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Population growth and family planning in Latin AmericaOfelia MendozaPublished online: 11 Jan 2010.

To cite this article: Ofelia Mendoza (1965) Population growth and family planning in Latin America , The Journal of SexResearch, 1:2, 161-170, DOI: 10.1080/00224496509550479

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The Journal of Sex Research Vol. 1, No. 2, pp. 161-170 July, 1965

Population Growth and Family Planning inLatin America1

OFELIA MENDOZA

The hunger and misery of two thirds of the world population arethe hunger and misery of the whole world. The freedom from hun-ger and from misery, enjoyed by a mere third of the world's popula-tion can not be considered true and secure until the whole worldenjoys the same freedoms.

Lester R. Brown an economist of the Economic Research Serviceof the U.S. Department of Agriculture, in his analysis of food pro-duction and population growth entitled: "Man, Land, and Food—Looking Ahead of World Needs", predicts that unless a way is foundsoon to control "the problem of world wide population explosion,starvation will take over as a partial solution of the hunger problem"(Brown, 1963).

It is estimated by the United Nations 1964 report that if the pres-ent world's population of 3.283 millions continues its present rateof growth of 2.1 % it will double in less than 35 years and by the endof this century it will be over 700,000 millions (U.N. DemographicYearbook, 1964).

More than two hundred millions of the world's population live inLatin America. This region has the highest rate of growth in theworld and in the history of mankind. Its population equals at thepresent time that of Canada and the United States combined. It willdouble in 27 years whereas the population of Western Europe willtake 115 years to double, that of Central Africa 50 years and that ofthe United States 41 years.

At the beginning of this century the total Latin America popula-tion was 63 millions, representing one fourth of the world's popula-tion. Today it is over two hundred millions, representing 7% of thetotal world population. Its population growth of 2.5% is the highestof all the regions (Brown 1963).

All the studies made by the United Nations specialized agencies1 Paper presented at the Seventh Annual Conference of the Society for the Scientific

Study of Sex, New York City, November, 1964.

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reveal that there is an acute shortage of food, housing, schools,teachers, medical, health and sanitary services and employment forthe present population in all these countries. All of them, also, lackthe necessary capital and technically qualified people for the develop-ment of their natural resources.

These studies indicate, also, that the influx of new generations isalready curtailing the development processes in the economic, social,cultural and political fields.

Great and dramatic changes of different degrees and rhythm havebeen taking place in each of the Latin American countries in thefields of population, education, health, .economics, religion, and inthe role of women in society, in the last 30 years.

These changes urgently demand the adoption of far-sighted andenergetic measures, including family planning, to prevent the other-wise inevitable social, economic and political tensions and chaos thatare growing in all these countries.

DEMOGRAPHIC DIFFERENCES AND SIMILAR TRENDS

The Latin American countries are a continental .unit on the basisof their diversities and similarities. This is why it is misleading tomake generalizations about them without making exceptions abouteach one of them and even within the regions of the same country.

The following indices of yearly population growth give an ideaof such differences (United Nations, 1964):

Argentina and Cuba 1.9%Bolivia 2.3%Brazil, Nicaragua 3.4%Chile, Peru 2.5%Colombia, Gautemala, Venezuela 3.0%Costa Rica 4.9%Dominican Republic, El Salvador 3.5%Ecuador 2.9%Haiti 1.2%Honduras 3.3%Mexico _. . . 3.5%Uruguay 1.3%Paraguay 2.4%

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POPULATION GROWTH AND FAMILY PLANNING 163

Among the similarities in the demographic trends are:1. The mortality decrease and the expansion of life expectancy

in the last 20 years, caused by the scientific discoveries and advancesin medicine and public health preventive measures.

2. The internal migratory movements from rural to urban areas,especially to the capitals and industrialized cities.

3. The age composition of their population, ranging from 40% toover 50% the number of children under 15 years of age and othereconomically unproductive groups (Inquiry, 1964).

