Family Planning and Birth Control: The Issues and a Solution

For years we have noticed the negative effects of uncontrolled childbirth in the forests. Men earn on average $2 US per day for work in the fields, and six to ten children are often far too many mouths to feed. Additionally, women lose their productive potential by being constantly pregnant and forced to care for young infants. The living conditions are the worst in the Americas.  Children are forced to raise younger children, and they are often plagued by disease, hunger, and too little attention from their parents who are constantly working from dawn to dusk.  Giving these families control over their reproductive futures will give them a means to decide how large a family they want, increasing their ability to work productively and allowing them to care for the children they already have.

Most women give birth in the forest, either because the Dominican authorities make it very hard for them to use the hospital (which they have a right to use), because they are afraid of the bribes nurses and others will extract from them (ohh, have we had to deal with corrupt nurses), or because they don’t have transportation, as the hospital is about 3 hours walking distance.

As the HAMU/Human Rights project progresses, we started a census and interviewed the women of the community, and found a very interesting trend. If our local Human Rights monitor, a Haitian woman from the same community, asks if they would like “family planning” or “childbirth control” methods, they will respond that they want nothing to do with that, some say, for religious reasons. But if our monitor asks if they would take the pills or injections if we provide them for free, about 50% say yes, and a startling 100% will say they would undergo the surgery.

A little more talking and it is clear that the Haitian women living in the Dominican forests want to take control of their reproduction. Most women will have their first child when they were 15 to 16, with a man 10-20 years older than them, then several years later find a permanent partner and have from 6 to 8 children (or as many as 15) by the time they are 35.

The women of the community are very aware of the advantages of family planning, and have a strong desire to reclaim control over their family’s future.  If given the means to prevent unwanted pregnancy through tubal ligation surgery, these women can put a stop to the endless cycle of needless suffering brought on by repeated high-risk childbirth in the isolated forest communities.

We are now working on proposals for a pilot project to pay for the surgeries of 20 to 50 women.

We estimate that each surgery, including transportation, hospital supplies, and a small stipend so that they can feed themselves and their children during the time of convalescence, would cost about US$200.

Our two Human Rights monitors have already undergone the surgery, one of them paid by us, and she is very happy with the results.  We hope to be able to offer the other women of the community the same choice and the same opportunity to improve their lives, their children’s lives, and their prospects for a happier, healthier, and more productive future.