Top Asian demographers, population experts, and UN staff gathered in Bangkok this week to address the region’s aging crisis. Despite the severity of the low fertility predicament, abortion, contraception, and “reproductive and sexual health” were the subject of one out of every four papers presented.
Due to sustained, extremely low fertility, Asia is home to the world’s oldest country, its fastest rates of aging, and its highest ratios of sex imbalance owing to the selective abortion of baby girls, leading to some 100 million “missing” women in Asia. Panel sessions included such questions as “how low can Asian fertility go,” how to improve data quality and accessibility, the effects of migration and urbanization, and labor force and employment.
Nonetheless, “reproductive and sexual health” accounted for 22 papers, nearly a quarter, pondering topics such as “determinants of contraceptive choice,” “risky behaviors in reproductive health,” “sexual health perspectives,” and “women’s reproductive rights and empowerment.” Half as many papers addressed poverty, and four considered infant and child health.
A paper by a RAND scholar and her collaborators revealed that where the government promoted contraception, abortion increased significantly. In Matlab, Bangladesh, the target of a celebrated experiment to see if traditional mores could be overturned to induce widespread use of contraception, the paper found that abortion increased from 38.0% to 78.6% in one of the areas studied and from 31.6% to 81.4% in the other between 1989 and 2008.
Shveta Kalyanwala and Rajib Acharya from the Population Council argued for expanded use of chemical abortion by personnel other than doctors by overcoming the resistance of physicians: “Mifepristone-misoprostol abortion, a safe, effective and acceptable non-invasive alternative for early pregnancy termination, holds great promise to increase access to safe abortion in countries such as India, where abortion has been legal for 40 years, but where the majority of the induced abortions are conducted in uncertified settings, and/or by uncertified providers…Efforts are needed that focus on changing the attitudes of certified physicians,” they concluded.
Deepti Singh, Srinivas Goli, and Sulabha Parasuraman from the International Institute for Population Sciences in Mumbai said their findings “more than support the hypothesis that repeated induced abortion is more among the women with higher son preference and greater socioeconomic status,” and that “repeated induced abortions [are] significantly higher among the women in younger age, higher socioeconomic status and with greater son preference.” The risk of repeat abortion was more than three times higher among highly educated women than among women with no education.
Sushanta Banerjee from the abortion group Ipas conducted a campaign to educate women on abortion by “improving knowledge and perceptions about abortion among women in rural Bihar and Jharkhand” through wall signs and street drama. Ipas was able to make women more aware that abortion was legal, but had more difficulty creating positive attitudes toward the practice. Banerjee concluded, “This may indicate that a longer period of intervention is required to change norms at the community level.”
UN Population Fund executive director Dr. Babatunde Osotimehin told the conference, “The poor, the rural, ethnic minorities and the young are especially disadvantaged in accessing reproductive health services” and he noted “the considerable unmet need for contraception,” a notion recently debunked by development experts as ill-defined and a poor indicator of development investment.
The conference was the second annual meeting of the Asian Population Association.