Our members often ask us whether it’s futile and a waste of time to advocate for increased access to family planning for women and couples in countries with strong religious identities. Our answer is that it is absolutely not!
The preference for and pressure to have large families in religious settings is complicated, and it’s an element of many religions that’s being challenged, not only by parishioners, but also by some religious leaders. For example, imams in some Muslim communities in Africa are saying that family planning is acceptable, as long as it’s used for birth spacing, which improves the health of children and their mothers, and not family size limitation (which is, of course, a natural benefit of spacing births farther apart). As with Christianity, there are very substantial differing interpretations of Islam from place to place. Iran, for example, has been a leader in terms of voluntary family planning.
In the United States, 98% of Catholic women who have ever had sex have used some form of artificial birth control. And 73% of Mainline Protestants and 74% of Evangelicals are currently using highly effective artificial contraception (sterilization, hormonal methods, or IUDs).
The Catholic Church certainly hasn’t made things easier in very observant countries such as the Philippines, where bishops control policy matters to a large degree (although the total fertility rate in the Philippines is declining consistently—it currently stands at 2.87, down from 6.54 in the late 1960s). But people’s desire to plan their families is often much stronger than their desire to be 100% obedient to the Pope’s interpretation of the Bible and Church doctrine on family planning. Most of the countries that we think of as staunchly Catholic have the lowest total fertility rates in the world, e.g. Portugal (1.24), Poland (1.33), Spain (1.38), Italy (1.49), Cuba (1.58), Puerto Rico (1.59), El Salvador (1.87), Ireland (2.00), and so on. Clearly, the observance of religion does not have to lead to large families.
Wherever birth control has been made readily available and consumers are educated about how to use it effectively, family size and fertility rates have dropped. Countries that now have fertility rates below replacement rate (2.1 children per woman), but had very high fertility (over 5 children per woman) just 40 years ago include Albania, Brazil, China (although that’s another story entirely, for a different blog post), Costa Rica, Iran, Lebanon, Martinique, Mauritius, Myanmar, South Korea, Thailand, Tunisia, UAE, and Vietnam.
The real issue is a lack of affordable and appropriate methods of birth control in the countries with the highest fertility rates—also, typically, the poorest countries. In those places, access to birth control and clear instructions on its proper use can be difficult to obtain, due to lack of funding, too few medical professionals, and wariness of side effects. That’s why we’ll keep working toward a doubling of U.S. foreign aid for international family planning—so we can help get family planning services and supplies to the women and couples in aid-dependent countries who desperately want them. Unfortunately, as a direct result of last November’s elections, we now must defend current levels of U.S. investment in key programs.
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 The number of live births a woman would have if current age-specific fertility rates remained consistent throughout her lifetime.
 Fertility data from the United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision: https://esa.un.org/unpd/wpp/DVD/Files/1_Indicators%20(Standard)/EXCEL_FILES/2_Fertility/WPP2015_FERT_F04_TOTAL_FERTILITY.XLS