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April 12, 2000: Column on International Family Planning

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First Lady



April 12, 2000

Every day, at least 1,600 women around the world die from the complications of pregnancy and childbirth. In developing countries, where only 53 percent of deliveries take place with a skilled birth attendant, complications of pregnancy and childbirth are the leading cause of death and disability among women of childbearing age. And according to the World Health Organization, maternal mortality statistics represent the key difference between developed and developing countries.

As many as one out of four of these deaths could be prevented through family planning.

Six years ago, representatives of 179 nations met in Cairo, Egypt. Determined to pave the way to dignity, respect and a better future for all women, they reached this historic consensus: Women's reproductive health and empowerment go hand in hand with a nation's sustainability and future growth. Saving women's lives, protecting their health, and offering them an education is directly linked to reducing abortions, promoting democracy, and improving the quality of life of all its citizens.

Every nation in Cairo agreed to an agenda that would make access to reproductive health care and family planning services a basic right, reduce infant, child and maternal mortality, and open the doors of education to every citizen -- especially girls and women.

In the past six years, I have seen firsthand the fruits of this extraordinary commitment. In Kazakhstan and Uzbekistan, areas with historically high abortion rates, I toured women's clinics that proved the link between access to family planning and extraordinary reductions in the number of women seeking abortions.

In Indonesia, I sat under a tree in a small village as young mothers learned the fundamentals of child care from trained midwives. In Nepal, I was introduced to Safe Home Delivery kits, which are handed out to all expectant mothers. At 13 cents each, the kits contain a bar of soap, twine, wax, a plastic sheet and a razor blade, and are designed to reduce the major causes of maternal and neonatal death by promoting clean hands, clean surfaces and clean cord care.

Traditionally, America has been a leader in providing family planning and reproductive health care to women and their families in developing countries. Yet, despite the strides we've made, there is still a long way to go.

Last week, in a White House ceremony marking World Health Day, the President underscored his administration's commitment to restoring full funding for international family planning programs -- funding that has declined by more than 30 percent since 1995. Among the important budget proposals he announced were increased investment in family planning efforts overseas, HIV and AIDS prevention and treatment programs in developing countries, and support for the United Nations Family Planning Fund.

Although one of the pillars of American democracy is free speech, our Congress has imposed a global gag rule on family planning organizations, preventing them from discussing all aspects of family planning with their patients. It is time to pass the President's proposals -- without these restrictions on free speech.

At the White House event, the President was joined by Dr. Enyantu Ifenne, a pediatrician who is in charge of Nigeria's development and population planning. In her brief remarks, she put a human face on the family planning issue. She told the story of 15-year-old Jamela, who was married at 12, and pregnant at 13. Tended by the village barber, she suffered serious physical injuries that will plague her the rest of her life. Yet, as Dr. Ifenne said, Jamela is one of the lucky ones -- she is alive.

hinyere, who is 28, lives in a region where a goat is slaughtered to celebrate the delivery of a woman's 10th child. She has seen so many women die during childbirth that, after her third child was born, she used contraceptives to avoid becoming pregnant again. She says, "I am able to do things I could not do before. I run my business. My husband is happy."

Dr. Ifenne pleaded for America's continued support for international family planning. "We need you to stay the course as we take the steps to nurture and sustain democracy in Nigeria," she said.

Democracy, as Dr. Ifenne knows, is not just about legally protected rights, elections or free markets. Democracy is rooted in people's everyday lives -- extending the benefits of education, health care, family planning and equal rights to all citizens, including women.

I hope that as Congress takes up the President's budget, members will put aside partisan politics and remember this: International family planning is not just a health issue. It is a necessary part of our foreign policy. In Secretary of State Madeleine Albright's words, "Family planning assistance is not just the right thing to do. It's the smart thing."

To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.


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