How It Started, and How It's Going: Global Family Planning Programs.

Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.

Sabina Faiz Rashid: research on community resilience.

Sabina Faiz Rashid talks to Andréia Azevedo Soares about anthropology, poverty, inequality and sex education in Bangladesh.

'Innate Nature' and 'Complete Nature': The Catholic Natural Family Planning Program and the Competition of Natural Methods in Mid-1970s Korea.

This article reviews the competition of two natural family planning methods in the mid-1970s when the Catholic Natural Family Planning program was underway in Korea. The Catholic Church, emphasizing the natural law, has recommended Natural Family Planning (NFP), a method of regulating childbirth by abstinence during the fertile period, since the mid-twentieth century. However, a group of gynecologists working at St. Mary's Hospital, a Catholic general hospital in Korea, questioned the utility of NFP. As an alternative, they proposed the method of Ovulation Regulation (OR), which regulates the menstrual cycle by inducing ovulation with steroids agents. This seemed to be no different than contraception with oral contraceptives disapproved of by the Catholic Church, but many doctors who advocated OR thought that this could be a new 'natural' family planning method to replace NFP. What is noteworthy here is the fact that not only NFP advocates, but also OR advocates attempted to justify their methods based on the authority of the 'nature.' In the debate over natural family planning methods, nature's legitimacy was given premise, not the object of doubt. Rather, the issue was the definition of nature. First, 'nature' in NFP signifies 'innate nature,' which excludes human intervention. According to this point of view, OR with steroids agents could not be natural. On the contrary, a group of doctors who advocated OR considered nature 'primal completeness.' If the natural order of the menstrual cycle could be restored, the artificial intervention of the administration of steroids was not a problem. Thus, both groups defended their arguments by redefining nature, rather than raising an issue of nature itself. The competition between 'innate nature' and 'complete nature,' a proxy war between NFP and OR, resulted in the victory of the former as the meaning of nature became fixed. Advocates of NFP pointed out that OR inhibits other physiological functions in the process of inducing ovulation, suggesting that the idea of 'complete nature' could never be achieved. The meaning of nature could no longer be controversial. Since the intervention was unnatural, nature meant innateness, the absence of intervention. Accordingly, the Catholic Bishops of Korea approved the Billings Method, a kind of the NFP, as the official family planning method, and gynecologists at St. Mary's Hospital of Korea also focused on the development and supplementation of the Billings Method. In short, the debate over the methods of natural family planning in mid1970s Korea was a clash of 'innate nature' and 'complete nature.' As a result, this confirmed the limitations of medical practice and reconfirmed the power of magisterium, the church's authority over medical practice.

The Contraceptive Pill in Ireland c.1964-79: Activism, Women and Patient-Doctor Relationships.

The twentieth-century history of men and women's attempts to gain access to reproductive health services in the Republic of Ireland has been significantly shaped by Ireland's social and religious context. Although contraception was illegal in Ireland from 1935 to 1979, declining family sizes in this period suggest that many Irish men and women were practising fertility control measures. From the mid-1960s, the contraceptive pill was marketed in Ireland as a 'cycle regulator'. In order to obtain a prescription for the pill, Irish women would therefore complain to their doctors that they had heavy periods or irregular cycles. However, doing so could mean going against one's faith, and also depended on finding a sympathetic doctor. The contraceptive pill was heavily prescribed in Ireland during the 1960s and 1970s as it was the only contraceptive available legally, albeit prescribed through 'coded language'. The pill was critiqued by men and women on both sides of the debate over the legalisation of contraception. Anti-contraception activists argued that the contraceptive pill was an abortifacient, while both anti-contraception activists and feminist campaigners alike drew attention to its perceived health risks. As well as outlining these discussions, the paper also illustrates the importance of medical authority in the era prior to legalisation, and the significance of doctors' voices in relation to debates around the contraceptive pill. However, in spite of medical authority, it is clear that Irish women exercised significant agency in gaining access to the pill.

'There Are No Other Options?': Rwandan Gender Norms and Family Planning in Historical Perspective.

This article surveys the evolution of Rwandan family planning practices from the nation's mythico-historical origins to the present. Rwanda is typically regarded as a patriarchal society in which Rwandan women have, throughout history, endured limited rights and opportunities. However, oral traditions narrated by twentieth-century Rwandan historians, storytellers and related experts, and interpreted by the scholars and missionaries who lived in Rwanda during the nation's colonial period, suggest that gender norms in Rwanda were more complicated. Shifting practices related to family planning - particularly access to contraception, abortion, vasectomies and related strategies - are but one arena in which this becomes evident, suggesting that women's roles within their families and communities could be more diverse than the historiography's narrow focus on women as wives and mothers currently allows. Drawing upon a range of colonial-era oral traditions and interviews conducted with Rwandans since 2007, I argue that Rwandan women - while under significant social pressure to become wives and mothers throughout the nation's past - did find ways to exert agency within and beyond these roles. I further maintain that understanding historical approaches to family planning in Rwanda is essential for informing present-day policy debates in Rwanda aimed at promoting gender equality, and in particular for ensuring women's rights and access to adequate healthcare are being upheld.

