There hasn’t been a World Population Conference since the 1994 International Conference on Population and Development in Cairo, Egypt.
Previous decennial conferences had been characterized by “acrimonious debate” over whether family planning programs were an effective means of lifting developing countries out of the poverty trap. In strong contrast, a consensus emerged from the 1994 conference. The Cairo consensus emphasized women’s empowerment—not particular targets for fertility rates, and not family planning programs per se. Access to contraception was part of the prescribed recipe for women’s empowerment, but more attention was paid to access to both education and jobs. I often summarize the underlying philosophy of the Cairo consensus to students in my introductory population courses as “take care of women and the population problem will take care of itself.” The belief was that empowered women will choose to have fewer children, so that if we pursued women’s empowerment, then explicit fertility policy would become unnecessary.
But do lower fertility rates actually arise from women’s empowerment? On the one hand, this almost seems like a ridiculous question: much evidence suggests that it does. To give just a few well-known examples, women with more education have lower fertility rates the world over, women’s labor force participation is also associated with lower fertility rates, and being able to opt out of marriage also reduces childbearing. Literature on why European fertility is so far below the replacement level emphasizes “expressive individualism.” The take-home message is that more choices means fewer babies.
I have no argument with that message when it is used to describe whole societies. More modern societies that offer individuals many different choices over the course of their lives have lower fertility rates than traditional societies with more limited life course options. This is especially true for women in the sense that societies which constrain acceptable options for women are among those with the highest fertility rates.
However, it is too often assumed that an empowered woman will choose to have few children. Worse, it is too often assumed that if the fertility rate has fallen, women’s empowerment has increased.
These concerns led me to look more closely at reproductive autonomy in Ghana. Fertility rates started falling in Ghana in the early 1980s, and by 1993 the total fertility rate was down to 5.3 children per woman. While certainly still high, that level was a full child lower than the 6.3 of 1983. In other words, the total fertility rate had fallen 16 percent in a single decade. If decreases in fertility rates serve as an indicator of women’s empowerment and if the rhetoric around the Cairo consensus applied at the individual level, then it would stand to reason that women in Ghana in 1993 should exhibit some degree of reproductive autonomy.
What I found instead was that Ghanaian women—even highly educated Ghanaian women—did not expect to have reproductive autonomy. I admit to not being very surprised by this finding. My co-author was a Ghanaian sociologist who had conducted focus groups at various educational institutions in Accra, Ghana’s capital, in 1993 precisely because he doubted that gender roles had changed as quickly as fertility rates had fallen. The urban fertility rate was 4.0 children per woman in that year, despite the national average being 5.3. The groups were asked to discuss how many children they would like to have and why. Individuals were also asked what would happen in a situation in which they wanted to stop childbearing but their partner wanted to continue, and additionally the reverse question of what would happen if they wanted to continue childbearing but their partner wanted to stop.
When we analyzed the transcripts, we found that women generally believed that they would not get their way in conflict situations with their partners unless “their way” was socially normative. That is, in groups in which many women wanted more than four children, the women believed that they would have to stop if their partner wanted to. Similarly, in groups in which desired fertility rates averaged fewer than three, women believed they would have to continue childbearing if their partner wanted to. In contrast, women believed that their preferences would prevail over their partners’ only in situations in which they wanted few children, but their partner wanted still fewer, and when they wanted many children, but their partner wanted still more.
These expectations indicate that reproductive behavior is governed more by social conformity than by reproductive autonomy. Women expected to be “empowered” to continue childbearing if they had two children and “empowered” to stop if they had five. But they did not expect to be empowered to stop at two or continue at five. These findings could simply be described in terms of regression to the mean: In situations in which couples disagree about further childbearing, the most likely outcome is the normative one.
And it isn’t just in Ghana: in Nepal, where the total fertility rate has recently dropped to under three children per woman, women generally still have three children even if their husband is opposed; but in low-fertility Italy third children don’t come without agreement from both partners. Fertility norms constrain individuals, especially when the couple disagrees about whether to continue childbearing.
The term “reproductive autonomy” is a strange one because the definition of autonomy includes independence, and human reproduction cannot occur independently. And yet it is often assumed that as women become empowered to make choices in their lives, they will gain reproductive autonomy. That would mean that they could make reproductive decisions independently, and so they would be able to decide unilaterally how many children to have, even when they have them through relationships with men. But when couples disagree about how many children to have, outcomes are shaped by the broader society—regardless of whether that society finds four children or two to be ideal.
