Population Control, Family Planning, and Maternal Health Networks in the 1960s/70s: Diary of an International Consultant

Over the past decade historians have explored the rise of the mid-twentieth-century population/family planning movement on both the international and the local levels. This article bridges the gap between these studies by exploring the work diaries of Dr. Adaline Pendleton ("Penny") Satterthwaite, a midlevel technical advisor who traveled to over two dozen countries for the Population Council from 1965 to 1974. Penny's diaries draw our attention to a diverse network of advocates who mediated between international population activists, state actors, and local communities while also acting as conduits for the transnational spread of strategies and resources. Her experiences also provide evidence of the coercive practices, gendered tensions, and political conflicts shaping the movement while illustrating the resistance and engagement of local actors, the existence of health- and women-centered approaches even during the high period of population control, and the many structural and social barriers shaping family planning projects in practice.

The effects of China's universal two-child policy

In October, 2015, China's one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.

How a network of conservationists and population control activists created the contemporary US anti-immigration movement

Continuing historical narratives of the early twentieth century nexus of conservationism, eugenics, and nativism (exemplified by Madison Grant), this paper traces the history of the contemporary US anti-immigration movement's roots in environmentalism and global population control activism, through an exploration of the thoughts and activities of the activist, John Tanton, who has been called "the most influential unknown man in America." We explore the "neo-Malthusian" ideas that sparked a seminal moment for population control advocacy in the late 1960s and early 1970s, leading to the creation of Zero Population Growth (ZPG). After rising to the presidency of ZPG, Tanton, and ZPG spun off the Federation for American Immigration Reform. After leaving ZPG's leadership, Tanton created additional anti-immigration advocacy groups and built up connections with existing organizations such as the Pioneer Fund. We trace Tanton's increasingly radical conservative network of anti-immigration advocates, conservationists, and population control activists to the present day. Tanton's archived papers illustrate, among other things, his interactions with collaborators such as ecologist Garrett Hardin (author of the famous "Tragedy of the Commons") and his documented interest in reviving eugenics. We contend that this history of Tanton's network provides key insights into understanding how there came to be an overlap between the ideologies and activist communities of immigration restrictionism, population control, conservationism and eugenics.

Defusing the population bomb in the 1950s: foam tablets in India

After the World War II era, Western experts explained that the progress of medicine, which had led to a decrease in mortality in developing countries ('control of death') was not accompanied by a parallel decrease in birth rates ('control of life'). This conjunction, they warned, would lead inexorably to population explosion and its terrifying consequences: famines, riots, political instability, expansion of Communism, wars. A heterogenous coalition of demographers, public health experts and politicians was urgently looking for an effective means to curb population growth. In the 1950s, many of them considered that mass distribution of foam tablets, a local contraceptive presented as simple to use, cheap and efficient, was a possible solution for the population crisis. At the same time, a potential opening of huge markets for this product generated intense competition among manufacturers and attempts to disqualify competing preparations as inefficient and dangerous for health. Struggles around the marketing of foam tablets, especially in India, reveal a unique combination of science, medicine, cold war politics, philanthropy and business. The presumed commercial and social potential of foam tablets was never fulfilled, due to the unreliability both of the product itself and of its 'backward' users, who either refused this contraceptive mean, or abandoned it promptly.

Achievements of the Iranian family planning programmes 1956-2006

Family planning programmes initiated in the Islamic Republic of Iran from 1966 met with limited success. Following the 1986 census family planning was considered a priority and was supported by the country's leaders. Appropriate strategies based on the principles of health promotion led to an increase in the contraceptive prevalence rate among married women from 49.0% in 1989 to 73.8% in 2006. This paper reviews the family planning programmes in the Islamic Republic of Iran and their achievements during the last 4 decades and discusses the principles of health promotion and theories of behaviour change which may explain these achievements. Successful strategies included: creation of a supportive environment, reorientation of family planning services, expanding of coverage of family planning services, training skilled personnel, providing free contraceptives as well as vasectomy and tubectomy services, involvement of volunteers and nongovernmental organizations and promotion of male participation.

