Bridging the Gap

This article was originally published in our Fall 2020 print issue.

Voluntary family planning services (hereafter VFP services) are an essential collection of culturally appropriate tools that offer women the opportunity to separate sex from childbearing and ultimately achieve their desired family size. Among several other resources, typical VFP services help educate couples on ways they can have safe sex to avoid incidences of sexually transmitted infections and unwanted pregnancies, and allow women the freedom to choose from a variety of modern contraceptives. Extending women the option to delay or prevent pregnancies is one of the most prudent methods available to help to empower women, ensure that their children are well educated and healthy, and reduce maternal and child mortality rates. In addition to these downstream benefits, effective VFP is a humane, choice-based solution to the timeless issue of unfettered population growth and the resulting worsened effects of climate change. 

In reproductive and population science, total fertility rates (TFRs) are measured as the average number of children born to each woman of childbearing age in a particular population. Today, the global TFR rests right around 2.5, though those rates can reach as high as 8 in rural regions across Africa and South Asia. Ultimately, these high TFRs have serious implications for expansive population growth that threatens the finite resources of this planet.

Unfortunately, TFRs are difficult to reduce in regions where women experience significant access barriers to VFP services including lack of knowledge, concern about health effects, religious and political conservatism, poor local funding, cultural stigma, and availability of healthcare providers. These barriers contribute to a large global unmet need for family planning that disproportionately affects populations in developing countries. Nearly 40% of married women and up to 77% of sexually active unmarried women in developing countries would like to stop or delay pregnancies but do not have access to any form of modern contraception. 

VFP services are the most effective and ethical method of reducing population growth. UC Berkeley Professor Malcolm Potts, a reproductive scientist and fervent advocate of VFP, states that “family sizes cannot fall unless women have the information and means to separate frequent sex from childbirth.” In fact, given that women in developing countries have a widespread preference for smaller families, family sizes fall naturally and rather quickly once women have access to contraceptives. For example, it took the TFRs in the United States 58 years to fall from 6 to 3.5 when family planning services including modern forms of contraception were completely illegal. In contrast, when modern family planning services were made available in Thailand, it took only 8 years for a similar fertility decline to take place. This illustrates the critical conclusion that VFP services circumvent the need for restrictive and coercive policies, and help women achieve their desired family size, which is nearly always lower than what women would be able to achieve without modern contraceptives. 

TFRs are further contextualized by the replacement fertility rate, or the number of children a woman and her partner must have in order to “replace” themselves in the population without contributing to exponential population growth. Voluntary family planning programs over the course of the last 60 or so years have helped 48% of the world’s population reach replacement level fertility, which is 2.1 children per woman. However, decades of prior population growth builds up such vast demographic momentum that even once replacement level fertility rates are achieved in a population, growth can continue for up to 60 years. Given that the planet’s current population growth rate is already threatening resources and contributing to worsening climate change, working to improve the reach of VFP and help women achieve their desired family sizes are both essential at this time. Professor Potts says that the “global population in 2100 will be determined by the actions we take in the current decade,” and that there is quite literally no time left to waste in slowing global population growth. 

Though developed countries release more carbon emissions into the atmosphere, population growth and resulting resource utilization will be concentrated in developing countries in the coming years. These are the regions that already have an inherently higher risk of experiencing the brunt of climate change-related events. As such, a fast-growing population size will put pressure on the internal resources of low-income countries and will decrease their tolerance capacity towards such climate change-related calamities. Additionally, as developing countries are growing in size and are actively trying to urbanize and chase economic growth, they are engaging in reckless consumption and overproduction. Such phenomena will continue to create more CO2 emissions and trap more heat in the atmosphere, ultimately increasing the vulnerability of the planet to global warming and natural disasters. As Professor Potts argues, “it is easier to change the population variable than the climate or consumption variables” when looking at ways to reduce the adverse impacts of impetuous human activities. In fact, Potts advocates for VFP planning as the most prudent solution to climate change, claiming that condoms are perhaps the most cost-effective way to reduce our carbon footprint. 

Our current global population is steadily nearing 8 billion people. Though non-uniform human behaviors make calculating a planetary carrying capacity for humans inexact, it is unquestionably clear that the Earth cannot sustain such a large population in the long-term. In fact, based on our current ecological footprint, scientists estimate that it would take the resources of 1.5 Earths to provide for the current population, a fundamental impossibility. The UN estimates that as long as there are no new actions taken to address our uncontrolled population growth, we can expect to add 2 billion more people to our population by 2050. If that were to become a reality, scientists predict we would need 3 Earths to sustain human growth and consumption. 

In a 2014 journal article entitled “Getting family planning and population back on track,” Professor Potts provides several population growth scenarios for the remainder of this century. His projections show that if global TFRs increased by just half a child, our population would reach 16.6 billion people by the year 2100. In contrast, if our TFRs fell by an average of half a child, our population would decrease to 6.8 billion people, a much more sustainable number. These estimates indicate that even extremely small changes in average family size will have significant implications for reduced population growth, an exciting prospect for population scientists and climate change activists. 

The urgency of the issue of rampant population growth cannot be overstated, especially given that we are already exceeding our estimated carrying capacity. VFP offers a simple, effective, and ethical solution to this problem. Unfortunately, VFP services have fallen off the policy agenda in many regions and are chronically underfunded across developing countries. Although there is a viable method available to reduce the burden of excess population growth, it is not a priority among many global and local leaders. Achieving widespread awareness and access to VFP services will require active efforts from public health experts and community health workers who firmly believe that family planning services are an investment rather than an untethered cost. Increasing funding for VFP services across the globe will not just benefit women and children at the individual level, it will deeply impact environmental sustainability and population growth trends for decades to come.