I realized through analyzing the focus group data from Ghana that the drop in the fertility rate had not given women reproductive autonomy. The data was compelling in part because University of Ghana students comprised one group. The other groups were from Junior Secondary Schools, Senior Secondary Schools, and less prestigious tertiary institutions like technical schools, but the most educated university women did not differ from the others with respect to how they thought conflict over reproductive goals would be settled. Women’s education did not raise even their expectations for reproductive autonomy.
The group from the University of Ghana wanted an average of 4.5 children. In almost every group, the young women said that the reason that they wanted the number of children they did was because they believed that people should only have the number of children for whom they could provide. But the women in the university group explained that they could have more children because they expected to have good jobs and be able to afford them. Fertility desires often remain higher than actual fertility. More educated women have fewer children in countries across the globe—the only threat to this generalization coming from the especially pronounced retreat from marriage in richer countries among the least educated. But that does not mean that more educated women necessarily want fewer children. When fertility decline in Ghana was new, the most educated thought that they were the ones who could still enjoy large families, even while others needed to settle for fewer children.
Education is an empowering force, but an educated woman does not necessarily want fewer children. More educated societies have lower fertility ideals, but more educated women might not.
The connection between oppression of women and high fertility rates seems perfectly natural when ISIS militants both lash women who are not properly veiled and shut down family planning clinics at public hospitals. But during the decades that the Cairo consensus has shaped population policy, the media has often treated high fertility rates as an indicator that women are oppressed when the connection is less clear. Even the research literature typically treats fertility decline in developing countries as an indicator of women’s status improvement. Of course the most careful writings do not make this mistake, but the strong emphasis on women’s empowerment as a path to low fertility has contributed to the perception that lower fertility rates mean women are doing better and having more choices.
And I doubted that. French fertility rates started falling rapidly in the early 1800s: Do we point to that era as one of expanding choices for French women? Were French women more empowered than women from others on the European continent, whose fertility rates did not begin to fall until around 1870? And did the post-World War II baby boom arise from curtailed freedoms?
As compelling as the Ghanaian women’s voices from 1993 were, data from a single point in time cannot speak to the issue of change. I wanted to know whether women’s influence over reproductive decisions actually increased as fertility rates declined. This question was surprisingly easy to research because Demographic and Health Surveys were fielded in Ghana in multiple years. Using the data from 1988, 1993, and 1998, another co-author and I examined the influence of education on fertility intentions. Fertility intentions are a little different than fertility desires: They measure whether or not someone intends to have another child, not just whether they want to. Intentions therefore incorporate circumstances and not just ideals.
We found that as a married woman’s education increases, the likelihood that she will intend to have another child does in fact decrease. But we also found that her husband’s education exerted a stronger influence on her fertility intention than her own education did. If there is at all a story here about education leading to reproductive autonomy, it is that more educated men have more reproductive control.
Our analysis of change over time presented a still greater challenge to common ways of thinking: As Ghanaian fertility decline progressed, men’s education came to matter more while women’s own education came to matter less. The fact that men’s fertility desires were falling faster than women’s over this time period seems to explain early fertility decline in Ghana far better than a story about women’s empowerment does.
It is easy to imagine a scenario in which women’s empowerment does in fact lead to fertility decline, but fertility having declined does not prove that women have been empowered. It is also easy to imagine that even where fertility rates have fallen because of men’s preferences, women still benefit: When fewer of women’s prime years are devoted to childrearing, women have time for other pursuits and their choices expand. Nonetheless, we do well to emphasize three basic facts that sometimes are lost in advancing women’s empowerment as population policy:
1. Men matter in reproductive decisions. Women cannot have reproductive autonomy without abrogating men’s influence and rights.
2. Women with higher status may have lower fertility rates for reasons other than wanting fewer children. Women having fewer children does not always mean that women are getting what they want. Taking the Cairo consensus seriously should mean supporting the right to implement high fertility desires as well as the right to implement low ones.
3. There are multiple paths to low fertility rates. Fertility decline is not a sign that women have become empowered.