The previous chapter was written from a consequentialist perspective, where disagreements about the direction and efficacy of population policies hinge on the merits of pursuing particular demographic goals. The extent to which collective outcomes are the primary or sole criterion for political decision making depends, however, upon prior ethical commitments. For liberals who maintain a strict division between the public and private realms, for those who believe that certain natural or human rights are absolute and non-negotiable, from a Kantian perspective for which autonomous moral agents must never be used instrumentally as means to external ends, consequentialist approaches to population control rest on flawed moral premises, regardless of the utility of outcomes or the mechanisms deployed.
This chapter assesses these normative arguments, whose criteria are ethical and political rather than environmental and demographic. They draw on classical liberal (and postclassical neoliberal) arguments about individuals’ freedom to make choices about their private lives and to be the best judge of their own interests. They include objections to utilitarian consequentialism, whose commitment to maximizing aggregate happiness is associated with expedient calculations that may override some individuals’ rights. This is in turn connected to broader debates about the distinctive nature of politics, as a strategic field of power relations in which the connections between means and ends differ from those espoused by moralists. These disputes have been rehearsed among political thinkers since Machiavelli. They have occasionally been applied explicitly to the population question and they continue to underpin current disagreements about the legitimacy of state interference in reproductive decisions. In a nutshell: do individual freedom, autonomy, privacy and rights preclude population control, or do adverse collective impacts from unregulated procreation sometimes justify public action, in which case how much latitude should it be accorded?
Classical liberal arguments about freedom are explored in the first part of this chapter. The core question here is whether, and if so under what circumstances, it is permissible for governments to interfere with reproductive liberty. Given population policies’ interest in modifying fertility behaviour, it is unsurprising that such arguments should have acquired particular resonance for feminists, for whom reproductive rights are central to women’s emancipation, empowerment and equality. Human, and in particular reproductive, rights arguments against population control are discussed in the second part of the chapter. The key question here is whether it is (ever) legitimate for governments to tell women (or couples) how many children they may produce, or whether this violates their rights. Note that both these discussions are framed in humanist terms. Among others, Donna Haraway’s work serves as a reminder of the ‘human exceptionalism’ embedded in most human rights discourse (although the rights framework is itself sometimes applied to animals and other natural entities when legal protection and respect are sought for non-human beings). While acknowledging that earlier population policies often perpetrated injustices, Haraway argues that it is an imperative of ‘multi-species reproductive justice’ that the problems caused by overpopulation are acknowledged and efforts made to reduce future numbers substantially.1
A good place to start is J. S. Mill’s essay ‘On Liberty’ (1859), because it is commonly regarded as the classic defence of (negative) liberty and because Mill includes reproduction freedom in his inquiry. Mill was a social liberal who used a modified version of utilitarian reasoning. He was aware that capacities for and experiences of personal happiness depend upon the broader social context, and here he championed a pluralistic liberal culture. His essay reflects on principles for establishing the limits of justifiable incursion on freedom, and it offers a robust defence of civil liberties and individual privacy. His aim, Mill writes, is ‘to assert one very simple principle’: regarding sanctions through physical force in the form of legal penalties, or moral coercion exercised through public opinion, the sole end that justifies non-consensual interference is ‘to prevent harm to others’ (his ‘harm principle’). ‘Over himself, over his own body and mind,’ he insists, ‘the individual is sovereign.’2
It might be inferred that in matters as intimately corporeal as fertility, negative liberty will be sacrosanct. Jeremy Waldron convincingly explains why Mill would not have included moral distress caused by unconventional sexual behaviour under his ‘harm principle’, or therefore regarded this as a legitimate area for intervention.3 Sexuality is a self-regarding act: that is, an act that affects only the individuals involved or affects others in trivial ways which they must tolerate. Mill himself objected to compulsory medical examinations for women under the Contagious Diseases Act. Conversely, acts that harm others’ interests in non-trivial ways are classified as other-regarding and they may in principle be interfered with by society or state. Mill here includes responsibilities to the society that protects liberty, placing a positive duty on individuals to avoid injuring others and to bear their fair share of society’s burdens. Once procreation occurs, sexual activity moves into this category of other-regarding acts.
It does not follow that such acts should automatically be subjected to public intervention. ‘As soon as any part of a person’s conduct affects prejudicially the interests of others, society has jurisdiction over it,’ Mill asserts, ‘and the question whether the general welfare will or will not be promoted by interfering with it, becomes open to discussion.’4 Evaluating the case for intervention must include its likely efficacy, the danger of unintended negative consequences, the degree of coercion required, the strength of society’s interest in the outcome and the cost of diminishing individuals’ self-reliance. In short, other-regarding acts are the stuff of the public sphere. Mill’s version of consequentialist ethics requires that the merits of public intervention – including the means to be used, the ends they serve and the particular circumstances in which interference might be warranted – are carefully deliberated.
