Last week my site supervisor at Planned Parenthood asked me and the two other interns to teach multiple lessons on reproductive health to secondary school children. We were told to focus on teenage pregnancy, specifically, how to prevent it.
I immediately felt uneasy about giving presentations on preventing pregnancy. On one hand, they could help give students agency or make them feel empowered. Additionally, one could argue teaching the teenagers any true information about their health is beneficial. Maybe through these presentations, we could teach a student necessary skills to prevent unwanted pregnancy, reducing their chances of not being able to finish school. But even after reminding myself of that, I couldn’t shake a gut feeling that it was slightly wrong.
I struggled with the paradigm itself. Here we are, three students with no degrees and no teaching experience, telling children information with serious implications for their health and entire lives. Some may argue I am the most qualified one could be, soon to graduate as a Public Health and African Studies major, with a pre-medicine concentration to become a pediatrician, yet I still felt like I was wrong for the job.
I knew why they asked us to do the lesson instead of a more qualified Planned Parenthood staff member: the students would listen to us, most likely because of our race and nationality.
After the presentations, I reflected. It wasn’t simply my lack of qualifications which felt off. Why else might it have felt so wrong?
I thought about the history of birth control itself and how I felt it was not adequately being considered. Historically, selective birth control programs have been used against certain population groups. In the U.S. alone, sterilization has been forced on people with disabilities, prisoners, and ethnic minorities. Some have called this practice eugenics.
I recognized we were teaching healthy behaviors, but we were also encouraging these young women not to have children, at least in the next several years. However, Westerners coming to African communities pushing birth control has an incredibly ethically questionable past, intertwined with coercion through incentives, gender bias through focusing on female fertility, and cultural imperialism through creating power dynamics.
I started thinking about the last time I discussed reproductive health in Africa in one of my courses at Davidson. My public health professor explained and critiqued an initiative led by Melinda Gates which worked to increase access to family planning and birth control in African countries. Some say they are “pushing birth control on some of the world’s poorest countries while their people cry for clean water, food, and basic healthcare.”
Other Western programs which provide contraceptives in African communities have faced criticism for other reasons. Some say in countries with weak health systems, some women receiving contraceptives have not had enough counseling about side effects, causing them to not trust contraception and sometimes, biomedicine as a whole. In Ghana we have met several women who claimed they did not get birth control because they have heard it will make them infertile.
This issue is so complicated I don’t know how to digest it.
- How do we decide the number of resources which go into improving water or preventing homelessness, as opposed to providing contraceptives?
- Why is it our job to provide contraceptives to African communities?
- How to we acknowledge history when adolescents might be too young to know about the past?
- How can you tell where the line is which separates providing and teaching birth control from population control?
“Who’s The Racist? Bill Gates Spending $18 Million On Population Control in Africa” https://www.dailywire.com/news/38447/whos-racists-bill-gates-spending-18-million-paul-bois
“Moral and Policy Issues in Long-Acting Contraception” https://www.annualreviews.org/doi/full/10.1146/annurev.publhealth.18.1.379
BBC Ethics Guide: Mass Birth Control Programmes http://www.bbc.co.uk/ethics/contraception/mass_birth_control_1.shtml