History of the Chinese Family Planning program: 1970-2010

BACKGROUND

China launched a nationwide family planning program offering birth control methods and family planning services in the 1970s. Promotion of the widespread use of long-term contraceptive methods has been one of the program's core strategies. This paper reviews the history of China's Family Planning Program at the national level from 1970 to 2010. Special attention is paid to the history of contraception policy.

STUDY DESIGN

This study provides an overview of the last four decades of the Chinese Family Planning Program. Programmatic goals are highlighted during different time periods, with special attention being paid to the role of contraceptive use and the history of contraceptive policy.

RESULTS

The Chinese Family Planning Program has experienced several transitions. It has evolved from the 1970s period of moderate policy, represented by wan, xi, shao (late marriage and childbearing, birth spacing and limited fertility), through the strict one-child policy of 1979 to the early 1990s. From the mid-1990s to the present, a relatively lenient policy has been in force, characterized by client-centered informed choice.

CONCLUSIONS

The success of the Chinese Family Planning Program has long been heavily dependent on policies advocated by the central government, including programs promoting contraception to reduce fertility rates. The Program also depended on a logistical support system, including organizational safeguards and free provision of contraception and family planning services.

The birth of biopower in eighteenth-century Germany

In April 2009, Sir David Attenborough, the respected face and voice of British natural history programmes for more than fifty years, became the patron of a new charity, the Optimum Population Trust (OPT), an organisation campaigning to limit the world's population. His reason for accepting the honour, he confessed to The Times, was that he was terribly worried about the dramatic increase of the world's population and the effect it was having on the quality of human life throughout the world:

There are three times as many people in the world as when I started making television programmes only a mere fifty-six years ago. It is frightening. We can't go on as we have been. We are seeing the consequences in terms of ecology, atmospheric pollution and in terms of the space and food production.

The construction of a "population problem" in colonial India, 1919-1947

This article examines the construction of a "population problem" among public health officials in India during the inter-war period. British colonial officials came to focus on India's population through their concern with high Indian infant and maternal mortality rates. They raised the problem of population as one way in which to highlight the importance of dealing with public health at an all-India basis, in a context of constitutional devolution of power to Indians where they feared such matters would be relegated to relative local unimportance. While they failed to significantly shape government policy, their arguments in support of India's 'population problem' nevertheless found a receptive audience in the colonial public sphere among Indian intellectuals, economists, eugenicists, women social reformers and birth controllers. The article contributes to the history of population control by situating its pre-history in British colonial public health and development policy and outside the logic of USA's Cold War strategic planning for Asia.

Eugenics discourse and racial improvement in Republican China (1911-1949)

