Unto the Least of These My Brethren:
U.S. Population Control Policy

As a convert, I am always impressed by the wisdom of the Church on issues concerning human life and the transmission of life. This wisdom is, perhaps, most evident in its rejection of efforts by the wealthy nations of the world, chief among them the United States, to impose birth control programs on poorer countries. Such efforts have been condemned frequently  by Pope John Paul II and bishops in this country and others.

The Myth of Overpopulation

For the last thirty years, we Americans have been subjected to a drumbeat of propaganda about the so-called overpopulation problem. The Population Bomb by Paul Ehrlich was only the first of many books that warned us that we were breeding ourselves off the face of the planet. Such “irresponsible” childbearing, we were told again and again, would inevitably lead to food shortages and famine, poverty and environmental disaster.[2]

In 1974 the National Security Council (NSC) gave further impetus to these fears, circulating a secret report which declared population growth to be a grave threat to US national security.[3] If the peoples of Asia, Africa and Latin America were allowed to multiply, the NSC claimed, their quest for social justice would inevitably lead them to communism.  This would limit the U. S. access to strategic minerals and other raw materials, both directly through the action of hostile regimes and indirectly because of greatly expanded local consumption.

Thus was population control declared to be a weapon in the cold war.  The immediate result was a huge jump in spending on birth control programs by the U.S. and its allies. Dozens of countries around the world were targeted, especially those which were considered to be vulnerable to communist insurrection (such as Thailand), and those sitting on top of valuable metals (such as the southern tier of Africa).

Today the Cold War is over and the population bomb has proven to be a dud. The specter of famine was never more than that—a ghostly phantom receding on the horizon. The number of people in the world currently stands at 5.9 billion, far below the 8 to 12 billion that Stein Bie, head researcher for the Food and Agriculture Organization, recently estimated the earth can easily support using existing agricultural technology.[4]  Food shortages occur in war zones—as in the Sudan—or in socialist economies—as in North Korea—but massive famines resulting from crop failure are a thing of the past.   

Moreover, as noted above, world population growth is slowing dramatically.  Demographers are now agreed that the population of the world will never double again.[5]  Based on our review of U.N. Population Division figures, we at the Population Research Institute expect that global population will peak at seven billion or so in 2030, then begin a long decline.[6] 

The reason for the coming depopulation is shrinking family size. The Census Bureau reports that the world's totally fertility rate (TFR)—the number of children born per woman during her reproductive lifetime--has declined to 2.9, its lowest level ever. As recently as 1985 the worldwide TFR was 4.2. In many countries, couples commonly stop at one or two children.

There are now 79 countries—representing 40% of the world’s population—with fertility rates below the 2.2 needed to sustain their present numbers. The developed nations have been hit the hardest. Fifteen of them, including Russia, Germany and Italy, already fill more coffins than cradles each year. But this “birth dearth,” as Ben Wattenberg has called it, has now spread well beyond the developed world. There are now 27 “developing” countries where women are averaging fewer than 2.2. children, including such unlikely nations as Sri Lanka and Thailand.   While the population of portions of Africa, Asia and Latin America will continue to grow for several more decades, the rest of the world will soon be in a demographic free fall.  

If the human face of this population implosion is melancholy—villages bereft of children, schools closed for lack of students—the economic consequences are nothing short of grim:  Labor shortages cramp production, the housing market grows moribund, and this in turn creates a drag on real estate and other sectors of the economy. One wonders how much of Japan’s current economic malaise can be directly traced to insufficient numbers of young people to power the economy?

Humanity’s long-term problem, it now seems, is not going to be too many children, but too few:  Too few children to fill the schools and universities, too few young people entering the work force, too few couples buying homes and second cars. In short, too few consumers and producers to drive the economy forward . The imploding markets of Europe and the economic sluggishness of Japan will spread soon enough to the U.S. and the rest of the world.All this prompts a pragmatic question: Why spend hundreds of millions of dollars a year on contraception, sterilizations, and abortion that will only bring that day closer?

Population Control Violates the Rights of Women and Couples

Population control advocates have been quick to claim credit for falling birthrates—and to ask for more billions to finish the job. But anyone who has seen the checkered path of “family planning” programs in the developing world finds it hard to take their claim—or request for additional funds—seriously.  

Something over two-thirds of the world’s fertility decline can be accounted for by simple modernity, as women marry later, have greater educational opportunities and work outside the home. The only population-control programs that have enjoyed conspicuous success have relied on the more or less compulsory sterilization of large numbers of women. The most notorious example is China, where for two decades the government has mandated the insertion of intrauterine devices after one child, sterilization after two children, and abortion for those pregnant without permission.

But the use of coercion in family-planning programs is not unique to China. The Population Research Institute has documented abuses in 38 different countries, most recently in Peru, where for the past two years a sterilization campaign has run roughshod over the people of that country.

The campaign began in spring 1996, when the Peruvian Ministry of Health set a national target for sterilizations.  Quotas were handed down to individual medical workers.  The medical director of the impoverished Huanacavelica region, for instance, ordered that “named personnel have to get 2 persons for voluntary surgical sterilization per month.”  According to this directive, “At the end of the year there will be rewards for the site that has . . . the greatest effort to bring in people.”