WHAT ARE THE PROSPECTS FOR POPULATION CONTROLIN LATIN AMERICA?

Population control policies to be effective must be set and imple-mented by governments, yet only the Ministries of Public Health ofPeru and Venezuela have stated their interest to sponsor researchinto the relationship that exists between population growth and thehealth, economic, social and cultural development in their countries.

The purpose of these research projects is to utilize their findings inhelping the governments to formulate population policies in ac-cordance with their countries' needs.

The general arguments in regard to overpopulation are the follow-ing:

1. That the Latin American countries still have extensive unpopu-lated land teeming with untapped natural resources, capable of ac-commodating many times their present population.

2. That population growth is an asset to the economic develop-ment and prestige of their countries.

3. That industrialization, resettlement of population from over-crowded to unpopulated areas within each country, modernization ofproduction will raise economic and educational standards. This inturn will reduce birth rates as it has happened in the industrializedcountries.

However, preoccupation over population growth is increasing indirect proportion to the dissemination of information on the impactof population growth on the economic, social and cultural develop-ment of the nations.

The Latin American Demographic Center (CELADE) has beensponsoring research projects, to provide comparable cross-national

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survey data on differential fertility and attitudes to fertility in sevencapital cities of Latin American countries: Argentina, Brazil, Co-lombia, Costa Rica, Panama, Mexico, Venezuela. Similar surveyshave already been completed in Peru and in Chile by CELADE.

It is encouraging that the 19th General Assembly of the UnitedNations will consider and debate a report prepared by the SecretaryGeneral which summarizes a survey conducted by the Economic andSocial Council among the Governments of member nations "concern-ing the particular problems confronting them as a result of the re-ciprocal action of economic development and population changes"

PROVOKED ABORTION: A CRITICAL PUBLIC HEALTH PROBLEM

IN LATIN AMERICA

The ensuing economic, social and cultural demands that affectmore cruelly the families who are victims of the vicious circle of ig-norance and poverty compel the women to risk their lives throughprovoked abortion.

Although abortion is illegal and morally condemned in all theLatin American countries, its incidence is growing alarmingly andis becoming an urgent and critical problem of public health in allof them.

Sporadic studies in the following countries: Argentina, Brazil,Costa Rica, Chile, El Salvador, Guatemala, Honduras, Nicaragua,Mexico, Panama, Peru, Uruguay and Venezuela, have confirmed theseriousness of the problem. All these studies were made in hospitalswith the exception of Chile, where they included the whole city ofSantiago, and are now extending to other areas of the country.

The following statistical data show that the trend in abortion isgeneral throughout the whole of Latin America (Monreal 1961,Planificacion, 1963).

Uruguay: Increase of the abortion rate:

1908 1925 1936 196320% 40% 50% 300%

This table shows the increase in the incidence of abortions from 20%in 1908 to 300% in 1963. The 300% increase is due to the fact tHatsome women have had 20 or more abortions.

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POPULATION GROWTH AND FAMILY PLANNING 165

El Salvador: Dr. Bustamante (1961) reported in the MaternidadSan Salvador, 2,133 cases of provoked abortion and 10,255 births.He estimated that the number of abortions not reported is equal tothe number of births. A recent study conducted last year in the sameMaternidad of 40 cases of declared abortion, revealed that of 169pregnancies, 40 of them had ended in abortion (Burleson 1963).

Mexico: In a Mexican study of 1000 women by Dr. Arturo Aldama(1962), it was found that of 137 women, more than 30% have hadabortions.

Panama: In a brief survey of the 1,648 maternity cases attendedyearly at the Santo Tomas Hospital it was found that 10% of themcame to the hospital because of after-abortion effects (Lavergne 1963).

Costa Rica: A study carried out in this country discloses the follow-ing data: the yearly percentage of abortions for the whole countryis 13.7%; but it reaches higher figures in some of the urban centers:15% in San Jose, 16.7% in Puerto Limon, and 18.5% in PuntaArenas (Urucuyo 1961).