He argued on many occasions that large families harm the working class by reducing real wages and impeding equality. Although his observation expresses a general truth about laws of supply and demand in market economies, the way that truth operates varies according to economic and demographic conditions. In the mid-nineteenth century, he contended, high fertility had become an unambiguously other-regarding act in old, ‘overpeopled’ countries like Britain, whereas in new settler societies like America, with their abundant resources and relatively scant populations, large families did not adversely harm others’ interests so procreation could safely be treated as self-regarding. He ruminated on the benefits of emigration/ immigration in this light, too. As a youth, Mill had been arrested for distributing illegal literature on contraception and during the course of his career he suggested various measures for reducing family size. Laws proscribing early marriage; the role of public opinion in deterring large families through ‘unfavourable sentiments’; opening employment to women, in order to sublimate passion and encourage fewer progeny; working-class education, including an understanding of the laws of political economy and exposure to the disciplinary effects of labour markets: these are all mentioned as ways to inculcate responsible reproductive behaviour.
In summary, Mill’s version of liberalism allows both more and less direct interventions in fertility regimes, provided they follow consideration of the ends to be achieved; a convincing case is made for the collective benefits, and individual liberties that do not substantially harm others are protected. Underlying his argument is a view that children are not merely a private good. As future citizens, they become a public resource or burden and, as such, public intervention is legitimate under certain circumstances. Because circumstances, and hence impacts, vary, he recognized that reproduction may in different times and places be classified either as self- or as other-regarding. Mill’s principle thus allows for contextual flexibility that avoids moral absolutism and rigid political boundaries, while maintaining important liberal and democratic constraints on interference. He maintains a bias towards personal liberty, such that freedoms cannot be overridden by consequentialist reasoning unless significant harm is demonstrated. Where public action is warranted, it is subject to careful scrutiny. Analysis in the rest of this chapter broadly supports this circumscribed consequentialism.
When neo-Malthusianism re-emerged during the 1960s, public responsibility for limiting population growth was often justified through reference to Mill’s ‘harm principle’, with expositions of harm being expanded to include shared social and natural ecosystems (‘the commons’). Garrett Hardin’s iconic essay ‘The Tragedy of the Commons’ (1968) may be viewed as a mid-twentieth-century update of Mill’s politics, inasmuch as individual liberties and responsibilities must continuously be reassessed in relation to public goods and collective outcomes.
Hardin explains why unregulated reproduction and consumption are ruinous for the commons. The tragedy he describes is indebted to Hobbes’s and Locke’s social contract theories and is actually twofold. First, a combination of unregulated acquisitive individualism and high fertility yields a classic collective action problem. Everyone is disadvantaged by the outcome, yet no one has a private incentive for restraint unless others are guaranteed to exercise the same. ‘Freedom in a commons brings ruin to all.’5 Thereafter, remedial actions (discussed further in chapter 3) converge around options for rationing. While Hardin identified both economic and political mechanisms for limiting user rights (markets and progressive taxation), he acknowledged that they all incur degrees of injustice, inequality, exclusion and loss. Accordingly, ‘we need to reexamine our individual freedoms to see which ones are defensible’. Like Mill, Hardin recognizes that measures are ‘system sensitive’. He argues that absolute, ahistorical liberties or rights are anachronisms because ‘as the human population has increased, the commons has had to be abandoned in one aspect after another.’6 Abandonment is not a one-off event but an ongoing process, as a shrinking realm of unregulated common life is incrementally destroyed or controlled. ‘Every new enclosure of the commons’, Hardin observes, ‘involves the infringement of somebody’s personal liberty’ and provokes an outcry before being accepted as necessary. He expected the next and most urgent infringement to be on people’s right freely to reproduce.
Such advocates of population policies, who insist upon the other-regarding nature of procreation, recognize that acts which might be ethically unobjectionable in their own terms may nevertheless inflict considerable damage on communities once they are multiplied. Hobbes’s state of nature, where unrestricted freedom results in a war of all against all, despite a common desire for peace and security, exemplifies the problem. The lesson Hobbes had drawn – that it is rational to surrender liberty to a central authority capable of imposing the beneficial outcome that eludes the disorganized multitude – was not lost on those who expressed concern about an environmental crisis caused by unrestrained reproduction and consumption. Their hope, however, was that coordination could be entrusted to democratic governments responsive to the concerns of informed citizens, who would consent to mildly coercive fiscal and legislative measures (such as disincentivizing taxes) for reducing the birth rate and embrace a culture of limits reinforced by economic (dis)incentives. This would avoid more harmful outcomes, including more stringent coercion, later.
