Move beyond persuasion to Chinese-style law - Brakes on babies

Monica Dystant, GUEST COLUMNIST

On this Mother's Day, Monica Dystant argues that while the maternal instinct is powerful, women - and men - should better assess their capacity to raise children. And since many refuse to act responsibly, and burden the State for decades later, the Government must step in and legislate reproduction.

Five decades after Independence, child neglect and abuse in Jamaica show correlation with poverty, reproductive behaviours and mental health. The downward trend of the national average notwithstanding, with more than half-million Jamaicans in abject poverty, the island struggles to control birth through family-planning education, contraceptive devices provided freely or at minimal cost.

Yet the poorer class of the reproductive population continues to procreate at a rate which challenges society's resources.

The objective reality is that there is a socially unmanageable crisis of large impoverished households with too many neglected, unaffordable children whose births are often narrowly spaced. In many instances, fathers are common to multiple households across Jamaica and abroad.

The socio-economic crisis, the breakdown of the social milieu and increased reports of crimes against children provide ocular proof that a radical birth-control intervention is necessary and timely.

The crisis suggests that the current persuasive approach to population control has lost relevance and effectiveness as a deterrent among the poorer class.

Culture and psyche continue to inform reproduction. Legislating procreation is a radical but necessary approach to prevent that class of reproductive citizens from the act of engaging in irresponsible sexual intercourse, which often results in pregnancy.

Social realities are largely responsible for the high rate of childbearing and child abuse in lower-status groups - typically the poor and uneducated.

It is the tendency of poor households to have large nuclear and extended families, often with children in need of care and protection. Evidence suggests contraceptive use is more popular in high-status groups - the typical educated, upper- and middle-income class.

Thus, the inverse relationship between higher education and gainful employment.

Decades of irresponsible reproductive behaviour has depleted Jamaica's resources and brings to centre stage the need to legislate procreation. Substandard living conditions in many communities demand a tough response to control the reproductive behaviour of the poorer socio-economic class.

Based on research evidence, repeat pregnancies, predominantly in the poorer class, are indicative of sociocultural, biological, psychological, educational and employment factors. Subcultural norms, myths, expectations and desires of sexual partners influence birth rate.

Jamaica struggles with its unemployed, unskilled citizens in poverty who nevertheless continue to have more children than citizens who can afford the costs of pregnancy and childcare. Consequently, the objective reality is a cycle of neglected and abused children.

For more than a generation, the country has relied on the persuasive, promotional messages of the National Family Planning Board (NFPB). The efforts of the NFPB have been commendable in curtailing birth; however, the message 'Two is better than too many' lends itself to different interpretations across socio-economic classes. Persons living below the poverty line are seemingly undeterred by adverse circumstances as they engage in irresponsible sexual pleasure.

consistent birth pattern

Notwithstanding the 0.2 per cent reported decline in population growth in 2009, there is a consistent pattern of birth among those who can least afford it. The Survey of Living Conditions 2009 reported housing-cost stress, though moderate, in the poorest households.

The fact that the survey pointed to a 16.5 per cent increase in poverty, attributed to the worldwide recession, seemed not to grab the attention of those who continue to 'make love without a glove'.

To what extent do persons in the reproductive age cohort continue to respond favourably to messages such as 'Get it, carry it, use it'; 'Sometimes naughty, sometimes nice, always sexy, always wise'; and 'Sexy, but not having sex'?

Birth-control and STI prevention messages, as with all sensitisation strategies, are time-bound. The society is saturated with sensitisation, and having reached a plateau, some sections have become immune to the message.

It is paradoxical that free-willed pregnancy is permitted at the same time we apply austere economic measures to pay debts and survive. Leaving birth decisions to people's choice only labours on the false premise that all men are rational; are deterred by hardships and painful experiences; and will change reproductive behaviours as a response to harsh economic reality.

The converse is true, verifiable by the health, education and financial sectors. The ability to make wise choices is compromised by conditions of mental or emotional impairment, lack of sound education, intellectual challenges and the Freudian id.

reliance on judicial system

There is heavy reliance on the overburdened, clogged judicial and social structures that regulate childcare and punish violators.

The current situation requires drastic measures that target not only our financial deficit, but stubborn social ills. We have widespread reports of mothers dumping babies in pit toilets and garbage containers and of child abuse and neglect. There is evidence of dishevelled, destitute street women and men, some bearing toddlers as they approach vehicles at traffic lights begging, often using the children strategically to appeal to the emotions of drivers. When questioned, invariably these beggars disclose having several children for different sex partners.

This is the reality of our society and evidences the need to restrict free-willed pregnancy.

Based on research, birth by legislation is unpopular in other parts of the world. China, in 1978, introduced the One-Child Family Planning Policy to control its population. This restricted urban couples to one child, which resulted in approximately 35.9 per cent of the population subjected to the one-child policy.

China's reproductive population was divided into urban couples, rural couples, ethnic minorities, and couples who were only 'one-children' themselves. Exemptions to the policy were extended to the special administrative regions of Hong Kong and Macau as well as to foreigners living in China. It is to be noted that the Chinese government used this policy to mitigate social, economic and environmental problems.

Notwithstanding China's centralised economy vis-à-vis Jamaica's democracy, the objective would be the same. Amid criticisms of this One-Child Family Planning Policy in China, a 2008 survey undertaken by the Pew Research Centre reported that 76 per cent of the Chinese population supported the policy.

As punishment is expected to fit crime, and prescription fit diagnosis, the response to free-willed pregnancy should accommodate our social reality.

To achieve the objectives of Vision 2030 and implement 21st-century development strategies in the required timeline, we need a change of prescription to a more potent medicine. The body has developed resistance to the gentle persuasive medicine of the NFPB. The treatment of unwanted, abused children should be situation-specific.

Should we continue the current prescribed treatment, we will inevitably experience deterioration in the already flawed social system.

Legislation would enforce psychological, medical and social assessment to determine affordability, social, financial stability - general fitness for reproduction vis-à-vis the degree of latitude the reproductive population now enjoys.

The old mantra of preventing unwanted children needs to be replaced. Some parents wanted the children, though knowingly unable to afford them, yet succumbed to maternal urges, coercion and cultural norms. Rationality and affordability became secondary.

The new mantra should be 'Prevent reproduction I cannot afford'.

It is imperative that persons of reproductive age are prevented from having children in the absence of required resources or capability for caregiving.

My recommendations are as follows:

1. The Ministry of Health, with its primary and secondary health-care providers, the NFPB and Ministry of Education, conduct surveys among the childbearing cohort to determine mental health, social and financial status.

2. Health-care workers provide guidance and counselling for and mandatory birth-control treatment to the poorer class of clients and patients.

3. Guidance counselling units in schools collect mental-health and socio-economic data that feed into databases of the relevant public-sector entities.

4. Ministry of Health, through its pharmaceutical division, prevent fertilisation by prescription drugs for reproductive-age persons living below the poverty line.

5. Antenatal hospitals/clinics arrange compulsory parenting classes/training at the point of registration and implement strategies to monitor births and treatment of children.

6.The NFPB and health centres deliver mandatory counselling and parenting courses for persons who want children.

7. Linkages of databases across relevant sectors provide instant information retrieval.

8. Psychometric testing and upgraded job descriptions to fully utilise skill sets and achieve optimal performance.

9. Trend analysis for tracking and monitoring reproductive behaviours and living conditions of clients and patients.

Monica Dystant is a trained counsellor, educator, social worker, and mother. Email feedback to columns@gleanerjm.com and mdystant@yahoo.com.