Grossman: Recognize family planning as a basic human right

Friday, May 25, 2018 8:30 PM

Family planning was declared to be a basic human right 50 years ago this month. The right to family planning was included in the International Conference on Human Rights held in Tehran in May 1968.

The concept of universal human rights started after World War II with the United Nations. Its charter included the obligation “to promote ... universal respect for, and observance of, human rights and fundamental freedoms for all without discrimination.” The Tehran conference was held 23 years later to define what those rights are. One of several points states:

“The protection of the family and of the child remains the concern of the international community. Parents have a basic human right to determine freely and responsibly the number and the spacing of their children.”

The 84 countries attending this conference agreed to be bound by the decisions, but the world has changed radically since then. For one thing, there are more than double that number of countries. Furthermore, global population has more than doubled, from 3,600,000,000 to 7,500,000,000 people. On the good side, there are more, safer and more effective methods of contraception available.

The right to family planning is supported by many programs, including FP2020, which works in many developing countries. Planned Parenthood and the federal Title X program in the USA are under jeopardy because of a proposed law limiting health care providers from mentioning the word “abortion.”

Unfortunately, the right to family planning is being limited or taken away in many countries. Funding for many organizations working internationally has been barred by the Global Gag Rule. The GGR prevents the U.S. from funding any foreign agency that provides abortion services anywhere – or uttering the word “abortion.” Because of the lack of these services, women will go without birth control and there will be millions of unplanned pregnancies – and thousands of women will die from complications of pregnancy – and, ironically, there will be more abortions.

The Tehran Proclamation has nine standards to uphold the human right to family planning. These include: non-discrimination; availability of information; accessibility of services and supplies; quality; autonomy of decision-making; privacy and confidentiality. I am happy to report my experience has been that these standards are upheld everywhere I have worked.

It is difficult to envision a UN conference being held in Iran now – there have been many changes since 1968. The Shah was overthrown in 1979 and the country became an Islamic theocracy, led by a “Supreme Leader.”

A pleasant surprise came about a decade later. High-level government and university experts held a conference in 1988 to discuss Iran’s population, which was increasing rapidly at that time. Attendees agreed “that the rate of population growth in the Islamic Republic of Iran was high and this would have a negative effect on the welfare of the people.

Hence, the participants strongly urged the Government to set up a family planning programme and integrate population factors in policy-making.” (quoted from A New Direction in Population Policy and Family Planning in the Islamic Republic of Iran)

The High Judicial Council of Iran decided “family planning does not have any Islamic barrier” so long as abortion was not involved. New laws were passed to promote small families. Couples were required to take birth-control classes before they could get a marriage license.

Government clinics were set up offering a wide choice of methods, including vasectomy. In addition, the government discouraged childbearing before age 18 and after 35 and recommended that children be spaced three or four years apart. The family planning program urged couples to have no more than three children; government employees lost some of their benefits, such as maternity leave and food coupons, if the family had more.

The total fertility rate (the average number of children that a woman bears in her lifetime) in Iran had been as high as 7.0, had decreased to 5.5 in 1988 and now is less than 1.8 (the same as the U.S.).

It doesn’t mean that population is shrinking – there are millions of children and teens whose reproductive years are still ahead of them – so it will take decades before the population stabilizes.

A dictatorship can use its influence to slow population growth. Although there are many dictators in the world today, I think Iran is the most successful in slowing its growth. That sort of heavy-handed governing wouldn’t work in the USA.

Indeed, I believe that people should have the right “to determine freely and responsibly the number and the spacing of their children.”

Dr. Richard Grossman practiced obstetrics and gynecology in Durango. Reach him at © Richard Grossman MD, 2018