A couple of years ago, I was in Abuja, Nigeria, working to integrate family planning within a health systems strengthening project. It was a Sunday; the day Goodluck Jonathan was being sworn in as president and the entire city was shut down because of the inauguration.
My colleague, a physician ob/gyn wanted me to see firsthand, the different service points in the health system. We drove about an hour or so out of Abuja and arrived at the maternity ward of a referral hospital. The delivery room was bustling, but supplies were minimal and facilities were bare boned.
The two midwives on duty had their hands full. They had already delivered four to five babies and were struggling to help a young woman through a difficult delivery. The woman showed up at the hospital that morning and as far as the midwives knew, she had not received any prenatal care. My colleague quickly jumped in to assist.
I remember sitting on a wooden bench with one of the midwives. We were separated from the delivery room by only a flimsy, green colored curtain. On the floor in front of us sat a young girl with orange ribbons in her hair, drawing continuous circles on the ward’s floor.
About 20 minutes passed and my colleague emerged asking for a sterile plastic clip to tie off the umbilical cord. He chastised the midwives for not using them and relying on string instead. They shrugged and told him the clips didn’t work; a conclusion he reached after trying five times. The midwife smiled and leaned against me to whisper – “That’s why we use the string- at least we can be sure the umbilical cord is tied off, even if it is not sterile.”
A few moments later, he appeared again, this time he was holding up a healthy, bawling, baby boy.
This experience crystallized in one powerful moment the challenges of getting health services to work for the people who depend on them. Mostly, I was struck by the sense of serendipity. If it hadn’t been for the presidential inauguration and for a random visit by a caring physician, this woman and her child may have died, or at minimum, had a long and painful labor.
Instead, we were able to celebrate the birth of her son, and her safe recovery from labor.
I sat back down and looked at the little girl on the floor and wondered…what choices would make the difference for this child? What health care and services could she count on in her lifetime? What opportunities would change her future prospects? And I was convinced once again of the simple truth that access to contraception is pivotal in determining the equation of future opportunities – hers, mine, all of ours. If this young girl had the information and means to make choices about her sexual health and childbearing, she would have a better chance to determine her own future.
Contraception matters. It not only changes lives, it saves lives. If an additional 120 million women who want contraception could get it by 2020, we could have 100 million fewer unintended pregnancies, 3 million fewer children dying in their first year of life, and 200,000 fewer women and girls dying in pregnancy and childbirth.
And now, we have an opportunity before us to truly level the playing field for all women and girls. A global community is recommitted and reenergized and we as individuals have the power to ensure that women’s autonomy over health-related decisions is a fundamental right, not a privilege.
The effort to make contraception available is part of our commitment to reduce poverty, enhance human rights, feed the hungry, give water to the thirsty and share the wealth we have with those who need it. Each of these pieces needs the other, and is integrally connected to each other in order to thrive. And without family planning – without support for women and girls’ lives and dignity – our vision for real, lasting change in this world is simply not whole.
If we act now and keep our promises, we can circle back to the little girl with the orange ribbons and assure her that she will not have to rely on the vagaries of chance appearances, if and when she is ready to give birth.
We can’t leave women’s lives up to chance. When we get the choices right for women, we get it right for development. And in the next seven years, with the lives, dreams and opportunities of millions of the world’s women at stake… we simply have no choice but to get it right.
Learn more about Family Planning 2020.