At this point, a few genealogical comments are helpful because the ideological landscape shifted during the 1970s, and one of its effects was to redraw the line between private and public, and thus between self- and other-regarding acts. Among the areas affected, procreation was redefined as a self-regarding act and inviolable rights associated with it (extending to the unborn foetus) were increased. This reflected a wider turn, both political and methodological, from collectivist and structural to more individualist and anti-state approaches (accompanied among critical theorists by a turn from politics to ethics). As government intervention was pared back, it was deemed especially coercive within the reproductive sphere. For the Reagan Administration in 1984, ‘the right of couples to determine the size of their own families’ was cast in opposition to ‘forcible coercion’ for demographic purposes.7 As a corresponding stress on individual rights and choices grew, the close relationship between rights and responsibilities that liberal thinkers like Mill had insisted upon dissipated.
The change was not uncontested. Paul Demeny, first editor of Population and Development Review, rejected the reclassification of reproductive acts by explaining that the ‘birth of a child, perceived as a gain for the single family, imposes costs on all other members of the society in which it is born – costs that are not taken into account in the private decisions that determine fertility’.8 Such critics questioned the analogy with market equilibrium and insisted that demographic externalities remain ‘a legitimate object of attention for collective and, in particular, governmental action’.9 The editorial for the Review’s first issue in 1975 shows how Mill’s ‘harm principle’ was being updated by games theory, which demonstrated how even personally rational procreative decisions can yield sub-optimal outcomes. The ‘sum total of individual decisions may not add up to the common good. When the aggregated private preferences and the public good in demographic matters diverge greatly, people may no longer be best served by the age-old practice of relying on spontaneous processes of social adjustment.’ At this point, fertility becomes ‘an explicit goal of public policy’.10
But the political landscape was shifting in other directions, too. As the international human rights paradigm strengthened under the Clinton Administration, new political constituencies acquired powerful voices on the population question. Among them, the International Women’s Movement (IWM) had become a significant force by the 1990s. It played a major role in forging the paradigm change represented by the Cairo consensus, wherein the ‘numbers game’ was denounced in favour of women’s reproductive health rights.
Liberalism’s individualist defence of personal freedom is closely related to its protection of basic human rights. Within this theoretical framework, reproductive rights raise some specific questions. Whose rights are they? Are they already covered by the universal category of basic (fundamental) rights, in which case can gendered aspects be deduced, or are they specifically women’s rights? In the context of population control, how do reproductive rights stand in relation to other rights such as the right to develop? Are reproductive rights in principle antithetical to political interventions in fertility choices, regardless of demographic or development outcomes? Do population policies necessarily violate reproductive rights? To address such questions, it is helpful to distinguish between different kinds of reproductive rights (see below). But first it is useful to understand the importance they assumed in response to charges levelled against population control programmes by the IWM. Four main objections may be identified here.
The first echoes a wider post-colonial critique of population control, which denies that there is a population problem at all. Instead, population’s problematization is understood as a political construction. Proponents of this objection rarely discuss numbers or biophysical limits. Rather, they identify demographic, development and environmental discourses as discursive strategies within a global power struggle. Hardt and Negri encapsulate this judgement in Multitude, where they argue that most ‘discussions of demographic explosions and population crises . . . are not really oriented toward either bettering the lives of the poor or maintaining a sustainable total global population in line with the capacities of the planet’. Instead, their supporters are ‘concerned primarily with which social groups reproduce and which do not’.11 Western population politics since the mid-eighteenth century is perceived to have been dominated by this colonial, eugenic logic.12 The feminist dimension of this critique maintains that worrying about overpopulation is a way of rationalizing control over women’s bodies. Betsy Hartmann exemplifies this view when she argues that the population (qua environmental) problem is an ‘over-exaggerated’ myth deployed to justify abusing women’s rights.13
While this objection focuses on fertility control, with feminist critics stressing its implications for women’s reproductive rights, it is relevant to mention that this constructivist, post-colonial position is applied also to a second key demographic variable, namely migration, which is addressed in similar terms. Immigration control and its justifications are opposed in this case to open borders, equated with a right to free movement. While this is too vast a topic to be considered here, it is important to appreciate the challenges it poses for national stabilization population policies inasmuch as these logically imply balanced migration (i.e. zero net gains), which social justice opponents consider immoral and economists undesirable.14
