IV Why reproductive health?

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For three major reasons, a reproductive health perspective and approach is needed, if the status of women is to be raised and the quality of their lives improved.

First, declines in maternal mortality require more than family planning or birth control methods alone. Indonesia, for example, has a maternal mortality rate of 450 per 100,000 live births, despite 50 per cent of married women using a contraceptive method. The same argument goes for China. Its maternal mortality rate is 115 per 100,000 live births but contraceptive use among the Chinese women is as high as 72 per cent.

In countries with improved living standards and whose governments have provided women with a comprehensive health package, maternal mortality rates have declined dramatically. Sweden’s maternal mortality rate, for instance, dropped from levels of around 1,000 to about five per 100,000 live births over a period of 250 years. And this decline occurred before any kind of modern contraception was available. Malaysia has a maternal mortality rate of 26 per 100,000 live births but contraceptive use is only 51 per cent.

These cases indicate that family planning alone is not enough to prevent maternal deaths. Efficient health care is more effective than fertility regulation in preventing maternal mortality.

Second, family planning alonewill not improve women’s health. Most governments resort to family planning to reduce fertility levels and population growth rates, not to improve women’s overall health and well-being.

A reproductive health approach, properly carried out and mindful of its fundamental and ethical principles, offers much more to women not only in terms of quality and range of services that respond to the needs of women throughout their life but with regard to enhancing women’s autonomy and self-determination.

Third, reproductive health is based on certain fundamental and ethical principles which respect women’s and men’s dignity and autonomy. As such, it is carried out in a manner that is not coercive, that does not disregard women’s and men’s needs, and that does not violate women’s and men’s basic rights.

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