Family Planning Advice in State-Socialist Poland, 1950s-80s: Local and Transnational Exchanges.

This paper scrutinises the relations between different models of family planning advice and their evolution in Poland between the mid-1950s and the late 1980s, focusing on their similarities and dissimilarities, conflicts and concordances. From 1956 onwards, the delivery of family planning advice became a priority for both the Polish Catholic Church and the party-state, especially its health authorities, which supported the foundation of the Society of Conscious Motherhood and aspired to mainstream birth control advice through the network of public well-woman clinics. As a consequence, two systems of family planning counselling emerged: the professional, secular family planning movement and Catholic pre-marital and marital counselling. We argue that reciprocal influence and emulation existed between state-sponsored and Catholic family planning in state-socialist Poland, and that both models used transnational organisations and debates relating to contraception for their construction and legitimisation. By evaluating the extent to which the strategies and practices for the delivery of birth control advice utilised by transnational birth control movements were employed in a 'second world' context such as Poland, we reveal unexpected supranational links that complicate and problematise historiographical and popular understandings of the Iron Curtain and Cold War Europe.

The 'Converted Unbelievers': Catholics in Family Planning in French-Speaking Belgium (1947-73).

This paper looks at the journey of eleven counsellors in marital counselling centres in French-speaking Belgium, from the creation of the centres in 1953, to the 1970s, when contraception became legal, and abortion became a public issue. At the time of Humanae Vitae, groups of volunteers, working within Catholic organisations where counselling took place, began to structure their activity around Carl Rogers's ethics of client-centred therapy, placing their religious ideology in a secondary position to focus on the problems experienced by the couples and women they were receiving in the centres. These were often challenges they were experiencing themselves in their own lives. The reiteration of the Catholic orthodox view on contraception through Humanae Vitae marked a gap between the counsellors and the Church. This contribution questions the identity-related tension of Catholics working in conjugal counselling centres and the type of commitments they made to both the conjugal centres and the Church in a moment where family planning was debated both in the Church and politically.

The history of tiered-effectiveness contraceptive counseling and the importance of patient-centered family planning care.

Public health workers, clinicians, and researchers have tried to increase long-acting reversible contraceptive (LARC) use by changing contraceptive counseling between patients and providers. Several major health organizations now recommend tiered-effectiveness counseling, in which the most effective methods are explained first so that patients can use information about the relative efficacy of contraceptive methods to make an informed choice. Some scholars and practitioners have raised concerns that, given histories of inequitable treatment and coercion in reproductive health care, tiered-effectiveness counseling may undermine patient autonomy and choice. This Clinical Opinion examines the development of tiered-effectiveness contraceptive counseling, how its rise mirrored the focus on promoting LARC to decrease the unintended pregnancy rate, and key considerations and the potential conflicts of a LARC-first model with patient-centered care. Finally, we discuss how reproductive justice and shared decision making can guide efforts to provide patient-centered contraceptive care.

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.

We Must Not Allow a Contraception Gap: Planned Parenthood's Campaign for New Birth Control and Feminist Health Activism in the 1990s.

In 1990, Planned Parenthood Federation of America launched a nationwide public relations drive called the Campaign for New Birth Control in reaction to reports that Americans were being deprived of contraceptives available in other parts of the world. This article will use Planned Parenthood's Campaign for New Birth Control as a case study of how reproductive rights activists organized around emerging contraceptive technologies in the late twentieth century. It will discuss how Planned Parenthood tried to rally a diverse range of constituencies around the notion of a "contraception gap." This construct was based on the presumption that developing new contraceptive technologies was unmistakably feminist because it gave women more options to control their fertility. However, other actors involved in the New Birth Control campaign believed the "contraception gap" was an inappropriate strategy for mobilizing broad support for birth control innovation.

Improved contraceptive use among women and men in Uganda between 1995-2016: A repeated cross-sectional population study.

