Paul Raushenbush: The Role of Faith in Family Planning
And now for some facts about women's reproductive health.
Approximately 800 women a day die during pregnancy and childbirth. For every woman who dies, approximately 20 more experience infection, disability, or injuries. The rate of mortality and injury of women during pregnancy and childbirth varies hugely between women living rich countries and poor countries, with the bottom being Afghanistan where one in 11 women will dying during pregnancy and childbirth. One in three women are married by the age of 18, one in nine by the age of 15, meaning that we are not just talking about women, but often about young girls.
An estimated 200 million women want to delay or avoid pregnancy but don't use effective family planning and the demand is expected to rise 40 percent by 2025. Of the 210 million pregnancies occurring each year, nearly 33 million are unintended. These lead to approximately 21.6 million unsafe abortions, causing some 47,000 deaths annually.
I learned these challenging figures when I was invited to moderate a panel called Faith and Family Planning at the Women Deliver conference that is happening right now in Kuala Lumpur. The goal of the conference is to advocate for the health and well being of women and girls across the globe in all areas of society, but especially in the area of pregnancy and birth.
It is crucial to talk about the role religion can play in the effort to empower girls and women in the area of family planning -- especially given that close to 90 percent of all people alive adhere to some religious belief, and that in rural areas of many developing countries health care is provided by religious organizations, or not at all,
However, the role of religion in the reproductive lives of women is also fraught and touches on many of the flash points that religious communities are grappling with today. These include the problem of gender inequity -- specifically in leadership roles; the authority of science within the religious worldview; and the agency of individuals, especially women, to develop and exercise individual conscience as weighed against the often mandated expectations of the community.
There is no question that religious influence can often seem adverse to those of us who believe that women's reproductive health is a fundamental human right. But what is also true is that this is a question about which there is an active debate within religious communities and that there is no one religious point of view. It is also true that even the most conservative religious communities can play a part in improving the health of women and girls.
Speaking to a packed room at the Faith and Family Planning panel, Dr. Pauline Muchina, who is a theologian and works at UNAIDS, helped clarify the question that often plagues any conversation on religion and family planning. "Almost everybody believes in family planning," Dr. Muchina explained, "but what we argue about is the method."
For instance, the Catholic Church hierarchy believes in 'natural' family planning that will help the couple to avoid pregnancy, but does not believe in contraception devices or pills. (Although what the people in the pews believe is an entirely different matter).
Dr. Muchina admitted that faith communities have both empowered and undermined the power of women and girls and emphasized that we need to talk about human sexuality along with faith and family planning: "We are all created in the image of God and we know that sex is a gift from God, yet sex can be dangerous or fulfilling depending on access to information and health services and things like contraception and condoms."
"My primary concern is to save lives. God has give us knowledge and technology to improve our lives through science. Are we going to throw condoms out? We are resistant to science in questions of sexuality, but when you you have a heart attack you go to the operation room -- you are willing to accept science then."
The Christian ethicist Dr. David Gushee explained that the evangelical Christian community has both deficits and strengths to offer the effort for comprehensive family planning for women and girls. The strength is that in the Christian view every life is infinitely sacred -- and that includes the lives of women. However, that ethical framework has been used largely in opposition to abortion instead of empowering women. That said, Gushee informed the room that evangelicals are not against contraception per say, as long as they are used inside of marriage.
For Middle East women's right activist Dr. Wajeeha Al-Baharna, sharing decision about family planning between husband and wife is a fundamental place to start. Dr. Baharna, a Muslim, insisted that Islam says that women and men should have equal say in the size of their families and timing of having children.
While these positions might not seem radical to a secular mindset, even small advances in how religious communities view reproductive health issues can have huge positive effects on the lives of women and girls on the ground.
Perhaps nobody is better able to speak about this than Dr. Babatunde Osotimehin, the Executive Director of the United Nations Population Fund.
When I asked him about how faith is playing a positive role in his work at UNFPA, he told me a story that happened when he was running the HIV program in Niger. They started with a 10 percent knowledge base about HIV, everyone was in denial and they tried everything -- TV, radio, theatre, and the knowledge just wasn't coming up at all. Then he went up and spoke to the head of the Muslim community (about half of the population) who agreed to go on camera and talk about HIV and the results were dramatic. Suddenly everyone wanted to get involved.
Dr. Osotimehin explained:
"If you are to engage religious communities whether Muslim, Christian, Animist, you need to understand the context, and respect it. You know they have limits, they have red lines and you respect those red lines, but you work in the middle ground where you think you can make a difference. In UNFPA now, we have religious organizations that work with us because the work we do is not abstract, it is about saving women and girls's lives. There is no religious leader in the world that will tell me that they would rather have women and girls die."
When asked if the UNFPA also has 'red lines' in dealing with religious communities on matters of reproductive health Dr. Osotimehin told me:
"It's a matter of give and take. UNFPA works in more than 150 countries around the world. You can imagine the varying social and cultural context in each of those countries. And we have made some major progress in some of those places. In Niger the use of family planning was like 5 percent, we set up something called 'The Husband School' that had religious leaders, community leaders and civil servants -- all men. We took them through all the issues. In three years we increased the contraception use from 5 to 20 percent. And the Nigerien public is almost totally Muslim.
I can't think of any country where it is total pushback and we can't do anything. It's about navigating it. Our red line is that nobody will stop us from saving the next girl's life."