The results of the above mentioned studies, the alarming numberof women that reach the hospital in emergencies and in critical con-dition, and the thousands of letters received in the office of the West-ern Hemisphere Region requesting contraceptive information, areproof that the women of Latin America desperately want to controltheir fertility, regardless of the legal and religious penalties.

Ninety-nine percent of the letters requesting contraceptive infor-mation come from husbands, which indicates that the men share theanxiety for fertility control.

The determination of these couples to reduce the number of theirchildren, even at the risk of the women's lives, is what has urged thedoctors and other leaders of the family planning movement in LatinAmerica to establish contraceptive services as a preventive healthmeasure and to fight for the inclusion of such services in the publichealth and social welfare programs in their countries.

From August 1961 to this date, thirteen countries have been en-gaged in some sort of demographic, social-medical or social researchand some family planning activities. They are Argentina, Chile, Co-lombia, Costa Rica, El Salvador, Guatemala, Haiti, Honduras,Mexico, Peru, Panama, Venezuela and Uruguay. Puerto Rico starteda national program in 1937.

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DIFFERENCES IN THE APPROACH TO THE POPULATION AND

FAMILY PLANNING PROGRAM

The approach to the problem differs in the various .Latin Ameri-can Countries.

Argentina: An organization o£ physicians has started to plan theestablishment of family planning centers. A few isolated groups orindividuals have done medical and social research in some of theslums.

Brazil: There are three family planning associations: "AssociacaoBrasileira de Planejamento Familiar"; this is a small group that oc-casionally sponsors lectures and newspaper articles on Family Plan-ning. The "Servico de Orientacao da Familia" in Sao Paulo haslegal status, community support and its own headquarters. It pro-vides marital education and has begun to give contraceptive servicesin slum areas and private Maternity hospitals. So far it has been unableto get medical support. The "Associacao Brasileira de Planejamentoda Familia" in Porto Alegre is sponsored by physicians and busi-nessmen. It is ready to start contraceptive services.

Chile: The Ghilean Family Planning program is the first and theonly nation-wide program in Latin America with the exception ofPuerto Rico. It is sponsored and administered by a National Com-mittee, "Comite Chileno de Proteccion de la Familia".

This Committee is composed of the Chairman of the Departmentof Gynecology and Obstetrics, Preventive Medicine, Public Health,Maternal and Child Care of the University of Chile. It also includesthe Chiefs of the Departments of Obstetrics and Gynecology of thepublic hospitals. All these doctors are government employees be-cause medicine has been socialized in Chile for more than 16 years.The President of the National Association of Gynecology and Ob-stetrics, who is chief of the Department of Obstetrics and Gynecologyat the Catholic Medical School, is also a member of the Committee.

The prestige of the members of the Committee and their excellentaproach to the family planning program has won general public ap-proval.

Contraceptive services are provided in nine government hospitals:six in Santiago and one each in Concepcion, Antofagasta and Temuco.

The Catholic Medical School is conducting a research project onthe Rhythm Method; and the School of Preventive Medicine of the

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POPULATION GROWTH AND FAMILY PLANNING 167

University of Chile, in cooperation with the Department of Demog-raphy and Human Ecology of Harvard University, School of PublicHealth is carrying out a study on contraception and abortion in oneof the poorest areas of Santiago.

Colombia: Colombia has one Interdisciplinary Committee for theScientific Study of Population (CIECP) that formulates and coordi-nates population studies in the whole country. This Committee is aDivision of the Medical Schools Association and its membership com-prises professionals from different fields belonging to the main Uni-versities of Colombia. In turn these Universities have organized theirown Section 1 Committees that carry out demographic studies andpractical programs of research and services in family planning. Forinstance, the University Committee for Research on Population(CUIP) of the Del Valle University, is doing research on the inci-dence of abortion in several regions of the State, and is operatingfamily programs in the Township of Candelaria and the Barrio ElGuabal, in Cali. The method used in these programs has been theRhythm Method, complemented by the use of anovulatory pills.The Sectional Committees have their representative at the CIECP,which is the central coordinating organization.

