Imani Tafari-Ama | Whose two is too many? Infertility as a development issue

Between 1973 and 1975, Jamaica’s birth rate was 4.5. However, findings from a 2021-22 national survey (the eighth of its kind), revealed that the birthrate has fallen to 1.9 per woman. This research focused on fertility, contraception, and overall sexual and reproductive health (SRH) of women and men aged 15-49, the chief childbearing years.

The current birthrate is less than the minimal 2.1 replacement frequency that keeps a balance between births and deaths. This decline is being seen by policymakers as a threat to the sustainable development potential of the nation.

In the 1970s, Jamaica’s National Family Planning Board (NFPB) introduced a fertility reduction programme that was popularised by the slogan “two is better than too many”. This theme conveyed the message that for the country to develop, the birth rate should be controlled.

IRONIC

It is, therefore, ironic that today, state officials are bemoaning the falling fertility rate. It seems that the NFPB’s birth-reduction programme has undermined the required SRH balance. This is a class-specific concern because middle and upper class women have long restricted child bearing, as a mechanism of improving individual development chances and keeping family wealth secure.

There have been concerns over the years, that people from underserved communities were not able to “plan their families and better their lives” as also promoted by the NFPB’s programme. This inability results from the unequal access of different social groups to healthcare in general and SRH care in particular.

It is lower-class families for whom the proverb “children are poor peoples’ riches” has most resonance. People from underserved communities have been the ones to place great value on childbearing as a cultural and socio-economic resource. The NFPB’s campaign was, therefore, directed at this sector of the society in an effort to constrain the reproductive capacities of those deemed least able to afford it.

At the time that the NFPB launched its plan to curtail the population, Rastafari, an indigenous spirituo-political movement that was born in Jamaica, responded that this campaign was “a plan to kill out black people”. The Rastafari resistance to the NFPB initiative came from the position that enslavement had already wreaked havoc with African peoples’ sexual and reproductive health and rights (SRHR).

SHORT LIFESPANS

The dehumanisation process entailed in the capitalistic labour system of enslavement resulted in chronically short lifespans. An enslaved person was expected to live an average of 29 years. In addition, Africans were sexually exploited and coerced to reproduce the enslaved population.

In resistance to the routine rape and enforced breeding system implemented on sugar plantations, several women would abort their babies or extend the lactating period, which produced an enzyme in the body called pectin. This prevented pregnancy. Women would also commit infanticide to prevent their children from growing up in enslavement. In fact, that was the crime of Sabina Park, the celebrated enslaved woman, who killed her infant just after childbirth. For this rebellious action, Sabina was tried and hung on the site of the present cricket grounds on South Camp Road.

Due to socialisation norms, women have been primarily responsible for childcare. However, the current trend is for many women to opt for delaying or cancelling childbearing. The alternative choice is to pursue higher education and careers, as a strategy of overcoming the pressures of poverty.

More and more women in childbearing years are choosing to delay or abort pregnancies in preference for achieving the educational requirements for being independent income earners. The tried and not always successful strategy of expecting support from multiple baby fathers has also motivated women to reduce the number of children for whom they must take care.

The reduced fertility rate must also be connected to the disappearing support system of the extended family. The reliability of this intergenerational resource has been eroded as a buffer against socio-economic dysfunction. A push factor for this change is the increased migration of primary family members. As the extended family, which used to provide secure social and economic support, becomes more and more unreliable as a cultural support mechanism,, many mothers have been left on their own to manage the welfare of their children.

In addition to low fertility rates, the government-sponsored study also draws attention to the high mortality rate for women. This rate peaked in 2021during the COVID-19 pandemic (2019-2022). Maternal mortality should be examined in tandem with this still-unexplained global crisis and current concern about the decline in the national fertility rate.

MYSTERIOUS SPIKE

This mysterious spike in the deaths of expectant mothers must be analysed as a factor that also contravenes the Millennium Development Goals (MDGs). Jamaica is a signatory to the United Nations’ 2030 target of maintaining deaths of mothers below 70 per 100,000. However, this figure has exceeded 100 per 100,000 for decades.

Jamaica has been delinquent as far as achieving MDGs 4 and 5, which address infant and maternal mortality rates. These failures also have negative implications for maintaining a sustainable fertility rate.

We also have to be concerned about the ways in which we are inserted into the world economy because women may be reducing their birth rates for socio-economic reasons. It could also be the case that they are infertile, a condition not covered by insurance policies and for which treatment is notoriously expensive.

Men may also suffer from infertility, a condition that is often socially stigmatised and denied. Blame games may ensue between partners without acknowledgement that diseases like diabetes, which can be traced back to the horrible conditions of the plantation, may contribute to male infertility. This is why health is one of the headings under which reparations recompense is demanded from former colonisers.

We also cannot leave out of the mix variables like HIV/AIDS and gender-based violence, which rob the population of many of our virile and potentially childbearing young men and women. Most concerning is the alarming epidemic of violence against women and girls (VAWG). One in three women worldwide die as a result of intimate partner violence, and in 2022, 4.9 million children died, many of preventable causes.

These intersectional factors that combine to threaten family size decisions ultimately also affect our capacity to have sustainability as a hallmark of nation building. Therefore, it requires sensitive leadership and policy direction to ensure that the push and pull factors at play are strategically considered to ensure that development is performed with people-centred intentionality.

Imani Tafari-Ama, PhD, is a Pan-African advocate and gender and development specialist. Send feedback to i.tafariama@gmail.com and columns@gleanerjm.com