To meet these targets, mobile sterilization teams travel throughout the countryside, holding “ligation festivals” and sterilizing as many women as possible at each stop. In many areas health workers receive a bonus for every procedure performed, while they can lose their jobs if they fail to meet their quotas. As the Huanacavelica directive notes, “At the end of the year each person will be evaluated by the numbers of patients captured.”

Dr. Eduardo Yong Motta, health advisor to Peruvian President Alberto Fujimori, openly defends targets and quotas. “Of course the campaign has targets . ... [Success is measured] through many methods, including numbers of acceptors versus non-acceptors.” He admits the dangers of setting targets, but insists that “the campaign had been a success.”

That Peruvian medical workers under heavy pressure to meet sterilization quotas should resort to coercion themselves is hardly surprising. Knowing full well this danger, the 1994 International Conference on Population and Development, held in Cairo, condemned the use of quotas or targets in birth control campaigns, an admonition Mr. Yong Motta and other population control enthusiasts regularly breach. 

Coercion takes various forms. First, there are repeated visits to the homes of holdouts.  As one woman remarked, the workers came “day and night, day and night, day and night” to urge her to be sterilized. Bribes and threats are also employed. Hungry women are offered the opportunity to participate in food programs, including programs supported by the United States, if they agree to sterilization. Women already participating in food programs have been threatened with expulsion. 

Rural women report that no mention is made of sterilization’s health risks. Nor are they given the opportunity to choose alternative methods of family planning; in fact, Natural Family Planning is actively discouraged. There have even been sterilizations performed on women without their consent, often during the course of other medical procedures. Victoria Espinoza of Piura has testified before a U.S. congressional committee that doctors at a government hospital told her she was sterilized—without warning or permission—during a Caesarean delivery. Her baby later died. She can have no others.

Dr. Motta attempts to defend the pressure tactics. “If the Ministry of Health did not do the campaign house-to-house people would not come,” he asserts. As far as the repeat visits are concerned, “It was a doctor’s responsibility to convince the patient into doing what was best and having [a tubal ligation]. Women in Peru have many children.”

Condemned by the Peruvian bishop’s conference, and the subject of several unflattering documentaries--including a PRI effort recently shown on Peruvian national television--the sterilization campaign has faltered of late.  The government will fall far short of its “annual goal” of 78,000 tubal ligations and 22,000 vasectomies this year,  Jorge Parra, director of the Ministry of Health’s “Reproductive Health and Planned Parenthood Program,” admitted on 4 June 1998.  Parra blamed the “collapse” of the program on “a subtle guerilla war” waged against the program by the Catholic Church. 

To understand how oppressive and intrusive Peru’s family planning program is, imagine how you would feel if someone from the Department of Health and Human Services showed up on your doorstep bearing contraceptives—let alone an order to report for sterilization.  Not all government-sponsored family planning programs are as coercive as Peru’s.  But there is an element of intrusiveness common to them all, for they deliberately seek to dissuade couples from welcoming children into the world.  

Population Control Undermines Primary Health Care

When the population controllers move into a poor country like Peru, primary health care invariably suffers. Government health officials and local medical associations are first coopted by highly prized opportunities for advanced training overseas, or even by generous gifts of limousines or sought-after office equipment. Once a country’s medical establishment has agreed to make “family planning” a priority, national health budgets tend to be spent disproportionately in this area.

At the same time, fertility reduction programs funded by such groups as the U.S. Agency for International Development, the United Nations Population Fund, or the International Planned Parenthood Federation, are set up. Generously funded by local standards, such programs become magnets for scarce local medical resources. Local doctors, attracted by the higher wages, abandon primary health care in favor of “family planning.”  Local health care clinics are transformed into “family planning” stations, where the only readily available medical care involves contraception, sterilization, and abortion. 

“Our health sector is collapsed,” reports Dr. Steven Karanja, the Secretary of the Kenyan Medical Association. “Thousands of the Kenyan people will die of malaria, the treatment for which costs a few cents, in health facilities whose shelves are stocked to the ceiling with millions of dollars worth of pills, IUDs, Norplant, Depo-provera, etc., most of which are supplied with American money. ... A mother brought a child to me with pneumonia, but I had not penicillin to give the child. What I have in the stores are cases of contraceptives.”

“Some of these contraceptives like Depo-provera cause terrible side effects to the poor people in Kenya, who do not even have competent medical check-ups before injection. Many are maimed for life . . . I look at [these women] and I am filled with sadness. They have been coerced into using these drugs. Nobody tells them about the side effects, and there are no drugs to treat their complications. ”

“Special operating theaters fully serviced and not lacking in instruments are opened in hospitals for sterilization of women,” Dr. Karanja also notes. “In the same hospitals, emergency surgery cannot be done for lack of basic operating instruments and supplies.[7]  

Such is the state of medical care in many developing countries, where generously funded family planning programs have become a magnet for local personnel, resources, and official attention, leaving primary health care programs to collapse from official inattention or outright neglect. 

How did this Come About?