BACKGROUND: Research on contraceptive behaviour changes over time in Uganda is scarce, yet it has among the highest fertility and maternal mortality rates of any country in the East African region. Understanding temporal patterns of contraceptive use for both women and men is vital in evaluating the effectiveness of family planning interventions and strategies, and identifying those with the most unmet need. Using repeated nationally representative cross-sectional samples, this study charts the changes in Uganda's population-based contraceptive use over recent years. METHODS: Five Demographic and Health Survey datasets for Uganda over 21 years, from 1995 to 2016, were sourced and interrogated. Eligible participants included all women aged 15-49 years and men aged 15-54 years. Responses to questions on modern and any (modern or traditional) contraceptive use were analysed. Stratified by gender, weighted regression analyses were employed to detect change over time. The patterns associated with key demographic variables were also investigated. RESULTS: Overall, 50,027 women and 14,092 men were included within the study. In 2016, 30.3% of women and 39.9% of men were using any contraceptive method, a significant non-linear increase from 13.4% of women and 20.3% of men in 1995. Furthermore, 27.3% of women and 35.9% of men were using modern contraceptive methods in 2016, an increase from 7.4% of women and 10.4% of men in 1995. All considered demographic variables were significantly associated with contraceptive use for both women and men (all P<0.001); and for women, all variables differentially changed over time (all P<0.001). CONCLUSION: This study showed a significant increase and dynamism across key demographic variables in contraceptive uptake by both women and men. Sustained family planning programs and interventions have successfully resulted in behaviour change across the Ugandan population. However, continued efforts are needed to further reduce Uganda's relatively high fertility and associated maternal mortality rates.

Reproductive Politics in Twentieth-Century France and Britain.

This special issue adopts a comparative approach to the politics of reproduction in twentieth-century France and Britain. The articles investigate the flow of information, practices and tools across national boundaries and between groups of experts, activists and laypeople. Empirically grounded in medical, news media and feminist sources, as well as ethnographic fieldwork, they reveal the practical similarities that existed between countries with officially different political regimes as well as local differences within the two countries. Taken as a whole, the special issue shows that the border between France and Britain was more porous than is typically apparent from nationally-focused studies: ideas, people and devices travelled in both directions; communication strategies were always able to evade the rule of law; contraceptive practices were surprisingly similar in both countries; and religion loomed large in debates on both sides of the channel.

English Women Doctors, Contraception and Family Planning in Transnational Perspective (1930s-70s).

This paper explores the influence of English female doctors on the creation of the International Planned Parenthood Federation (IPPF) and the production and circulation of contraceptive knowledge in England and, to a lesser extent in France, between 1930 and 1970. By drawing on the writings of female doctors and proceedings of international conferences as well as the archives of the British Medical Women's Federation (MWF) and Family Planning Association (FPA), on the one hand, and Mouvement Français pour le Planning Familial (MFPF), on the other, this paper explores the agency of English female doctors at the national and transnational level. I recover their pioneering work and argue that they were pivotal in legitimising family planning within medical circles. I then turn to their influence on French doctors after World War II. Not only were English medical women active and experienced agents in the family planning movement in England; they also represented a conduit of information and training crucial for French doctors. Transfer of knowledge across the channel was thus a decisive tool for implementing family planning services in France.

Sex in the laboratory: the Family Planning Association and contraceptive science in Britain, 1929-1959.

Scientific and medical contraceptive standards are commonly believed to have begun with the advent of the oral contraceptive pill in the late 1950s. This article explains that in Britain contraceptive standards were imagined and implemented at least two decades earlier by the Family Planning Association, which sought to legitimize contraceptive methods, practice and provision through the foundation of the field of contraceptive science. This article charts the origins of the field, investigating the three methods the association devised and employed to achieve its goal of effecting contraceptive regulation. This was through the development of standardized methods to assess spermicidal efficacy; the establishment of quality, strength and manufacturing standards for rubber prophylactics; and the institution of animal trials to ensure the safety of specific contraceptives. The association publicized the results of its scientific testing on proprietary contraceptives in its annual Approved List of contraceptives. This provided doctors and chemists with a definitive register of safe and effective methods to prescribe.

The Origins of Family Planning in Tunisia: Reform, Public Health, and International Aid.

This article explores the origins of the national family planning program in Tunisia during the 1960s. It moves beyond previous interpretations of the global population control movement that emphasized external intervention at the hands of international organizations. Instead it analyzes the mutually beneficial partnership between Tunisian president Habib Bourguiba and the Population Council, an American organization committed to reducing population growth. Using Tunisian sources and Population Council records, it argues that after independence in 1956, Bourguiba sought to address France's underdevelopment of public health during the colonial period with robust reforms and international aid. Implementing a family planning program enabled Bourguiba to acquire resources that contributed to training Tunisian medical personnel, funding clinics and health services, and increasing the distribution and circulation of contraception. This article demonstrates that actors in the Global South were not mere beneficiaries of international health initiatives following decolonization; they were active participants and negotiators of their implementation at home.