The Fertility Conundrum

It is perhaps inevitable that contraception and population growth are controversial topics, given the many perspectives – economic, social, political, and epidemiological – brought to bear on them. Striking the right balance among these different viewpoints is no easy task – but much depends on getting it right.

BOSTON – It is perhaps inevitable that contraception and population growth are controversial topics, given the many perspectives brought to bear on them. Reproductive-health activists focus on family planning and a woman’s right to control her own body. Economists look at the impact on sustainable growth. Governments fret about over-population and unemployment. Health workers worry about sexually transmitted diseases and malnutrition. Striking the right balance among these different viewpoints is no easy task – but much depends on getting it right.

New contraceptive technologies – in the form of condoms, pills, and implantable devices – provide reversible and permanent forms of protection. But their usage varies widely – from just 4.8% of young women in Chad to 84.6% in China – reflecting differences in cost, availability, and cultural norms.

Contraception indisputably brings health and socioeconomic benefits. A 2012 study reported that its use averted an estimated 272,040 maternal deaths in 2008, 44% fewer than might otherwise have occurred. Contraception use has also helped less developed economies by raising women’s employment and earnings potential.

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