The implication is that it is not only unnecessary but also politically too dangerous to pursue demographic goals, given the sinister geopolitical interests and dubious morality of elites. Such concerns sound a salutary warning about the ease with which anxieties (commonly parsed as ‘fear of the other’) about reproduction, gender and ethnicity can be co-opted for reprehensible political purposes. The previous chapter suggested that supporting gradual population decline in developed countries might help appease critics who associate population control with genocide. But here, too, critics argue that women of colour and minorities have been targets of abusive or exclusionary fertility and migration controls justified by unwarranted demographic and economic rationalizations. On the other hand, sociologists like Nikolas Rose worry that eugenics has become a rhetorical term used to condemn every intervention in population variables, whereas ‘Limiting population size for economic reasons’ (and surely environmental ones, too), while not immune to criticism, ‘is not the same as seeking to maximize racial fitness in the service of a biological struggle between nation-states’.15
Other feminist objections focus more specifically on the instrumentalist implications of consequentialist approaches to population growth. This second objection arises from a neo-Kantian injunction against using women’s bodies instrumentally to achieve collective ends. It is held to transgress a ‘central tenet of the international women’s health movement’, namely that ‘women’s health and rights, not macrodemographic objectives, are of paramount concern’.16 A woman-centred focus on reproductive health means recognizing its inherent value as a way ‘to empower women, and not as a means to limit population growth, save the environment, and speed economic development’.17 Third, although feminists welcome family planning services, they argue that under population control directives these are less concerned with liberating women from unwanted pregnancies than with reinforcing structured gender inequality. Thus Sonia Corrêa reasons that ‘human reproduction takes place through women’s bodies. Therefore, religious and cultural institutions and the population establishment operate through existing gender systems.’18 Policy regimes that promote fewer births may from this perspective be regarded as no less gender-biased than patriarchal institutions like the Catholic Church. In Joni Seager’s succinct formulation, ‘Population control is a euphemism for control of the women.’19 Finally, such warnings are illustrated by examples of risky reproductive technologies (such as the IUD debacle in India during the 1960s and the use of dangerous injectables) and coercive means (most notoriously, compulsory sterilizations and abortions), whereby women’s health is sacrificed for the purpose of reducing numbers. Such measures violate basic human rights by compromising bodily integrity.
Pulling these different strands together, it follows that family planning programmes must not only be voluntary on the part of their individual users but also oriented towards women’s individual reproductive health needs, rather than being designed primarily for wider socio-demographic (and a fortiori post-colonial) purposes. In formulating these objections, the Women’s Movement focuses especially on situations where women’s choices not to use (certain kinds of) birth control or to settle for small families are contrary to population stabilization goals, yet are judged valid expressions of their reproductive autonomy. Susan Himmelweit’s historical note is instructive here. Initially, she observes, reproductive rights meant women’s right not to reproduce through access to free, safe contraception and abortion. Later, attention shifted to women’s right to reproduce, with a corresponding refocusing on sterilization and abortion abuse (and on rights to access infertility treatments).20
In order to address the questions posed at the beginning of this section and to respond to these feminist objections to population control policies, it is helpful to recall some of the theoretical disputes that inform human rights discourse, again starting with consequentialist ethics and its critics. From a utilitarian (Benthamite) standpoint, (self-evident) natural rights are meaningless fictions. Societies may nonetheless agree upon specific positive rights that are codified in and enforced by law. Human rights operate somewhere in between. They draw on moral intuitions that all human beings enjoy certain universal rights, qua humans, and are equal in this regard. Basic human rights, such as to life, liberty and security, are enshrined in international laws that may be backed up by international courts and included in national constitutions. They are not explicitly gendered, but their application or violation clearly has gendered implications.
Additional human rights that have proliferated more recently seem to be of a different order. They often entail socio-economic rights, or entitlements, and in this form they look more like ideals: ideals whose fulfilment is both contingent on competing models of economic structure and service delivery and harbours significant resource implications. Chris Brown thus observes that ‘most economic and social “rights” are best seen as collectively agreed upon aspirations rather than as rights as the term has conventionally been used’.21 In this sense, they function strategically by imbuing political demands with moral force. While advocates of women’s reproductive rights recognize that broader structural problems of gender inequality require extensive systemic changes, the legalistic framework of reproductive rights appears useful for articulating women’s grievances and demands.
It is sometimes argued, in a more materialist vein reminiscent of Marx, that if the criterion for basic human rights is that they are a precondition for exercising other rights, then a fundamental right to subsistence and the satisfaction of at least basic needs must be included. Yet this right is undermined by poverty and by degradations of the commons. If rights imply corresponding duties to rectify impediments, moreover, basic human rights must involve an obligation to ensure propitious material conditions, conditions that arguably include sustainable demographic and environmental outcomes, as well as adequate (reproductive) health services and equitable gender relations. In other words, satisfying rights in more than a formal, legal sense cannot be divorced from attention to adverse impacts from aggregated individual acts, that is, consequences.