This paper aimed to examine the advent of eugenics and its characteristics in republican China. Although eugenics was introduced into China as a discourse to preserve and improve race by the 1898 reformers such as Yan Fu (1854-1921) and Yi Nai (1875-?) in the late imperial period, it was not until the republican period that eugenics discourse started to combine with the discourse and movement related to social reform. The May 4th intellectuals put forward criticisms of Confucian patriarchy, propagating science and democracy. They pointed out that the large family system was a source of every social evil, and argued the need for a small family system based on monogamy. The aim of the small family system was to improve both the race and the environment. Such thinkers argued that freedom of love and the liberation of individuality were necessary for this end. Zhou Jianren (1888-1984), Lu Xun's youngest brother and representative eugenicist in the May 4th period, combined eugenics with freedom of love and the liberation of individuality. Pan Guangdan (1899-1967) and Zhou Jianren debated the eugenics controversy in the 1920s. They raised the freedom of love and the liberation of individuality as central issues related to the eugenics controversy. The eugenics debate was developed into the controversy between biological determinism and environmentalism in the late 1920s. However, these issues did not continue to be brought up in the 1930s. The main issues concerning the eugenics controversy in the 1930s were cultural identity and the population problem. Particularly in the 1930s, the scope of birth control as the solution to the population problem was extended from the individual person and family to nation and race. For eugenicists like Pan Guangdan, birth control violated the aim of eugenics and brought about the degeneration of the race. However, such theorists did not deny the value of birth control itself. The supporters of birth control thought that selecting superior descendents and eliminating inferior descendents fit with the ideals of eugenics. They thought that the propagation of contraception could suppress the increase of inferior and weak descendents, and result in the improvement of the race. Physicians suggested the necessity of birth control and organized birth control clinic, Chinese society did not pay attention to their arguments and activities in 1920s. After birth control made at issue from the 1930s, physicians started to discuss eugenics and play the important role in the medical practice. Chinese physicians passed a resolution of birth control for mothers and children's happiness and health and public health in 1930s.As a result, Chinese intellectuals supported eugenics and supported the proposition that eugenics could improve the race. On the basis of this situation, the Guomindang government legislated eugenic laws related to contraception, eugenic marriage, and sterilization and the isolation of hereditary defaulters in 1945.

[Contraception as an instrument against population growth: expert discussions and the public sphere in 1960s West Germany]

Theoretically, the introduction of the contraceptive pill in the 1960s created new possibilities to control population growth on a global scale. Several of those involved in developing the pill belonged to the transnational population control movement. In the Federal Republic, demographic and medical experts in the 1960s debated the advantages and dangers of the new contraceptive, and they argued about whether it could be of benefit in West Germany and/or in developing countries. The paper examines the contemporary debate about the pill and the role it was awarded in the effort to solve what was considered a global population problem.

A suitable country: the relationship between Sweden's interwar population policy and family planning in postindependence India

This article delineates a strong continuity, particularly in terms of personnel, between interwar domestic population policies and Sweden's postwar participation in international and transnational population-control programs. It argues that Swedish engagement in population control and family planning in the emerging Third World, and particularly in South Asia, was motivated by the conviction that poverty and underdevelopment must be attacked on several fronts simultaneously, with population control being one of the most important. In its first bilateral aid programs Sweden would prioritize the promotion of birth control primarily because it was still too controversial to be promoted multilaterally, not least for religious reasons; and because Swedish experts were regarded as especially liberal, rational, and secularized. Sterilization expertise played no decisive part in this continuity. When first establishing themselves in South Asia, Swedish experts would recommend the rhythm method and other contraceptive methods that depended on self-control.

The theory of epidemiologic transition: the origins of a citation classic

In 1971 Abdel R. Omran published his classic paper on the theory of epidemiologic transition. By the mid-1990s, it had become something of a citation classic and was understood as a theoretical statement about the shift from infectious to chronic diseases that supposedly accompanies modernization. However, Omran himself was not directly concerned with the rise of chronic disease; his theory was in fact closely tied to efforts to accelerate fertility decline through health-oriented population control programs. This article uses Omran's extensive published writings as well as primary and secondary sources on population and family planning to place Omran's career in context and reinterpret his theory. We find that "epidemiologic transition" was part of a broader effort to reorient American and international health institutions towards the pervasive population control agenda of the 1960s and 1970s. The theory was integral to the WHO's then controversial efforts to align family planning with health services, as well as to Omran's unsuccessful attempt to create a new sub-discipline of "population epidemiology." However, Omran's theory failed to displace demographic transition theory as the guiding framework for population control. It was mostly overlooked until the early 1990s, when it belatedly became associated with the rise of chronic disease.

