.
Some memes are harmful. An example is a tradition in Nigeria that leads to the death of many children. For eons Traditional Birth Attendants used mud or other unclean substances to dress newborn babies’ umbilical cord stumps. If tetanus spores are present, the baby can die a horrible death from tetanus. This improved when TBAs were taught the advantages of cleanliness and sterile instruments. Now pregnant women getting prenatal care are immunized against tetanus and there are many fewer deaths.
Galileo, who was born 450 years ago this month, suffered because of a religious meme. This meme slowed the development of knowledge for centuries.
Ancient Egyptians thought that the sun rotated around them—the geocentric model of the solar system. A Greek may have first proposed that Earth revolved around the sun 2500 years ago—the heliocentric model. For centuries people believed that the earth was the center of the universe, supported by theology that interpreted the Bible thusly. One verse that supports this meme is found in Psalms 104:5: “(God) built the earth on its foundations, so it can never be moved”. There are still people who hold that the sun goes around the earth—including 26% of US citizens, according to a recent National Science Foundation survey!
In the early 17th century Galileo defended the heliocentric theory, for which he was accused of heresy and placed under house arrest for the rest of his life. The Inquisition’s ban on reprinting his works was only lifted a century later. It was not until the 19th century that the Roman Catholic Church removed books advocating heliocentrism from its Index of Prohibited Books. Pius XII was the first Pope to acknowledge the many important contributions of Galileo—in 1939. Yet there are people who believe that heliocentrism is a conspiracy ( It is amazing how long this meme has persisted!
Years ago I sold “green umbrellas” at a public health meeting. From a campaign in Bangladesh (where it rains a lot), these umbrellas carry slogans such as “stay well” and “take health services” in Bengali. A doctor from Bangladesh bought one, then a few minutes later returned and wanted his money back. I asked him what was wrong. He replied that one of the sayings is “small families”, and we should have as many children as Allah gives us. This is another case of a religious meme that has outlived its usefulness, since Bangladesh is very crowded.
I find it amazing that some religions have not yet recognized the benefits of contraception to individuals, to families and to the world. The official doctrine of the Roman Catholic Church is that only periodic abstinence (the “rhythm” method) is acceptable. This policy is ignored by many of the 1.2 billion Roman Catholics worldwide—and many women I have talked with have left the Church because of this policy.
In many Catholic countries, such as Brazil and in Western Europe, couples use modern contraception resulting in average family size less than two. There are places, including some of the poorest countries in the world where this prohibition against effective contraception is followed. They will continue to be stuck in poverty so long as people are prohibited from using modern family planning. Rwanda is an example; its rapid population growth was one factor leading to its genocide 20 years ago.
Memes can outlive their usefulness to society. It is time for women to have the same status and rights as men, and for all people to have the access to the means to manage their fertility.

© Richard Grossman MD, 2014

By Richard

I am a retired obstetrician-gynecologist who has been fortunate to live and work in the wonderful community of Durango, Colorado for 40 years.

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