Q: Why did you start your work in family planning?
A: During the 1970s and 80s I spent a lot of time with women in Africa, Asia and Latin America. Fear of death in childbirth, child marriage, family violence, pain, poverty and resignation were common themes. Health information and services were woefully inadequate. I chose to work in family planning because it is a vital reproductive health resource and the only one that was available to poor women in developing countries.
Q: Why were reproductive health services so poor in developing countries back then?
A: Governments did not feel that reproductive health other than family planning was worth investing in. Data about women's reproductive health were sparse and maternal deaths were estimated, not counted, while morbidity was ignored. This neglect was based on the argument that preventing pregnancy was a better way to prevent these deaths than providing obstetric services. Sexually transmitted infections in females and induced abortion were subjects people refused to deal with, even though abortion, nearly always unsafe or fatal, was being used as a means of birth control. This was evident from the few statistics that were available and from my experience working with these women.
Q: Can you recall an incident that illustrates the consequences of this neglect?
A: One strong image illustrates the lack of services and basic human rights for women who had abortions. In Cameroon I visited a sparkling new maternity hospital on a hill. Down below, in what was often a sea of red mud, was a dilapidated building where women with complications of "backyard" abortions were often left lying by the door by family members …