Florence Achcirocan, a 36-year-old mother to seven children, at home with her kids in Uganda. Florence has lost five babies—three at birth and two as infants. Photo: World Vision
“I want to stop giving birth,” says Florence. “Right now, I face so many challenges… My children had to drop out of school. They lack clothing. I can’t provide for their basic needs,” she continues. “Because of my health challenges, I’m old enough to stop. I want to go to the health centre and find out about family planning.”
Pregnancy takes a substantial toll on a woman’s body—whether she lives in Canada or anywhere else—but the risks are more pronounced in developing countries, where access to quality health care isn’t a foregone conclusion. (In Canada, a woman’s lifetime risk of maternal death is 1 in 8,800; compare that to Uganda, where it’s 1 in 47.[10])
When a woman lives in difficult conditions, without a varied diet or access to prenatal vitamins, back-to-back pregnancies leave her especially vulnerable. Her nutritional stores, especially iron and calcium, are likely to become depleted and she will be less equipped to breastfeed her baby, meaning the child’s long-term health may be compromised as well.
The health risks are even more extreme for teenage mothers, who are more likely to become malnourished during pregnancy—their bodies are still growing, even as they sustain the child growing within them. With pelvises not fully developed, girls face higher chances of complications in delivery.
Healthy timing and spacing of pregnancy
Educating women and teens about the importance of family planning and methods of contraception could prevent as many as one in three maternal deaths and improve the survival rate of children.[11] For this reason and others, World Vision incorporates family planning into our programs in the communities where we work, where it’s appropriate, encouraging healthy timing and spacing of pregnancy. That means encouraging women and their partners to:
- Wait at least two years after a live birth before attempting to conceive,
- Wait at least six months after a miscarriage before attempting to conceive, and
- Wait until age 18 or older before conceiving for the first time.[12]
Beside these guiding timelines, World Vision works alongside community partners to clear up fears and misconceptions about family planning. We help women understand their options when it comes to birth control, so they can choose a method that works best for them and support them in the decision if needed.
To reduce of the rate of malnutrition in children, this young mother from Cambodia receives information on feeding and vaccinations. Photo: World Vision/Makara Eam
While educating women themselves has always been the focus of this kind of work, family planning is a complex issue, influenced by family, culture and religion. Women may not always be the chief decision makers in their own reproductive health. For this reason, World Vision involves other players in the education process as well.
Partnering with faith leaders
Family planning happens at the household level. Still, would-be parents are influenced by their community’s norms and values—which are often intrinsically linked to its religious beliefs. By equipping faith leaders with facts about the benefits of healthy timing and spacing of pregnancy, and contextualizing those principles within scriptures and social teaching, clergy are equipped to use their platforms to positively influence the health of their congregations.
"[Working with faith leaders] is a great way to address tough issues in a context that really resonates and gets to the deepest underlying norms and beliefs in the community,” says Andrea Kaufmann, Senior Advisor of Faith and External Engagement at World Vision International. “It invites […] people to share their own voices and experiences. As faith communities we accept children lovingly and we also want them to experience healthy, flourishing lives in every way."
Small group coaching
World Vision works with married couples in small discussion groups, where they learn about the benefits of birth spacing and the importance of gender equality in decision-making. It’s a great place to ask questions in a non-threatening atmosphere. At the end of the sessions, couples who decide they would like to implement family planning measures in their own homes are referred to health centres for more support and counselling. In many cases, these couples have gone on to advocate within their communities, encouraging others to space their children in a way that will ensure health and stability for the whole family.
Educating men
Men play a crucial role in birth spacing—particularly in traditional, patriarchal cultures. World Vision runs workshops where fathers are coached in gender equality, sharing childcare responsibilities and upholding the health of their partners and children as they make family planning decisions together.[13]
Working with youth
World Vision empowers young people with information, helping them make life choices that will set them up well for the future. We coach teens to understand their rights, delay early marriage and advocate for the elimination of forced marriage in their communities. We also support comprehensive, evidence-based sexuality education that meets international standards and includes information about the types and uses of contraceptives to protect themselves from sexually transmitted infections and unplanned pregnancies[14] as well as the important options of abstinence and marital fidelity.
Strengthening health care systems
World Vision works in communities to support health systems that are already in place. This includes training health workers to provide counselling in family planning and birth spacing, and ensuring facilities have the equipment and supplies they need to provide women and girls with proper care before, during and after pregnancy.
This health care centre in Cambodia provides a place for this mother in Cambodia to learn about family planning and effective ways to keep her child healthy. Photo: Makara Eam
The essentials: Equality and informed choice
I still love being part of an extended family gathering—whether at home with my own clan, or on my visits overseas with World Vision. But I’ve learned just how much poverty can complicate the conversation about family size for parents around the world.
My parents had the opportunity to attend school and later, university. They moved from Guyana to Canada, where they rooted and raised a family of their own. And I’m grateful that as a Canadian, I’ve never had to worry about going hungry a day in my life.
“In the end, though, the conversation has less to do with the actual size of a family and more to do with information and choice.” Photo: Author’s family archives
In the end, though, the conversation has less to do with the actual size of a family and more to do with information and choice. In every part of the world, women and girls deserve to feel heard and to have ownership over what happens with their bodies. Men deserve an education on why that’s important, so that they can support their partners and build families they’re able to help care for. And everyone—whether their family is large, or small—deserves the information and autonomy to make informed choices about how many children they bring into this world.
You can support new and expecting moms with things like prenatal vitamins and education. Learn more.
