Categories
Family Planning Reproductive Health Sterilization

The Other Side of Reproductive Coercion

The image above provides information about the article cited below.

            Reproductive health abuses, especially coercion, have turned many people away from concern about human population. I agree: reproductive coercion should be shunned.

            Examples of coercive actions include sterilization of both women and men in India—even though patients didn’t really know what was being done. Coerced sterilizations also happened in the early 20th century in the USA—especially people who were who weren’t of the dominant race or were thought to be mentally or genetically deficient.

            There were attempts to wipe out Native Americans, which started when Columbus “discovered” the New World, and may have continued into the 20th century. This apparently happened at Indian Health Service hospitals, where a high proportion of Native women had their tubes tied. Fortunately, federal laws now require use of a special consent form that makes it difficult to perform sterilization procedure without real informed consent.

I have also read about Puerto Rican women being sterilized against their will in the past. When I practiced there in the 1980s, I saw no sign of coercive sterilization. In fact, the reverse was true. I remember Maria, who was desperate to stop having children. She couldn’t afford reliable birth control such as an IUD and pleaded with me to tie her tubes. Unfortunately, she didn’t have insurance and the hospital wouldn’t let me do the surgery unless they could be certain of payment.

 That brings up the other side of reproductive coercion—women are often forced to bear, and raise, children that they did not intend to have.

Obamacare and many other programs will pay for contraception in the US. However, most governmental programs will not pay for an abortion when a contraceptive method fails. Unfortunately, unintended pregnancies occur with all methods, and some states prohibit abortion under any circumstance, including rape.

 Since abortion has been tightly restricted or outlawed in many states, it has become impractical for countless women to obtain abortion care. Unfriendly laws have coerced many women to carry unintended pregnancies. Although networks exist to help women abort unwanted pregnancies, many people still aren’t able to make the choice they want.

A careful study of births in Texas found that abortion-limiting legislation increased unintended births. This research compared the number of births after Texas Senate Bill 8 (preventing abortions after 7 weeks of pregnancy) was in effect with the prior years’ births. They found that there were almost 10,000 more births in the relevant 9 months after SB8 took effect. Many of these excess births were probably unwanted because the women were coerced into carrying a pregnancy by their inability to access abortion care.

I predict that coercing women to bear and raise children will have bad effects on society. We know that people who result from unwanted pregnancies don’t do as well in life; they have more contact with mental health and with law enforcement agencies. We also know that Texas has one of the higher maternal mortality rates in our country, and forcing women to give birth is likely to cause the death rate to go even higher.I believe that the basis for antiabortion laws has little to do with the claimed religious beliefs; the states with the strongest “right to life” laws seem to have the weakest support of mothers and children after birth. I also believe that many people who advocate against abortion and for population growth do so for selfish economic reasons. Speaking of population growth, Nandita Bajaj, an expert on a cause of population growth—pronatalism—will be talking at Lifelong Learning in Durango on February 15th

© Richard Grossman MD, 2023

Categories
Population

Overpopulation and War

Aerial view of a residential section of the Gaza Strip


When I was in high school, I read an advertisement in Scientific American magazine. It said, in part: “…unless a favorable balance of population and resources is achieved with a minimum of delay, there is in prospect a Dark Age of human misery, famine and unrest;”

This statement, which was signed by 34 Nobel Laureates (among other dignitaries) went on to say: “We believe that widespread, effective and voluntary use of medically sound and individually acceptable birth control is an essential factor in any humane design to raise world living standards and achieve world peace.”
To me, this is as true now as it was in 1960.
I give thanks that so many people recognize the importance of family planning, and that we have so many options for medically sound, voluntary family planning..
Thank you for reading.
Richard

            Can high population density lead to war? Recent events suggest that it can.

            You are probably aware that, on October 7th, the Palestinian Islamic Resistance Movement (also called “Hamas”) launched a surprise attack on its neighbor, Israel. Israel has retaliated with most of the terrible devices of modern warfare and thousands of deaths.

Although Hamas rules the Gaza Strip, Gaza is not an independent entity. It is surrounded on 3 sides by Israel. Israel has surrounded Gaza with an almost impenetrable wall to control the passage of people and goods. Israelis guard the handful of gates through the wall, and have watch towers and other means of controlling Palestinians’ passage.

Israel also controls access to Gaza from the Mediterranean Sea on the west. Much of Gaza’s potable water comes from Israel, as does their electric power. Both of these necessities are now severely restricted, causing a humanitarian crisis in Gaza. Because Israel controls Gaza Strip’s airspace, territorial waters and also controls the movement of people and goods in or out of Gaza by air or sea, Human Rights Watch has advised the UN Human Rights Council that it considers Israel to be occupying the Gaza Strip.

            From what I can discern, there are several reasons for high levels of aggression in the Palestinian Territories. The population density in the Strip is one of the highest in the world. Because of this, homes are crowded together with little room for parks or even an occasional tree. Living in close proximity, with little access to nature, increases stress. Hot conditions have been shown to increase aggression. Finally, the unemployment rate in Gaza is the highest in the world, at 45%. For young people, it is even higher, at 70%! Unemployed young men are the most likely group to be belligerent. 

            Despite its crowded conditions, people in the Palestinian Territories have high fertility. It is commonly thought that this is a consequence of their embattled position—that more people will give the Palestinians more strength. Although slightly lower, the Israeli fertility is also high, especially for a relatively rich country.

            The Palestinians in Gaza are in a terrible situation, and Hamas made it worse by their aggression against their neighbor. Then Israeli Prime Minister Benjamin Netanyahu escalated the aggression by quoting 1 Samuel 15:2, 3 from the Bible, likening Hamas to the ancient Amalekites:

This is what the Lord Almighty says: ‘I will punish the Amalekites for what they did to Israel when they waylaid them as they came up from Egypt. Now go, attack the Amalekites and totally destroy all that belongs to them. Do not spare them; put to death men and women, children and infants, cattle and sheep, camels and donkeys.

            Despite the fact that Palestinians occupied the land before Israel was created, they have had a terrible deal. There are similarities with the American Natives, with several differences: we European settlers killed off a huge percentage of the indigenous people; North America is larger and less crowded than the Levant, and our land is more productive; and Israel has had significant international financial support.

I have two personal conclusions about this conflict. Amongst other issues, the high population density in Gaza may be a contributing factor to the war with Israel. This factor is not mentioned in most media reports on the conflict. Furthermore, for all its benefits, religion can be terribly destructive, especially if it fails to reflect current, more peaceful, ethics.

©Richard Grossman MD, 2023