In addition to these Institutional Committees, there exist severalAssociations for the Scientific Study of Population. Their purposeis to promote discussion of the population problems among the Gov-ernment, the Church, the community leaders, industry, etc.

The structure of the population studies in Colombia makes pos-sible national integration and coordination, optimum use of avail-able funds, avoidance of useless duplications and the application ofthe same methods for the different areas of the country.

The CUIP of the Del Valle University, under the joint spon-sorship of the American Assembly of Columbia University and thePopulation Council, is organizing a Panamerican Assembly for theStudy of Population Problems in Latin America. About 80 delegatesfrom all the countries in the American Continent, representingseveral professional fields, are expected to attend. This Assembly willtake place in the city of Cali, Colombia, from the 11th to the 13th ofAugust, 1965.

Guatemala: The "Sociedad de Bienestar de la Familia de Guate-mala" has been conducting medical and social research projects onfertility control and providing contraceptive services in private doc-

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tor's offices. Recently, it has been granted permission from the Min-istry of Public Health to open a birth control service at the LatinAmerican Hospital in Guatemala City.

El Salvador: The "Asociacion Demografica Salvadorefia" has strongprofessional support from the schools of Medicine, Public Health andPreventive Medicine; but the Ministry of Public Health refuses toprovide birth control services in any of the government hospitals.Contraceptive services are provided by the Association in privatedoctors' clinics. At the same time it has been conducting demographicand abortion studies.

Honduras: The "Asociacion Hondurena de Planincacion de laFamilia" enjoys full medical support. It was founded in 1961 andbegan its contraceptive service in July 1963, at its outpatients clinicof the Gynecologists and Obstetrics Department of the General Hos-pital "San Felipe", the largest hospital in the country. The birthcontrol clinic's staff is trying to extend contraceptive service to pub-lic health and welfare centers. It is also conducting medical and so-cial research to find out what are the most accepted methods amongthe different economic groups.

Mexico: There are three separate organizations in Mexico. The"Sociedad Mexicana de Proteccion a la Familia" and the Sociedad inMexico City, and the "Sociedad Chihuahuense Pro Bienestar de laFamilia" in Chihuahua. The first association in Mexico City wasestablished in 1958 and started its birth control clinic in 1959. Itsmain interest has been Medical research, especially on oral contra-ceptives. Last year this association was dissolved and the two abovementioned, were established. Both of them are opening more clinicsin the city. The Association in Chihuahua has been operating a birthcontrol clinic at the Palmore Sanatorium since 1961.

Peru: There is no private association in Peru, but the Health Min-ister is planning to sponsor medico-social demographic studies, andits relations to the social, cultural and economic development of thecountry. Also, with the cooperation of a group of intellectuals, he ispreparing a Seminar on Population Problems in Peru.

Panama: There is no private organization in Panama, but Dr. JulioA. Lavergne has been doing research on provoked abortion at theSanto Tomas Hospital, and he was able to arouse the interest of 'sev-eral physicians.

Also, the Statistical Department of Panama, in cooperation with

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CELADE (Centro Latino-Americano de Demografia), has been car-rying out demographic studies in Panama City and research onFecundity and Attitudes Related to Family Structure.

Uruguay: The "Asociacion Uruguaya de Planificacion Familiar"was established in 1962. It operates a birth control, infertility, andcancer detection clinic at the maternity clinic of the Pereira RosellHospital. It also conducts a medical and social research program andhas a community education program on family planning and sexeducation. Three symposiums have been held for this purpose.