Advocates of absolute moral rights understandably resist this reasoning. Logically, absolute rights ‘must exclude any reference to the possibly disastrous consequences of fulfilling the right’ inasmuch as this implies acknowledgement of exceptional circumstances for overriding it. Utilitarianism’s critics draw attention to abhorrent policies that ‘unrestricted aggregative reasoning might justify’ under certain circumstances.22 This slippery-slope argument is frequently levelled at purely consequentialist reasoning and it appears to fit with arguments for reproductive rights, inasmuch as population control is charged with ‘aggregative reasoning’ that may justify ‘abhorrent’ coercive acts like compulsory sterilization.
When expressed in this way, disagreement between consequentialists and moral individualists seems to result in an impasse between means and ends, or individual versus collective interests, except where they happen to coincide. This oppositional, either/or formula is illustrated by a recent intervention that asks whether it is ‘morally permissible to interfere in human procreation through state regulations as to family size, or whether that impermissibly infringes on human rights’.23 Yet this theoretical opposition is surely too stark to accommodate the situation in which such questions arise, where embodied individuals share socio-ecological spaces and have overlapping as well as competing interests. Between ‘interference’ and ‘abhorrent’ coercion, too, there lies a rich toolkit of policy options, as discussed in chapter 3.
Recognizing that freedoms or rights are practised or claimed within an intersubjective field suggests that rights might be differentiated and prioritized in relation to consequences, consequences that are not just an abstract outcome calculated by adding up utilities (qua subjective preferences, as aggregate ‘happiness’) but complex, messy outcomes that emerge within changing historical conditions which require ongoing assessments of relative, distributed benefits and burdens. Simply opposing women’s reproductive rights to demographic and environmental outcomes is too simplistic from this perspective, especially given that women and their children comprise a majority – and an especially vulnerable one – of the planet’s inhabitants, and that they are among the world’s people who both suffer from ‘the burden of human numbers’ (Haraway) and share responsibility for and interests in ameliorating this burden. This fuzzier presentation may be less theoretically neat or morally satisfying than more dualistic formulations. Yet it can still accommodate a degree of inviolability for basic rights, while situating others within a shared political and ecological terrain that is sensitive to changing biophysical conditions, a position congruent with what was earlier identified as Mill’s circumscribed consequentialism.
Amartya Sen’s work is representative of this system-sensitive position. Sen rejects both purely consequentialist approaches that neglect basic rights and their counterparts that ignore consequences in favour of inviolable reproductive rights. He does not believe that resisting coercion should rely on disparaging environmental concerns about population growth or disavowing them as a racist plot. While acknowledging the existence of ‘wildly exaggerated’ claims, he does not dismiss concerns as unfounded. If the situation is not bad enough to justify coercive panic, he concludes, it does warrant decisive action to reduce fertility rates, using non-coercive means.24 This balance seems to me politically sensible and morally defensible as an alternative to the more rigid liberty/rights versus coercion dichotomy that has framed population debates over recent decades.
In order to put this premise on a sounder theoretical footing and to address the IWM’s criticisms more head-on, I propose distinguishing between three categories of reproductive rights claims, each having a distinctive level of inviolability vis-à-vis demographic consequences. They are: basic human rights (a universal right not to suffer violence and coercion that in this case refers especially to violations of women’s bodies); socio-economic rights (in this case, a contingent right to reproductive health services that include but are broader than family planning); a moral right that is specific to the reproductive realm, as adopted by the UN in 1966. This grants all couples the right to decide when, whether, and how many children to procreate, and is arguably the most contingent and context-sensitive of the three categories.
Basic human rights to life, liberty and security are not gender specific. They include all people’s right not to be sexually violated or subjected to gross bodily harm, and they therefore cover the more egregious abuses of bodies associated with coercive population control (it is worth remembering that the main victims of coerced sterilization during India’s Emergency were men). The 1948 Universal Declaration of Human Rights protects the integrity of all bodies, including their sexual and reproductive functions. It prohibits violations of the flesh such as rape, domestic violence, forced or under-age marriage and female genital mutilation (FGM). This logically includes a right not to have contraceptive devices inserted, or foetuses removed, without consent. Recognition of the woman-specific aspects of these rights and their enforcement nevertheless remains lamentably deficient.
What a woman-centred approach to these basic rights brings home is that moral agents are embodied and that the way bodies are treated is mired in systematic gender inequalities. This includes reproductive functions that are sexually specific, but also the way different basic rights are prioritized. The IWM is therefore justified in insisting upon a more woman-oriented understanding of basic human rights and in drawing attention to their widespread abuse, including in some population programmes. This is reflected in a phrase popularized during the 1990s: ‘women’s rights as human rights.’ Although there is a danger of sexual essentialism if women are reduced to their sexual identity or reproductive function, the equation highlights gender bias within human rights discourse (as male-centric in its construction of the rights-bearing individual), as well as in its application (which tends to neglect rights violations that affect women specifically). In order to endow reproductive health services with some of the aura and universality of a basic right, some feminists additionally argue that their absence equates to discrimination against women since this precludes their exercising other basic rights. This becomes impossible to the extent that they are denied the means to control their own bodies and fertility.