The limits of scientific planning: Doxiadis and the Tehran Action Plan

Tehran after the Second World War experienced a modernization drive and rapid population growth. In 1972, the Greek planner, Constantinos Doxiadis, who had already undertaken major housing and planning projects in Iran, was invited to prepare an action plan for the city, to guide the future investment for easing the city's problems. Doxiadis saw cities as nightmares, but advocated that a holistic scientific analysis and a naturalist approach to urban growth management could address their problems. In applying his ideas to Tehran, however, the limits of his ideas of scientific planning became evident, not only through contextual pressures, such as lack of time and data, but also through the planning consultant's approach, in which commercial considerations and the application of readymade solutions could shape the outcome. Rather than working with the context, Doxiadis followed the modernist tenet of breaking with the past, proposing the creation of West Tehran, an alternative to the city where all future growth should take place on a utopian basis. The radical nature of his proposals, his death, and a turbulent revolution aborted the impact of his action plan on Tehran, while faith in modernist scientific planning was widely being abandoned.

Socio-cultural aspects of the high masculinity ratio in India

The paper aims to explicate those factors accountable for the continuing imbalance in the sex ratio and its further masculinization over the whole of the 20th century. Here it is contended that the traditional practice of female infanticide and the current practice of female foeticide in the contemporary period, especially in the north-west and Hindi-speaking states, have significantly contributed to the high masculinity ratio in India. In addition, increasingly higher survival ratios of male children, particularly from the 1951 census onward, have been the prime reason for a declining proportion of females in the Indian population. As the Indian value system has been imbued with a relatively higher preference for sons, improvements in health facilities have benefited males more than females, giving rise to a highly imbalanced sex ratio in the country. This scenario, however, has steadily tended to alter in favour of greater balance in sex ratio.

A metaphor at midlife: 'The Tragedy of the Commons' turns 40

Since 1968, when Garrett Hardin wrote his essay entitled 'The Tragedy of the Commons', the idea that human reproduction must be brought under the coercive control of state power has been rejected by every government on earth, with the qualified exception of the People's Republic of China. The metaphor that Hardin used to convey his message, however, has proliferated, adapted and evolved. Its original neo-Malthusian message now largely forgotten, 'The Tragedy of the Commons' has become a wildly popular metaphor in a variety of fields from ecology to property law to the programmatic architecture of the Internet.

Strategies for achieving research utilization in the Bangladesh population program: implications for health education. 1980-81

Effective research utilization in program planning and implementation is a continuing problem in both developed and less developed nations. This is particularly so in social programs. This paper addresses the issue from the standpoint of some twelve years of experience in the Bangladesh population program. The focus of this paper is on communication between administrators and researchers-the problems that arise, and the strategies that may be used to facilitate communication in order to improve use of research findings.

Attitudes to and practices regarding sex selection in China

This paper explores the problem of China's 'missing' girls--estimated to run into many millions. It considers the impact of the underpinning Confucian value system in China that has produced a culture of son preference and which, together with China's compulsory family planning program and 'one child policy', has effectively established a 'one son policy'. Discussion of the various means by which the birth or survival of daughters have traditionally been prevented provides the context for identifying the contribution of new sex selection procedures to the maintenance of son preference in contemporary Chinese society. The paper concludes that China's son preference is not simply a personal problem for the millions of 'missing girls' who were destined to live a shorter life and for the surviving girls who continue to face considerable discrimination simply because they are of the 'wrong' sex; it heralds a social and demographic disaster of major proportions for which neither the government nor the people of China appear to have the will or the means to forestall.

Rethinking the “early” decline of marital fertility in the united states

In this article, I rely on new estimates of nineteenth-century mortality and the Integrated Public Use Microdata Series to construct new estimates of white fertility in the nineteenth-century United States. Unlike previous estimates that showed a long-term decline in overall fertility beginning at or before the turn of the nineteenth century, the new estimates suggest that U.S. fertility did not begin its secular decline until circa 1840. Moreover, new estimates of white marital fertility, based on “own-children” methods, suggest that the decline in marital fertility did not begin in the nation as a whole until after the Civil War (1861–1865).

