A History of Family Planning in Twentieth-Century Peru

A History of Family Planning in Twentieth-Century Peru

A History of Family Planning in Twentieth-Century Peru

A History of Family Planning in Twentieth-Century Peru


Adding to the burgeoning study of medicine and science in Latin America, this important book offers a comprehensive historical perspective on the highly contentious issues of sexual and reproductive health in an important Andean nation. Raul Necochea Lopez approaches family planning as a historical phenomenon layered with medical, social, economic, and moral implications. At stake in this complex mix were new notions of individual autonomy, the future of gender relations, and national prosperity.

The implementation of Peru's first family planning programs led to a rapid professionalization of fertility control. Complicating the evolution of associated medical services were the conflicting agendas of ordinary citizens, power brokers from governmental and military sectors, clergy, and international health groups. While family planning promised a greater degree of control over individuals' intimate lives, as well as opportunities for economic improvement through the effective management of birth rates, the success of attempts to regulate fertility was far from assured. Today, Necochea Lopez observes, although the quality of family planning resources in Peru has improved, services remain far from equitably available.


I cheered in 1995 when Peruvian president Alberto Fujimori gave a speech as the only male head of state at the Fourth World Conference on Women in Beijing. There, Fujimori praised the skilled ways in which women were able to organize themselves to overcome economic hardship. To a standing ovation, he also announced the recent legalization of surgical sterilization as a contraceptive in Peru. Just a few years later, the press began to publish a series of heartbreaking and indignant accusations about forced surgical sterilizations of hundreds of women in several rural areas of my home country. the reports involved officers from the Ministry of Health, directors of rural health centers, and even the U.S. Agency for International Development, and led to investigations by the Peruvian Ombudsman’s Office and the U.S. House of Representatives.

Yet, once more swung the pendulum when it became apparent that there was more to the story than powerful agencies and physicians victimizing poor, illiterate, indigenous, rural women. the same newspapers that brought the abuses to light reported details that made guilt seem less than straightforward. the Catholic Church, today an opponent of all contraceptive methods, had been behind many of the accusations of forced sterilization. Were the accusations less credible because of that association? Moreover, some local politicians lamented that sterilizations occurred in a country that they considered underpopulated. How did they determine such want of population? Physicians themselves were perplexed by accusations of abuse, as they believed they acted according to the standards of their profession in securing informed consent from women and in performing the surgeries. Finally, at least some of the women who had undergone the surgeries were satisfied with the outcomes. Not only had those women agreed to the operations voluntarily, but they had even traveled in search of the free-of-charge surgeries when these were not performed near their places of residence.

Family planning has long been a contentious issue in Peru, and the book you are reading is about why this is so. Even today, the prevalence of modern contraceptive use in Peru hovers around 50 percent, a rate among the lowest in the Americas, next to that of Guyana (40 percent), Guatemala (34 percent) . . .

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