Contraceptives and their Reception

Madrigal von Muchow

The history of contraceptives and their reception in Latin America is as complex and varied as the region itself. Countries generally furnished availability and encouraged use through family planning programs, many of which were supported by U.S.-based organizations, such as USAID. Latin American countries have a storied and contentious history with reproductive health care and family planning, which are intrinsically tied with movements of international aid, eugenics, and nationalism (Measham, 1975). At the introduction of the oral contraceptive pill to international markets in the 1960s, their availability was controversial, especially where church, state, and populace disagreed (Briggs, 2002).

Family planning movements in Latin America had close ties to the changing political climate surrounding population and the government’s role in managing it. As Carter notes, a “neo-Malthusian” movement was forming through the twentieth century, and governments were increasingly concerned with how they would manage their populations (2018). Death rates were falling rapidly, and populations of Latin American countries were growing at astonishing rates, around 3% annually at one time. In an extension of Thomas Malthus’ nineteenth-century observations, national leaders and public health officials saw this growing population as a cause of social ills, and endeavored to control this boom in population for social betterment. Governments, with and without the aid of international or U.S.-based organizations, set out to do this through family planning programs, aided by new, high-tech contraceptives, like the pill and the IUD (Robles et al., 2012).

Population control, in some contexts, bore signs of a heavy influence of eugenics. A substantial number of public health and governmental leaders, especially in the interwar period, saw the population’s health as inherently tied to its demographic makeup. Reducing the population, not only through numbers, but in a specific way as to favor the “ideal” populations and reduce births of “undesirable” ones. A particular example of this was Peru’s forced sterilization program in the 1990s, wherein the Fujimori government sterilized scores of indigenous women without proper consent, and sometimes, their knowledge (Ewig, 2006). Other countries adopted less extreme measures, but still saw family planning as a way to curb the growth of poor communities (Briggs, 2002).

The Roman Catholic Church, which has a significant presence in many countries in Latin America, has had a fraught relationship with the existence and expansion of contraceptives. In 1968, eight years after the general availability of oral contraceptives, the pope released the Humanae Vitae, an essay codifying the opposition of the church to any and all non-natural methods of contraception. In some countries, such as Peru, however , members of the Catholic church cooperated with the family planning movement as an expression of charity and social responsibility (Necochea Lopez, 2008). In Peru, liberation theology emerged as a central philosophy of the church, and within this, the alleviation of poverty through contraception was generally accepted. However, this was the exception to the rule. Most Catholic powers opposed contraceptives and family planning on religious grounds, which limited their availability, depending on how much sway the church had in the governance of a particular country (Measham, 1975).

International aid organizations, such as USAID and the International Planned Parenthood Federation (IPPF), have had a significant role in promoting contraceptives in Latin America. The international consensus, post World War II, was that unchecked population growth was a hindrance to development and a high economic burden to countries. Some Western countries, such as the U.S., saw growing populations as a security threat to their own populations, and international organizations resolved to promote family planning as a solution (Bertrand et al., 2015). USAID began its Population Program in 1965, and by 1969, was spending $45 million annually worldwide to promote family planning. The IPPF developed 14 family planning associations in several countries, which later became member associations of Planned Parenthood. USAID supported the IPPF, as well as independently financing some of the associated member organizations (Bertrand et al., 2015).

Governments often influenced the availability and influenced the social acceptance of contraceptives. Many Latin American countries were hesitant towards, if not outright against, international aid organizations’ promotion of family planning programs. Some saw it as another imperialist interference, and that the U.S. was attempting to control their population and limit their national power. Others adopted contraceptive promotion for their own nationalist or eugenicist aims, seeking to limit the birth rates of marginalized or “unwanted” populations in their society (Morgan & Roberts, 2012). Many governments were hesitant to promote or even discuss, at the outset, a highly stigmatized topic that the church was officially opposed to. In Puerto Rico, for unique example, centralized government efforts at promoting family planning and medical birth control proved impotent against the influence of the Irish Catholic clergy. Instead, middle class professionals were the influencers who were ultimately responsible for the widespread use of birth control, which skyrocketed between the 1940s and 1960s (Briggs, 2002).

A Puerto Rican woman and practitioner consult.

The case of Puerto Rico, in particular, is an interesting one, as well as one that is intrinsically tied with the introduction of the oral contraceptive to Latin America. A small Caribbean island, in Puerto Rico concerns about overpopulation were rampant in the 1950s, as its population density was surging. Here, some of the first large trials of hormonal contraception were conducted in the early 1950s, in which they found unpleasant and dangerous side effects, before safety had been ascertained in North America (Briggs, 2002).

Though the introduction of modern contraceptives and family planning programs in Latin America varied wildly, their reception depended largely on involvement with the church, each country’s acceptance of foreign aid, the policy of each government itself within international discourse, and the involvement of the population. The Catholic church itself had a complex relationship with the family planning movement, and its power in each country influenced that country’s reception of contraceptives. In addition, an individual country’s acceptance or rejection of international aid and programs, as well as its government’s interests in population control, greatly influenced its response to advent of modern contraceptives.

References

Bertrand, J. T., Ward, V. M., and Santiso-Galvez, R. (2015). Family planning in Latin America and the Caribbean: The achievements of 50 years. Chapel Hill, NC: MEASURE Evaluation.

Briggs, L. (2002). Reproducing empire : race, sex, science, and U.S. imperialism in Puerto Rico. Berkeley: University of California Press.

Carter, E. (2018). Population control, public health, and development in mid twentieth century Latin America. Journal of Historical Geography, 1-10.

Ewig, Christina. (2006). Hijacking Global Feminism: Feminists, the Catholic Church, and the family planning debacle in Peru. Feminist Studies, 32(3), 632-659.

Measham, A. (1975). Latin America 1974: An overview. Studies in Family Planning, 6(8), 281-282.

Measham, A., & Rodrígues, W. (1975). Brazil. Studies in Family Planning, 6(8), 265-267. doi:10.2307/1964968

Morgan, L., & Roberts, E. S. (2012). Reproductive governance in Latin America. Anthropology & Medicine, 19(2), 241–254.

Necochea Lopez, R. (2008). Priests and Pills: Catholic Family Planning in Peru, 1967-1976. Latin American Research Review, 43(2), 34-56.

Robles, R. R., Martinez, R. E., Vera, M., and Alegrita, M. (1987). Sociocultural factors associated with contraceptive use in Puerto Rico. PAHO Bulletin, 21(4), 395-404.

Valenzuela, M. S., Herold, J. M., Morris, L., and Lopez, I. (1991) Survey of reproductive health in young adults, Greater Santiago, 1988. PAHO Bulletin, 25(4), 293-305.