Pretransitional population control and equilibrium

A persistent theme in much anthropological writing is the concept of the deliberate control of population numbers by hunter-gatherers as a means of achieving moderate family size, adequate nutrition, and constrained adult mortality. An analysis of the mix of theory and field evidence that led to this conclusion finds the case not proven. On the contrary, Malthusian constraints can operate, and probably did operate, to produce a hunter-gatherer society where most adults were reasonably robust and healthy even though child mortality was high and life expectancy short. The absence of population limitation in pre-Neolithic times implies high mortality as well as high fertility, and weakens the argument positing a Neolithic mortality crisis.

The road to abortion (II): how government got hooked

The first part of this series traced close links between eugenics (the effort to breed a "better" human race) and population control throughout the greater part of this century up to the 1960s. It stressed the population work of early eugenicists and eugenics sympathizers such as Frederick Osborn, Margaret Sanger, Gunnar Myrdal, Alan Guttmacher, Garrett Hardin and John D. Rockefeller 3rd. This second and concluding part will show how population controllers, from the 60s onward increasingly added economic and foreign-policy concerns to their original "eugenics" motive of improving human genetic stock. Working in both Democratic and Republican administrations, they gained major government backing for their programs and also played a key role in the legalization of abortion. I will use President Richard Nixon's administration as an example of heavy government involvement.

Producing citizens, reproducing the "French race": immigration, demography, and pronatalism in early twentieth-century France

This essay examines how, in the context of depopulation and mass immigration, members of the French pronatalist movement advanced a policy favouring immigrants from Italy, Spain, and Poland. Because the 'demographic crisis' created a shortage of citizens as well as workers, pronatalists held that foreign workers must also be assimilable, and able to produce French offspring. While the racial difference of colonial subjects was deemed immutable, pronatalists called for the immigration of white foreigners whose less 'modern' condition promoted fecundity, traditionalism, and gender dimorphism. Evidence is drawn from demographic studies, the press of France's largest pronatalist movement, and a pronatalist advisory committee created by the Ministry of Health in 1920.

Carrots and sticks: fertility effects of China's population policies

For 20 years following 1949, average total fertility per woman in China hovered just above six children. The year 1970 marked the beginning of persistent fertility declines. By 1980, the rate had dropped to 2.75, and since 1992 it has remained under 2. While some of this transition can be accounted for by broad socioeconomic developments, the extent to which it is attributable to China's unique population policies remains controversial. This paper analyzes household data from the 1992 Household Economy and Fertility Survey (HEFS) to provide the first direct microeconomic empirical evidence on the efficacy of these policies.

Fertility policy in Ceausescu's Romania

This study tests a model for the impact that Ceausescu's pro-natalist policies had on the Romanian fertility rate between 1967 and 1989. Using time-series analysis the authors' findings show that the Ceausescu regime continually struggled with the Romanian population to increase the national birthrate. As a result the regime's policies, there was a significant increase in overall fertility between 1967 and 1989, when the Ceausescu regime was overthrown. Reasons are offered as to why Romania pursued such policies and was able to make them work, while other Eastern and Central European regimes proved to be less able to sustain drives to increase national fertility. This article also presents a model of what has happened to the Romanian fertility rate since 1989, showing that there has been a significant decline in fertility in the post-Communist period.

Family planning and the politics of population in Tanzania: international to local discourse

Population politics in Tanzania reflect multiple understandings of the ‘problem’ of population. While Tanzania has a long history of family planning service provision through its childspacing programmes, a national population policy was not adopted until 1992. This work explores the ambiguity and ambivalence reflected in the discourse surrounding the Tanzanian National Population Policy. Although an international consensus on questions of population and family planning may have been reached at the 1994 International Conference on Population and Development in Cairo, when we look at actual cases of policy formulation and implementation, the discourse reflects ambiguity and conflict rather than consensus. The Tanzanian case suggests that this ambiguity may be strategic. Competing ‘positive’ and ‘negative’ approaches have been articulated from the level of national policy negotiations to that of local implementation. This enables the Tanzanian government, promoting a ‘positive’ view of population, to ally itself with proponents of an expanded reproductive health agenda without alienating the elements of the population establishment that pushed for a population policy and fund its implementation.

