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Family Planning and Reproductive Health. A tale of three revolutions and an unfinished Agenda. Family planning and reproductive health-. A tale of three revolutions The Reproductive Revolution. “ And God blessed them, and God
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Family Planning and Reproductive Health A tale of three revolutions and an unfinished Agenda
Family planning and reproductive health- A tale of three revolutions • The Reproductive Revolution
“And God blessed them, and God said unto them, Be fruitful and multiply, and replenish the earth, and subdue it.” Holy Bible: Genesis 1:28
Crowded planet: Global population hits 7 billion October 31, 2011 World's seven billionth baby is born. Danica May Camacho, a girl born in Philippine capital Manila, is chosen by UN to symbolically mark global population milestone.
Population Clock 2011 Every minute • 266 births • 108 deaths • 158 natural increase World population grows by about 83 million annually.
World Population • First billion around 1800 • Second billion 1930 (130 years) • Third 1960 (30 years) • Fourth 1974 (14 years) • Fifth 1987 (13 years) • Sixth 1999 (12 years) • Seventh 2011 (12 years) Projected population • 8 084 mid- 2025 • 9 587 mid- 2050
The Reproductive Revolution Total fertility rate • World 2.5 • More Developed 1.7 • Less Developed 2.6 • Less Developed (excl. China) 3.0 • Least Developed 4.5 Population Reference Bureau 2011 World Population Data Sheet
World fertility, 2.5 children per woman, is half the level in 1950-1955 (5 children per woman).
Contraception From medical indications to a way of life
Women aged 15-49, married or in union, currently using contraceptives (2009) Million • World 739 • More developed regions 117 • Less developed regions 622 Least developed countries 46 Other less developed countries 576 (United Nations Population Division 2012)
Egypt Total fertility rate 2.9 Contraceptive prevalence 60 % Population mid-2011 82.6 million Projected population million • Mid-2025 100.9 • Mid-2050 123.5 Population under age 15 30.8%
Population momentum Population will continue to grow as more young people join the reproduction pool.
Infertility and the population problem In a world that needs vigorous control of population growth, concerns about infertility may seem odd, but the adoption of a small family norm makes the issue of involuntary infertility more pressing. If couples are urged to postpone or widely space pregnancies, it is imperative that they should be helped to achieve pregnancy when they so decide, in the more limited time they will have available. Fathalla MF. The agony of infertility. WHO Bulletin 2010.
Family planning and reproductive health- A tale of three revolutions • Reproductive revolution • Contraceptive technology revolution
“And Onan knew that the seed should not be his; and it came to pass, when he went into his brother’s wife, that he spilled it on the ground, lest that he should give seed to his brother.” Holy Bible: Genesis 38:9
The contraceptive technology revolution • Contraception outside the bedroom • Long acting contraception • Effective reversible contraception
Women aged 15-49, married or in union, currently using contraceptives (2009) Any method Modern methods • World 62.7 % 56.1 % • More developed regions 72.4 61.3 • Less developed regions 61.2 55.2 • Least developed countries 31.4 25.0 • Other less developed countries 66.0 60.2 (United Nations Population Division 2012)
Family planning and reproductive health- A tale of three revolutions • Reproductive revolution • Contraceptive technology revolution • Sexual revolution
“And the eyes of them both were opened, and they knew that they were naked; and they sewed fig leaves together, and made themselves aprons.” Holy Bible: Genesis 3:7
The dissociation of sex from reproduction • Sex without reproduction • Reproduction without sex
Sex: A duty became a pleasure The Homo sapiens is the sexiest of the primates. Or is it?
The forgotten Ape Lola Ya Bonobo, or "Bonobo Paradise" in the Lingala language, is an 86-acre sanctuary set in verdant hills 20 miles south of Kinshasa, Democratic Republic of the Congo, founded by Claudine André, a Belgian woman raised in the Congo,
Make love, not war "Bonobos use sex to deflate tension. Competition for the best food could cause a fight, so they defuse it by having sex first." Claudine André
In Bonobo Paradise, who rules? Bonobos are perceived to be matriarchal. Females tend to collectively dominate males by forming alliances. Although male bonobos are individually stronger, they cannot stand alone against a united group of females.
Family planning and reproductive health- A tale of three revolutions • The Reproductive Revolution • The Contraceptive Technology Revolution • The Sexual Revolution AND THE WINNERS ARE?
Family planning and reproductive health- A tale of three revolutions AND THE WINNERS ARE WOMEN
Women and the reproductive revolution The emergence of the woman from behind the mother
Women and the contraceptive revolution Women for the first time had women-controlled methods which they could use, even independent of the cooperation of their male partners, to regulate their fertility and to enjoy sexual life without fear of unwanted ill-timed pregnancy.
Women and the sexual revolution In the early 20th century, Marie Stopes, a British leader in the family planning movement, noted that a popular demand of women was for a simple pill or drug to make their husbands less, rather than more, passionate, and women often said they liked everything about marriage, except “the going to the bed side of it”.
Family Planning and Reproductive Health-A tale of three revolutions An Unfinished Agenda
Family Planning and Reproductive Health An Unfinished Agenda The Reproductive Revolution
The neglected tragedy of maternal mortality in developing countries An unfinished agenda
GLOBAL VILLAGE DAILY REPRODUCTIVE HEALTH NEWS _____________________________________________________ DEATH TOLL IN HUMAN REPRODUCTION 1370 women reported killed during physiological duty; thousands more, seriously injured.
Every minute One woman dies from complications related to pregnancy and childbirth
“I am going to the sea to fetch a new baby, but the journey is long and dangerous and I may not return." A Tanzanian mother, about to give birth, speaking to her older children. Local African folklore
Lifetime risk of maternal death The adult lifetime risk of maternal death (the probability that a 15-year-old female will die eventually from a maternal cause) is 1 in 31 in sub-Saharan Africa, 1 in 11 in Afghanistan, and 1 in 4300 in developed regions. In Belgium, the risk is 1: 10 900. WHO 2010.
“In front of the door a couple of neighbour women are standing, muttering and whispering. The ten children have just come back from school and are standing around bewildered. Inside, the house had a terrible look. There is a huge pool of blood in the kitchen, and tracks go into the shop and through the living room. And the bedroom! It looks like someone has been murdered. The bedding is all awry, a wash basin, the floor…everything covered with blood.
“In front of the door a couple of neighbour women are standing, muttering and whispering. The ten children have just come back from school and are standing around bewildered. Inside, the house had a terrible look. There is a huge pool of blood in the kitchen, and tracks go into the shop and through the living room. And the bedroom! It looks like someone has been murdered. The bedding is all awry, a wash basin, the floor…everything covered with blood. Frau Schultz is lying in bed, pale as wax, and sunken as warmed-over death” Lisbeth Burger (German midwife) Breslau, 1936
Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.