Venezuela: There is no family planning organization in this coun-try, but birth control services are provided at the "Maternidad Con-cepcion Palacios", the largest Maternity in the country. These serv-ices are to be extended soon to other government hospitals. As wasmentioned before, the Ministry of Public Health is planning to es-tablish a Department of Population Studies.

RESUME

1. Although Latin America, and especially the Caribbean coun-tries, have the highest index of population growth in the world, thegovernments and the public in general have ignored this phenome-non, or have considered it a sign of progress; but as more and moreinformation is disseminated with regard to the relationship of popu-lation growth to the economic, social and cultural development ofthe peoples, a greater number of responsible persons are becominginterested in learning more about the problem and finding solutions.

2. It is encouraging that the governments of Peru and Venezuelaare planning the establishment of Departments of Population Studiesin the Ministries of Public Health and that the 19th General Assem-bly of the U.N. is going to discuss the Report of the Secretary Gen-eral on the answer of the inquiry among governments on problemsresulting from the reciprocal action of economic development andpopulation.

3. Regardless of the negative attitude about population control inLatin America, the overpopulation of the individual family is a criti-cal health problem among the underprivileged classes of every coun-try. For this reason, family planning is accepted by all those whounderstand its real meaning.

4. Contraceptive methods have been used throughout history byeverybody who knew of them and could pay their high prices in or

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out of their own countries. But for the underprivileged classés, theonly known method is provoked abortion. For this reason, the inci-dence of provoked abortion is rising in all of Latin America toalarming proportions and is becoming a critical social, cultural, pub-lic health and economic problem.

5. It is the doctors in public hospitals who take care of the womenwho get there in critical condition due to the consequences of pro-voked abortions, who are directing the family planning movement inLatin America. They do everything possible to provide all the scien-tific contraceptive methods they know, including the RhythmMethod, but restrictive laws hinder their efforts in some of the coun-tries.

References

Dr. Arturo Aldama, El Aborto Provocado, Problema de Salud Pública XVI ReuniónAnual de la Sociedad de Higiene, held in Mexico D.F., Noviembre 1962.

Lester R. Brown, Economic Research Service of the U.S. Department of Agriculture,U.S. Government Printing Office, Washington D.C. 1963.

Dr. Noel David Burleson, T. S. Aida Rodriguez, Dr. Ernesto Vazquez Amori, Estudio delAborto Provocado en El Salvador. Departamento Medicina Preventiva y SāludPública, Escuela de Medicina, Universidad El Salvador. 1963.

Dr. Jorge Bustamante, Pérdida Gestacional por Aborto en el Hospital de Maternidadde la ciudad de San Salvador, 1961, trabajo presentado al 4to Congreso CentroAmericano de Medicina, San José, Costa Rica.

Inquiry among Governments on Problems Resulting from Reciprocal Action of EconomicDevelopment and Population Changes, Report of the Secretary General to the Gen-eral Assembly of the United Nations. E13895, 18 May 1964 and E13995 add I.

Dr. Julio Armando Lavergne, Paper presented at the Second Seminar in Family Planningfor Latin American Leaders, New York, October 6-18, 1963.

Tegualda Monreal, El Aborto Provocado, S'intesis Bibliográfica Reciente, Colegio Médicode Chile, Cuaderno Medico-Sociales Vol II No. 2. 1961.

Planificación Familiar, El Simposio Público que se realizó en Montevideo, 27-28 deSeptiembre 1963. Anfiteatro Maternidad, Hospital Pereira Rosell, Montevideo.

United Nations Demographic Year Book 1963 and Population Reference Bureau Inc.Population Bulletins, April 1961 and October 1964.

Dr. Constantino Urucuyo, Dr. Antonio Portuguez, Mesa Redonda Obstetricia, Gineco-logía, C.A. de Managua, Revista de la Federación Centroamericana de Sociedades deObstetricia y Ginecología, 9th Ave. 1-45, Guatemala, Guatemala. 1961.

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