In sum, these are rights of the first rank, rights that can never be legitimately violated on consequentialist grounds. Indeed, even from a utilitarian perspective, permitting their abuse would compromise individuals’ security sufficiently to outweigh any aggregated happiness arising from it. It is consistent with these basic human rights, which protect bodily as well as moral integrity, that they must recognize women’s right not to be forced to carry an unplanned or unwanted conception to term. To force a woman to lend her body to the gestation of another being against her will, by criminalizing abortion or endangering her health by obliging her to seek an unsafe illegal termination, is a violation of her basic rights. It effectively enslaves women to other people’s morality and biology (a fate eluded by men). Just as no woman should be compelled to abort against her will, so no woman should be compelled to gestate a foetus and give birth either. Yet, in 2013, fewer than one-third of governments allowed abortion on request.25 Northern Ireland is just one example where abortion is in virtually every case constitutionally illegal. Coerced childbearing remains far more prevalent than coerced birth control.
A second category of reproductive rights concerns the right to access comprehensive reproductive health services. Rights in this category seem to fit best within the category of aspirational socio-economic rights, given that universal public health care is not just lacking due to incapacity in poor countries but is ideologically resisted in some wealthy ones too. Although reproductive health rights are commonly associated with women’s rights, the capacious definition of reproductive and sexual health provided by the World Health Organization (WHO) is more inclusive. For example, it informs Principle 8 of the Cairo ICPD’s Programme of Action (1994), which urges all states to satisfy a universal right to ‘the highest standard of physical and mental health’ possible, through gender equality and ‘universal access to health care services’. Besides women, beneficiaries in specific areas include infants, children and, sometimes, men. It goes without saying that the health benefits incorporated (such as improving maternal health and infant survival rates) are important both intrinsically and as development goals. They have since been incorporated into the MDGs and SDGs, although the (environmental) public health benefits associated with population stabilization are not mentioned. But while mortality decline falls within the WHO’s remit and family planning remains a component, fertility decline is noticeably absent as a rationale for improving reproductive health services. This partly reflects the success of the IWM in changing the basic paradigm from population outcomes to women’s health entitlements.
The IWM is not monolithic but an umbrella of women’s organizations. Some simply campaign for better health services for women. Aspirational rights serve their purpose by imbuing their demands with moral force. But others pursue a wider political agenda of reconstructing the entire framework in which fertility is problematized, such that reproduction and service provision would be reconstituted from women’s perspective. They are among the most vociferous critics of population control. Yet, in the first case, it is not self-evident that the disavowal of demographic policy aims advances their campaign, and in the second a human rights approach seems at best limited in the pursuit of deeper transformational goals.
For the former groups, aspirational rights to access basic (reproductive) health services can arguably be strengthened by applying a version of the materialist argument mentioned earlier: that, in order to exercise basic rights (e.g. to life), individuals must have access to requisite levels of personal and environmental health. Thus, demographic concerns may not be irrelevant and their relationship to family planning services need not be simply instrumental. Provided that provisos about voluntary consent and basic rights are respected, I see no good reason why the family planning component should not be invoked strategically, to gain additional political and financial support from demographic narratives that recognize the social and environmental advantages (including for health outcomes) of a planet with smaller future generations in which every child is planned, wanted and nurtured within the constraints of planetary boundaries. From this perspective, it is unhelpful to cast population stabilization and its supporters as the enemy of women’s reproductive rights, or to explicitly rule out the sort of demographic justifications for family planning programmes that can successfully mobilize resources behind services that benefit women. There is a caveat that women’s health must always be paramount when providing contraception, with more research on birth control methods needed. But since fertility decline has no longer been ring-fenced because of its wider advantages, foreign aid and under-funded health budgets have been diverted elsewhere, as demographers predicted, thus further undermining efforts by less developed regions to complete transition or satisfy the ‘unmet need’ of more than 200 million women for family planning services.