The environment in the People's Republic of China 50 years on

This article describes and analyses changes in the environment and related policy developments in the People's Republic over the past 50 years. When discussing the quality of China's environment it must be remembered that the population of the country has doubled over the past half century and the economy has grown rapidly, particularly over the last two decades. Pessimists argue that the current population of over 1,200 million has exceeded the number which can be supported at a good living standard. Despite such views, there has been some ground for optimism in recent years, with China's greater environmental awareness and increased openness, its realization that the environment can be a tool in international diplomacy, and the increasing importation of environmental protection techniques. Yet overall, China has not done enough to maintain environmental quality and has not chosen to make many environmentally friendly transport investments.

Hygiene, population sciences and population policy: a totalitarian menace?

Mike Hawkins, Social Darwinism in European and American Thought 1860–1945. Nature as Model and Nature as Threat (Cambridge: Cambridge University Press, 1997), 348 pp., £19.95, ISBN 0–521–57434 X.

Carl Ipsen, Dictating Demography. The Problem of Population in Fascist Italy (Cambridge: Cambridge University Press, 1996), 281 pp., £35, ISBN 0–521–15545–7.

Simon Szreter, Fertility, Class and Gender in Britain 1860–1940 (Cambridge: Cambridge University Press, 1976, 704 pp., £50, ISBN 0–521–34343–7.

Alain Desrosières, La politique des grands nombres, histoire de la raison statistique (Paris: La Découverte, 1993), 437 pp., FF 220; ISBN 2–707–12253–X; English translation by Camille Naish, The Politics of Large Numbers. A History of Statistical Reasoning (Cambridge, MA: Harvard University Press, 1998), 416 pp., $45, ISBN 0–674–68932–1.

Paul Weindling, Health, Race and German Politics between National Unification and Nazism 1870–1947 (Cambridge: Cambridge University Press, 1989), 641 pp., £22.95, ISBN 0–521–42397–X; French translation by B. Frumer, L'Hygiène de la race (Paris: La Découverte, 1998), 301 pp., FF 160, ISBN 2–707–12706–X.

Over the last ten years a series of social historians have published studies of the link between the definition of scientific categories and the implementation of demographic policies in Europe. This discussion of the classification of populations in terms of social class, race or location (rural, urban, underprivileged areas) has complicated the traditional theories of the scientist and politician, Max Weber, and the student of ‘bio-power’, Michel Foucault. Now, historians of political ideas are finding living examples to illustrate recent advances in the sociology of science, establishing themselves at the interface between the history of human health and that of population policies. The aim is to throw light on the exchange between scientists and population management: among the themes to be treated are natalism, populationism, hygienism and eugenics.

From population control politics to chemicals: the WHO as an intermediary organization in contraceptive development

Studies of laboratory work have rarely focused on the role of intermediary organizations in developing R&D activities. Most studies focus on a single university-based research laboratory or an industrial R&D unit. Moreover the rejection by social constructivist scholars of universalistic, deterministic explanations of the development of science and technology has led to an overemphasis on the local features of scientific and technological work. Based on a case study of the role of the World Health Organization (WHO) in contraceptive R&D, this paper suggests that an analysis of the role of intermediary organizations enables us to go beyond a too-narrow focus on the micro-sociological dynamics of laboratory work, to include the macro- and meso-sociological dimensions of science and technology. First, a focus on intermediary organizations enables us to learn more about the manner in which locally specific laboratory cultures are transformed into translocal research practices. This paper shows how literary technologies, and to an even greater extent material technologies, are important tools in accomplishing standardization of local laboratory cultures. Second, a focus on intermediary organizations enables us to study how concerns that go beyond the laboratory--in this case, population control policies and the agenda of the WHO--help to shape laboratory practices.