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Durango Herald Family Planning Population

Celebrate 20 Years of Population Matters!

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Twenty years ago this spring Morley Ballantine (then the Herald’s editor) gave me the responsibility of writing a column on human population issues. I want to take this opportunity to give an update on population and to thank some of the people who have been involved.

I believe that this is the only regularly appearing newspaper column about issues of human population. Indeed, it is probably the only regularly appearing treatment of this most important subject in any medium. It started as an idea for a book with short chapters, each with a verb in the title, and with a positive message about what individuals can do about population. Gail, my wife, and I were able to think of just 17 chapters initially and we worried that there might not be enough content for a whole book. About 240 essays later I have a long list of possible future topics!

Bill Roberts has been my editor and friend throughout these two decades. We seldom see each other, but have mutual respect. Bill has been great in keeping me in line: “stick to the subject” read one of his emails. Richard Ballantine has taken over his mother’s concern for population. He has provided support not only for these columns but also financial support through the Ballantine Family Fund for relevant events in our community.

For several years a group observed World Population Awareness Week in Durango. We brought in speakers and had events—but too often they competed with the wonderful Lifelong Learning series at Fort Lewis College. Fortunately Rich Hoehlein, organizer of this series, has agreed to have occasional talks on topics related to population rather than splitting the audience.

Gail is my first sounding board. I trust her reaction to an idea or draft article more than my own. She finds mistakes in drafts that I’ve been over many times, and comes up with solutions to writing problems. I am lucky to have such a talented writing partner.

When Population Matters! first hit the press, world population was about 5.7 billion; it has increased by a billion and a half to 7.2 billion in the past 20 years. This rapid increase is partially due to the International Conference on Population and Development, which shifted the focus away from population. The word “population” was tinged by a past history of coercion; instead the Conference focused on “reproductive health”.

Now we can measure the consequences of population and consumption using the “Ecological Footprint” concept, and have discovered that we are using resources much faster that the planet can provide. We also know that climate change is a repercussion of population growth, as are the decreasing numbers of wildlife and loss of species.

We have made many improvements in family planning since 1995. Emergency Contraception has helped prevent unplanned pregnancies. EC was rarely prescribed 20 years ago, but now EC pills are available in over 50 countries, in many without prescription. We have recognized Long Acting Reversible Contraception (LARC) as being much better than methods that require daily or weekly usage. Another LARC, a new IUD, will soon be available.

The Affordable Care Act (“Obamacare”) has taken a positive step to lower our high unintended pregnancy rate. It provides contraception without co-pay for any enrollee. (Unfortunately it does not pay for vasectomies!) An experiment in Colorado showed that it is possible to lower the teen pregnancy rate (and to decrease the number of abortions) by providing LARCs without charge to uninsured women. Unfortunately, a Colorado legislature killed funding to continue this program.

Even before EC pills were available without prescription it was possible to get them over the Internet. This same model is being used to provide birth control pills. But isn’t “the pill” dangerous? There are some risks with hormonal contraception, but a study in England has shown that women who used oral contraceptives, on average, lived longer than women who did not. Planned Parenthood has been providing pills safely for years to women without an exam—just a blood pressure reading. This miracle medicine is now available at: https://www.prjktruby.com for just $20 per month. This fee also helps to pay for birth control for women in the developing world, thanks to PRJKT RUBY.

My sense is that people are becoming more aware of population issues. FP2020, the program to provide quality family planning services for many of the world’s poorest countries, is a barometer of this change. My hope is that the USA will continue to see programs that will lower our high unintended pregnancy rate.

© Richard Grossman MD, 2015

PS: I have been distributing these monthly columns by email to people all over the country–and a few outside the USA. I promise only one email a month. If you would like to be added to the listserv, please contact me at: subscribe@population-matters.org
Thanks!
Richard

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Join Me in Celebrating my 70th Birthday

I’ve lived more than half my life here in La Plata County and have reached a milestone. This month I turned 70. My only sibling, Clara, died too young at age 71, although our parents both lived to over 85. This is a good time for me to take stock.
Writing this column for the Herald has been a real pleasure. I have had reason to research all sorts of subjects and to pretend that I’m an expert in them all. Thanks to the Herald for giving me a way to exercise my mind—and hopefully stave off dementia!
It has been my great privilege to have been a part of so many people’s lives as a physician in our community. One of my greatest pleasures is to re-meet folks I have helped into this world. An unrealized goal was to deliver three generations of babies. It has been wonderful, however, to help deliver the sons and daughters of people I first met as newborns.
One of my reasons for becoming a physician and then specializing in obstetrics and gynecology was concern about human population. The world’s population has tripled since my birth, and that of the USA has more than doubled. Because of economic development and our higher standard of living, human use of resources has been multiplied many times. My original reason for concern about overpopulation has to do with my wanting to work for peace. High population density, and thus competition for resources, is a common reason for war. I am still working to minimize this cause of armed conflict. However, now there are many other reasons for concern about population, including extinction of species and climate change. I have been accused of performing abortions only to slow population growth; this is not so! There are strong individual reasons, too—almost as many as there are women with unplanned pregnancies.
Abortion is seldom mentioned in the media except with an associated dark cloud. I am proud to be a physician who performs safe, legal abortions in a caring atmosphere. Whenever I think of retiring from being an abortion provider I remember the quiet teen who sat up after her abortion and said: “Thank you doctor. You gave me back my future.”
I have a conundrum. Sometimes people comment on my quirky sense of humor, but it has not been exercised much when writing these columns. Perhaps the subjects I write about are just too serious for me to find ways to joke about them. I need help: if you can think of jokes about the future of the planet—climate change, extinction of species and overpopulation—please write me.
I also have a bucket list—a list of things I would like to do while I still am able. One big item on the list is to continue exploring the world and our immediate surroundings. We still backpack, but the distances we hike before making camp are getting shorter. Fortunately our dog, Tyrone, helps carry stuff.
Obstetrics has one unique disease that kills women and babies. Physicians have never figured out what causes preeclampsia (also called toxemia of pregnancy or Pregnancy Induced Hypertension); my bucket list includes researching its physiology. About 30 years ago I came up with a hypothesis—that PIH is the woman’s body’s way of compensating for the baby’s obstructing blood flow to the lower half of her body. I never got around to testing this theory, but I hope to do start that study soon.
One of my successes has been to learn enough Spanish to be able to function medically in that language. This has been a help to the many immigrants (and their wives) who do much of the low-paying labor in our area. Recently I have volunteered at the La Plata Community Clinic where Spanish is valuable. It seems strange, after limiting my practice to just women for so long, to also care for men, but they are rewarding. This clinic deserves our community’s support.
I am fortunate that my life is still exciting. Gail and I just celebrated our 47th wedding anniversary. We still enjoy each other’s company, and she has been a wonderful support. I feel very lucky that we found each other.
It has been a great pleasure to be a part of the Durango community, and that of the Herald. Thank you all—including those of you who disagree with me—for being part of my life. Please join me in celebrating my transition to geezerhood!

© Richard Grossman MD, 2013