A woman pushes twins in a pram along a street in Beijing on August 16, 2022. China announced a slew of perks aimed at encouraging families to have more babies, as birth rates hit a record low. Photo: AFP
Opinion
Bai Yiming and Paul Yip
Bai Yiming and Paul Yip
Population policies must put women’s reproductive rights front and centre
In low-income countries, where early marriage and a lack of contraception result in unwanted pregnancies, boosting awareness of and access to contraception is crucial
In high-income countries, the high cost of having children deters women. Here, family-friendly policies, in the workplace and beyond, can be helpful
As human civilisation has evolved under the rule of law, women’s reproductive rights have gradually become an internationally recognised fundamental human right.
With the global population hitting 8 billion last year, the United Nations Population Fund’s latest report expresses concern about the drawbacks of population control measures that harm women’s right to make autonomous decisions about their own body, particularly on reproductive issues. The report urges respect for individual choices when campaigns or interventions on fertility issues are implemented.
The most crucial aspect of respect for reproductive rights is addressing the gap between women’s reproductive intentions and reality, thus helping each woman realise her reproductive aspirations. At present, some women have more children than they would want while others have not had their ideal number of children. Neither group is happy.
In high-income countries, the cost of raising children is so steep that many women decide to have only one child, or remain childless. The economic burden is a major barrier. Given the significant improvements in the educational levels and financial status of women in the past few decades, the opportunity cost of having a baby can be too much to bear.
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‘Our resources are limited’: India’s battle to curb high birth rates in Bihar state
‘Our resources are limited’: India’s battle to curb high birth rates in Bihar state
In low-income countries, women face early marriage, an unmet need for contraception and pressure to have many more children than they would like. In these countries, a lack of knowledge about and access to contraception can cause significant harm to women.
This includes high rates of unintended pregnancies, girls and women not being able to complete their education or having to give up their jobs, and women dying from complications arising from unsafe abortions.
Therefore, the first step towards improving women’s reproductive environment should be to uphold their right to sexual and reproductive health and to make contraception accessible to them. However, a variety of factors influence contraceptive use among women, including prior experience with contraception, knowledge of contraceptive methods, consideration of the costs, effectiveness and side effects of each method, religious prohibitions and social norms.
Some women believe that contraception can have an impact on their sex lives and even lead to infertility. Even if they have some knowledge and understanding of contraceptive methods, they are unable to obtain the contraception they need because of high prices or having to travel long distances to access public health facilities.
For example, in 2012, only 10 per cent of married women aged 15 to 49 in Nigeria used modern contraception to limit or increase the interval between births. The pill was the most common contraceptive method among women at 71 per cent, with condoms the most common among men at 91 per cent. Only 24.7 per cent of women and 17.9 per cent of men were aware of long-acting reversible contraception, which includes intrauterine device and subcutaneous implants.
A recent study showed that women in larger cities in China had their chances of employment drop by almost 7 per cent with the birth of their first child compared to before they had children, and those chances dropped a further 9.3 per cent with the birth of a second child. This is mainly seen in middle-income families and plays a large role in the fall in China’s fertility rate. Implementing a more flexible, humane maternity leave system is badly needed.
A woman lies on an operation bed to get sterilised at a primary health centre in Bhoodbaral, in India’s Uttar Pradesh state. Photo: AFP
A family-friendly working environment is critical to ensuring women can continue working even after having two or three children. If they lose their job and the opportunity to earn money to support their family because they have a second or third child, who will support their children?
In an ideal world, the government would be able to provide for all of a child’s needs. However, given the current economic situation and the strained finances of many governments, they can only provide families with limited rewards and incentives.
As a result, it is imperative that women who need to return to the workforce after giving birth are able to find jobs quickly. Free training and employment guidance could be of help here.
Women cannot be left to fend for themselves – they need the support of their government. Having a child is an individual choice, but we must ensure that it is not a compromise. This is the best way governments can serve the people as it would yield multiple benefits.
High-income countries that are trying to improve their fertility rates should consider increasing incentives for having children, strengthening technical support for assisted reproductive technologies, and promoting a more open, harmonious parenting culture, as well as improving educational and other infrastructure to boost knowledge of and access to contraception. These can help women achieve their child-bearing aspirations in a way that truly respects reproductive rights.
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South Korea’s demographic crisis: young people opt out of having kids
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In acting to protect women’s rights and reproductive interests, we should promote gender equity and uphold women’s rights before, during and after pregnancy. At the same time, we should remember that respecting women’s desires is the main priority.
Fertility levels will have a long-lasting impact on the trajectory of population growth. The best outcome is that every woman is able to have the number of children she deems ideal. Governments can help make sure women have this choice by developing family-friendly measures and policies.
Bai Yiming is a researcher in population studies at the University of Hong Kong
Paul Yip is a chair professor (population health) at the University of Hong Kong
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