The government of the United States has been the principal architect, cheerleader, and fundraiser for population control programs. Since the 1970s, “stabilizing world population growth” has been enthroned as one of the five goals that all U.S. foreign aid programs must advance. In pursuit of this objective, some $385 million in population funds were appropriated by Congress in 1997 alone, with an additional $25 million budgeted for the United Nations Population Fund.

The present administration has pursued this war on population with special fervor. One of President Clinton’s first official acts was to rescind the Reagan Administration’s Mexico City policy, which forbade any U.S. funds from going to organizations that perform, promote or advocate the legalization of abortion. The chief beneficiary of this family-unfriendly act was the International Planned Parenthood Federation, which does all three, often in defiance of national laws. 

In the months leading up to the 1994 Cairo conference on Population and Development, U.S. officials took an even more radical position. Not only did they argue for global targets for population growth, they also pressed for the worldwide legalization of abortion to help meet these targets.   Dee Dee Myers, then White House Press Secretary, openly acknowledged this link on 1 April 1993, stating that the worldwide legalization of abortion was “part of the overall approach to population control.” 

Timothy Wirth, then Under secretary of State for Population and the Environment, fumed the following month that the 114 nations that continued to place restrictions on abortion were violating “basic human rights.”  These sentiments were echoed by U.S. AID administrator J. Brian Atwood, who at a meeting of Population Cooperating Agencies in 1994, was quoted as saying that “while obstacles cannot be removed overnight, this administration will continue to stand for the principle of reproductive choice, including abortion.” 

President Clinton’s effort on behalf of global population targets failed, as did his related initiative to make abortion an integral part of “reproductive health” and, therefore, of worldwide population control programs.  Sentiment in favor of such assaults on the dignity of the human person remain pervasive in the upper echelons of this administration, however.  

The Solutions to Population Control

What can the layman do to fight this worldwide problem for which our country is primarily responsible?  After all, the origins of the population control movement go back 30 years. So ingrained have these ideas become that many now accept the pessimistic notion that the human race is breeding like so many lemmings, and is ultimately headed for the same end.  Education, then, is an important part of stopping the population control movement.  People need to be aware that we are in much graver danger of living on a depopulated earth than one with too many people.

Catholics, especially, can also help spread the truth that people are not to be seen as mere numbers, but as unrepeatable unique individuals with immortal souls created by God to spend eternity with Him.

There have been recent Congressional efforts to control the population control agenda. The first of these initiatives is to reinstate the Mexico City policy. This is important, and Congressman Chris Smith (R-NJ) should be commended for his leadership on this. Still more is needed. The Mexico City policy will not eliminate problems such as those occurring in Peru because it keeps funds only from those organizations that promote or perform abortions overseas. Programs of forced sterilization would not fall under its purview.

A second Congressional proposal would move $100 million from the budget for population control and put it into child survival programs.  This, too, would be helpful, but still more is needed. 

The third proposal, which would eliminate population control spending altogether, would be most effective. And, admittedly, most difficult to pass.

Population control programs continue to lead to human rights abuses. At a February 25 congressional hearing, for example, USAID assistant administrator Mark Schneider announced that the government of Peru was ceasing its population control campaign. Just two days later, a Peruvian newspaper published an interview with health minister Costa Bauer in which he announced that not only would the campaign continue, it would be expanded.  Even now, in the face of fierce public opposition, the Peruvian government--with U.S. backing--continues to press forward with its population control agenda.

I find it troubling, to say the least, that U.S. tax funds support, promote and, indeed, undergird massive programs to control the population growth of other nations. We have no business telling families in the Third World how many children they should or should not have. Rather, we should spread and uphold the Church’s teaching on responsible parenthood, in which the frequency of births and size of the family is a matter to be determined as follows: (1) by the free, informed, mutual decision of the couple; (2) based on their conscientious assessment of their responsibilities; (3) to God, themselves, their children and family and the society of which they are a part; and (4) enlightened by the authentic teaching of the Church’s magisterium regarding the objective moral order and the licit methods of spacing or limiting pregnancies. (Most Rev. James T. McHugh, “The Person, the Family, and Fundamental Choices,” Reprint from the 1983-1984 Respect Life Program Manual, NCCB)

Our faith tells us to be generous in welcoming children into the world. The “better angels of our nature” so admonish. How much good we could do by sharing this message with couples across the globe? How much good we could do with the funds now poured into urging—and even insisting—that familiesnot welcome children, were the funds used instead to provide basic health services and sanitation. Children are not commodities to be accepted or rejected at will. They are our link to the future and teachers of their parents in the virtues of patience, prudence and humility.  “Children are living, breathing signs of God’s love in our world. ... They are laughing, walking loving signs of hope in our midst.”[8] 

With the Catholic Bishops of the United States, each of us has an obligation to ask and answer this question:

Our nation stands in judgment now, as it did more than a century ago: are we to be a nation that honors its commitments to the right to life, or not? And if not, then just what does our nation stand for?[9]

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Steven W. Mosher is President of the Population Research Institute and an internationally recognized expert on China, human rights, population control and demography, inter alia. He has authored seven books and over 100 articles and papers on these and related topics.