Review

Global perspectives on reproduction

PRIVATE DECISIONS, PUBLIC DEBATE: WOMEN, REPRODUCTION AND POPULATION
Panos Publications, 1994

Issues of reproduction and population are again at the forefront of public debate, following the recent international conference on population and development. This book is a well-timed and informative look at these issues from the perspectives of women in developing countries.

The book consists of 13 articles written by journalists from developing countries which vividly demonstrate the influences affecting women’s reproductive decision-making.

Common themes affect women the world over. The first article, from India, highlights the problem of untreated reproductive tract infections. Articles from countries as diverse as Tanzania, the Philippines and Chile show the high costs of illegal and unsafe abortion. A combination of traditional and religious pressures are considered: son preference in South Korea, Pakistan and Egypt; refusal to provide modern contraceptive and abortion services, especially to adolescents, in Chile and Tanzania; female genital mutilation and its horrific consequences on women’s health in Burkina Faso, Egypt and Ethiopia. Economic pressures are also highlighted: in the Philippines women cannot afford to take time off work to breastfeed their children; in Tanzania young girls and single women are economically dependent on men; in Thailand many poor families rely on their daughters involvement in the sex industry. The article from Thailand illustrates women’s lack of choice most starkly -- safer sex is not feasible for women if they have no say over their husband’s sexual life outside of marriage or if they want a child, and an increasing number of women are discovering that they are HIV positive.

These accounts challenge the somewhat simplistic view of a rapidly growing Third World where all people need to do is stop having so many babies. The book demonstrates concerns from the point of view of predominantly poor, rural women who have little say in their domestic situation, the national economy or in policy-making over healthcare, education services or legal rights.

One of the book’s strengths is that it shows the debate going on within countries rather than from the point of view of external ‘experts’. For example, in Chile many feminist activists feel a conflict between support from the church during Pinochet’s regime and its current conservative viewpoint. The book also highlights what people are doing to address the issues, such as women activists in India training community members as ‘barefoot gynaecologists’.

What is not covered much is the issue of population and development. The book does not highlight the external impact of economic programmes. One article, from Ghana, shows how a poor country that has a ‘structural readjustment programme’ and a health system based on the UK’s, cannot provide essential services to women, and the resulting high personal and economic cost.

Overall this book explains, in women’s own words, what their reproductive concerns are and provides a clear overview of they are doing to address these.