In fact, the transnational position is less clear than the Cairo consensus suggests. True, the UN’s summary of the 1994 ICPD proceedings emphasizes the new focus on ‘meeting the needs of individuals within the framework of universally recognized human rights standards instead of merely meeting demographic goals’.26 It thereby iterates the international paradigm that has been dominant since. Yet the ‘merely’ is important. Rather than simply opposing individual rights to demographic goals, the conference’s Programme of Action had recognized their compatibility. Since
the ultimate goal is the improvement of the quality of life of present and future generations, the objective is to facilitate the demographic transition as soon as possible in countries where there is an imbalance between demographic rates and social, economic and environmental goals, while fully respecting human rights. This process will contribute to the stabilization of the world population, and, together with changes in unsustainable patterns of production and consumption, to sustainable development and economic growth. (Italics added)27
Despite the terminological change, the Programme acknowledges that neo-Malthusian measures are both efficacious for improving quality of life and compatible with voluntary consent, provided appropriately non-coercive means are deployed. This is accompanied by calls for young people to be given responsibility ‘to ensure that every child is a wanted child’, but also by a conclusion that ‘family planning and contraceptive supplies will need to expand very rapidly over the next several years’:28 the view the UN reiterates in 2017 and a plea that supports women’s aspirations for comprehensive reproductive health services.
For the latter, more radical groups, it is germane to ask how well the human rights approach actually serves their ambition of advancing gender equality through fundamental social change. Its formal, legalistic framework is surely limited. Critical ‘scrutiny of customary laws and practices of cultures which conflict with women’s rights as human rights’ is a crucial complement.29 Yet this scrutiny must also include an assessment of human rights discourse itself since critics are aware that its emphasis on personal autonomy and choice may reproduce customary and practical gender bias. Corrêa echoes earlier feminist misgivings in noting that human rights discourse draws on western concepts predicated on a (masculinist) premise of possessive individualism, in which rights to self-determination are socially disembedded.30 Yet social embeddedness again implies a broader realm of intersubjective life that is ineluctably located in, and enmeshed with, broader biophysical and socio-economic systems, as well as patriarchal structures. Human rights are therefore neither theoretically innocent in their gendered assumptions nor adequate on their own for achieving gender equality. This does not deny their usefulness, but it does underscore their limitations in transforming deeper inegalitarian cultures and sustaining environmental integrity, goals that might themselves benefit from fewer people and whose advancement requires continuous attention to collective outcomes. Recent developments highlight the importance of maintaining a critical attitude towards rights discourses and their ideological context. Since the highpoint of IWM attacks on population control during the mid-1990s, the global merging of political conceptions of individual rights with economic notions of subjective choice has continued apace. When the Global Network for Reproductive Rights concludes that the ‘neoliberal restructuring of Third World economies’ has had ‘a devastating impact on the public provision of health care, particularly for women and children’, it confirms feminist misgivings about relying on formal, individualist approaches.31
The foregoing discussion acknowledges the importance of the second category of reproductive rights as women’s health rights. Two possible implications have, however, emerged. On the one hand, such rights have been ranked below basic human rights inasmuch as they are aspirational, socio-economic rights dependent on broader political, ideological and fiscal conditions. They have moral force but they remain relative and contingent, rather than absolute and universal, because their satisfaction is context dependent. They endow the provision of women’s reproductive health services with moral force, justifiably emphasizing the intrinsic value of women’s well-being. I have argued, nonetheless, that it is unnecessary and unhelpful to present these rights as essentially antithetical and hostile to population stabilization policies, beyond insisting that basic human rights are respected. On the other hand, if reproductive health rights are recognized as a material condition for exercising other more basic rights (to life, liberty and security), this inflates their importance but draws attention to their embeddedness within a wider biosocial fabric. Since collective, structural outcomes matter here, it is unhelpful to pit individual rights against consequentialist reasoning. A reproductive rights approach has, finally, been deemed inadequate for pursuing the wider aim of achieving gender equality, which requires a more extensive engagement with the numerous and profound ways in which women’s basic rights are routinely violated.
Reproductive rights as procreative rights A third set of reproductive rights concerns the post-1966 recognition of a right to choose family size. It is clearly restated in the Cairo Programme of Action (Principle 8): ‘all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so.’ Based on the UN’s summary of this right’s provenance, it seems clear that its original motivation was to satisfy parental desire for the means and knowledge to plan (and space) their children, without which choice is illusory. The underlying rationale was clearly not to facilitate large families since these are implicitly understood as a default outcome where planning fails and choice is absent.32 Early versions present the right to use birth control as a condition of gender equality, not as a vehicle for attacking neo-Malthusian policies. Given that some 40 per cent of conceptions worldwide are estimated to be unplanned, and that there remains significant unsatisfied demand for high-quality family planning services, providing couples with the means to make genuine procreative choices would represent a massive contribution to satisfying all three categories of reproductive health rights.
