I. Introduction

A Framework for Understanding Reproductive Health

On Women’s Health: Beyond Reproduction

by Marilen J. Dalan, M.D.

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For sometime now, population discussion has resounded with the term “reproductive health.” Obviously, the term can have several meanings. And its use would depend on the interpretation given by a profession, a political perspective or ideology.

It is important for the media to establish a framework of understanding that will rationalize its repeated reference in the public forum.

Reproductive health is part of women’s overall health. After almost five decades of discussion, the international community has agreed to adopt the concept of “reproductive health” as an approach to the crafting of population policy. It has provided a saner approach to the solution of population problems.

The concept may be interpreted in different ways. Reproductive health may be pursued through different programs, depending on the social and economic conditions prevailing in the country. But there are fundamental and ethical principles upon which reproductive health is based. Women advocates hope that policies will reflect these principles. These principles should be understood to clarify the basis of conceptual discussion.

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The tendency to equate “reproductive health” with “family planning” needs correction. While the principles of “reproductive health” have been used to revise previous population policy approaches, reproductive health should not be understood as just another name for population control. It is grounded in reproductive rights’ and is a basic condition of “women’s empowerment!’ (unfortunately another misunderstood and abused term). Women’s empowerment is not only about abortion and fertility control. Rather it is about those conditions which enable men and women to fulfill their potential, including their sexuality. It is about freedom from fear of incest, rape, the kind of harassment, discrimination, exploitation, and violence that exploit women because they are women. The empowerment and liberation is sought for men as for women, because these fears hold back both male or female from understanding and appreciating their being fully and equally human:

But then again the ability to be (or not to be), or the forces that lead to empowerment, is really a question of one’s access to a range of opportunities for jobs, livelihood, property, education, housing, health care, credit, as well as political participation. These are basic enabling conditions that help a person enjoy a fuller life; building up one’s personal confidence and self-esteem. These conditions allow a woman to choose if and when to get pregnant, if and when not to. These conditions give one the leverage to “negotiate safe sex;” to say no to an oppressive husband and to seek protection against his abuse. These enable a man or woman to step out of the closet with the truth of their sexuality. These conditions help men and women to stand up against the stereotypes perpetrated by custom, cultural tradition or religion that hold them down, especially in those areas related to sexuality.

Reproductive health and reproductive rights are central to empowerment. Development can evolve basic enabling conditions that reduces poverty levels, strengthens safety nets for marginalized sectors, and focuses on the economic independence for the country and for the individual.

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Reproductive health and its enabling conditions are ends in themselves, and should be pursued as such. Whether or not these should bring fertility rates down in the future is no longer the overriding concern. The driving force is not the determinationof how many children everybody should have or what size a family should take. The shift signifies the movement of population concerns from the numbers count. What matters most is that women and men can make real choices. And that they are able to live well with the choices they make.