The relative importance of rights and responsibilities remains vague here. Is there a right to choose irresponsibly, regardless of the consequences for others? The allusion to responsibilities suggests that this may not after all be an absolute, disembedded right that sanctifies what some would define as merely lifestyle preferences. This is Sarah Conly’s contention in her book One Child: Do We Have a Right to More? (2016), which has recently reopened debates about this category of reproductive rights. Conly argues that a right to procreate does not entail a right to do so without restraint.33 She invokes the kind of environmental concerns discussed in chapter 1 and draws from them a robust assertion that the best way to achieve sustainability is for governments to regulate procreation through a one-child policy. This, Conly reasons, would swiftly shrink population to a sustainable number, whereupon regulations could be modified.
What is interesting about Conly’s argument is the way it reinterprets the nature of a procreative right in order to justify limiting couples to a single biological child. Inasmuch as there is a self-regarding (basic) right to procreate at all (and she is not entirely convinced there is), she configures it as a right to personal fulfilment from raising one’s natural offspring. For this, a single child is deemed sufficient. Conly insists that there cannot be a right to more because nobody requires (has a ‘fundamental interest’ in) more than one child in order to live a minimally decent life. This analytical move allows her to avoid arguing for a temporary suspension or overriding of rights by asserting that no (moral) right to unlimited reproduction exists in the first place. After one child, governments may therefore legitimately specify the number of additional offspring permitted, depending on circumstances. Conly does recognize a more basic set of human rights (similar to those identified above) whose abuse is not permissible. But because family size is a lifestyle choice, it does not figure among them. Since she takes the unsustainability of current (population and consumption) growth rates to be incontestable, and sees little evidence of selfimposed limits, Conly maintains that it is confused and naive not to countenance regulatory action on the grounds that voluntary compliance can be relied upon or is inviolable.34
Conly’s argument bears hallmarks of Mill’s circumscribed consequentialism, but I think her one-child policy would falter when confronted with the kind of deliberation Mill requires before regulating other-regarding acts. In less developed rural economies without social security systems, larger families may be a rational economic, rather than merely a lifestyle, choice. The Chinese example, moreover, shows a single-child family norm is susceptible to adverse unintended but now welldocumented consequences (selfish singletons, heavy family burdens on the young, a skewed gender ratio, rapid population ageing). Replacement-level two-child policy anyway seems more intuitively appealing and therefore more likely to win voluntary compliance and democratic assent. If it were accepted as a maximum, the number likely to produce fewer would probably suppress the TFR below replacement level, resulting in the sort of gradual population decline commended earlier. Regardless of precise numbers, though, it is Conly’s support for a regulatory regime that is most significant. After a basic right to reproduce has been safeguarded, further procreation is classified as other-regarding and hence as amenable to legitimate interference, provided certain safeguards are accepted. Having dispensed with moral arguments against intervention, Conly focuses on the kind of basic rights-compatible measures that are available for anti-natalist purposes.
Elizabeth Cripps advances a somewhat similar argument but from a social justice perspective. She argues that failing to make hard moral choices to restrict population growth now may result in more tragic options later.35 Alongside the (normatively easy) supply of reproductive health services, her hard choices mean considering mildly coercive ‘incentive-changing’ measures. The tragic choices that may ensue from failing to manage population growth now may entail more coercive instruments later. Like Conly, Cripps distinguishes between a fundamental interest in experiencing parenthood and a lifestyle preference for unlimited progeny. ‘We need not assume an all-trumping, interestbased right in choosing family size which renders impermissible any collective action to influence procreative behaviour. However, a constraint has been introduced. Incentive-changing population policies can stay on the table, but only once the opportunity to parent at all has been secured.’36 Once a basic right to parent a child has been recognized, Cripps allows a ratcheting up of incentives following first births. Her social justice concerns about the differential effects of such measures nevertheless add an important layer to considerations of just what kind of anti-natalist means are acceptable (see chapter 3).
This chapter has distinguished between three categories of reproductive rights: inviolable basic rights that offer universal safeguards against the violation of women’s bodies; reproductive health rights that are unequivocally beneficial but aspirational and contingent on wider economic and ideological conditions; and procreative rights that are recognized by the UN but which environmental critics would limit to a single self-regarding act of parenting, with further procreation becoming an other-regarding act that may be regulated according to its ecological impact. This tripartite division is designed to put theoretical flesh on a mediated position (circumscribed consequentialism) that safeguards basic rights (and self-regarding acts), while recognizing other rights as dependent on circumstances (as embedded) and therefore as legitimately amenable to political interventions designed to secure the commons. It is nonetheless important to remember that these are moral rights that are regularly abused in practice. The argument rules out a strict moral or political opposition between rights or liberties, and outcomes or consequences, as well as a rigid libertarian dichotomy between individual and society/state. It provides legal safeguards against some measures associated with population control but not others. Having ruled out intransigent in-principle arguments against anti-natalist population policies, the remaining question is whether efficacious but permissible means are available for reducing fertility rates. This is the subject of the next chapter.