OF ALL THE 20TH CENTURY'S GREAT HUMANITARIAN ventures, none appears to have accomplished more than the campaign to control world population. Fertility rates have declined in every region of the world, and women now bear, on average, half as many children as they did 50 years ago. At a time when poor people are rioting over rising food prices, one could well imagine how many more hungry people there would be if the world's population had continued to grow at its old rate.
Yet few of those who work in family planning today--almost no one uses the term "population control" anymore--are rushing to claim credit for averting disaster. In part that's because studies show that their efforts account for only a very modest share of the decline in fertility. The movement itself is largely becalmed. Aid levels for family planning have been flat or declining since the mid-1990s, even though birthrates remain high in many countries and tens of millions of women in sub-Saharan Africa and other regions still lack access to birth control and safe abortion. Family planning workers in places such as Nigeria and India often find that the people they seek to help suspect their motives, doubt their assurances about the safety of contraceptives, and wonder whether they have a hidden agenda.
That skepticism, and the hesitation of family planning advocates to trumpet success, is in part the legacy of the movement's own mixed history. As it gained momentum and a sense of urgency after World War II, the movement to reduce population growth encountered an unexpected array of complex practical and moral problems. What happens when a cause suddenly captures the public imagination and money pours in, along with demands for immediate action that can't easily be satisfied? What should be done when ordinary people are reluctant to do what's supposed to be good for them, or for humanity? What if they have more immediate needs that might impede achievement of the global goal? Especially in the 1960s and '70s, the heyday of population control, the movement gave a lot of wrong answers.
Family planning was meant to help people take charge of their own lives, but in India and other developing countries it often came to mean applying varying degrees of coercion, from pushing risky contraceptives on reluctant clients to paying cash rewards to poor people who agreed to be sterilized. In the pursuit of their great goal, population controllers proved willing to sacrifice other efforts to improve the well-being of poor people around the world. And they were so persuaded of the necessity and rightness of their mission that they shielded much of their work from oversight and, more important, accountability to those they were supposed to serve. At a time when some are calling for a major new crusade against global poverty, their story provides a cautionary tale.
Family planning grew out of two somewhat contradictory movements. The eugenics movement, a creature of the 19th century, attracted those who were concerned not just about the numbers but the kind of people who might inherit the earth. Eugenicists aimed to breed better people by sterilizing the "unfit" and encouraging "fitter" parents to have more children. After World War I, feminists promoted birth control as a means of liberating women and preventing poverty and war. "No woman can call herself free who does not own and control her body," declared birth control advocate Margaret Sanger. But Sanger, like many other progressives of the day, was sympathetic to eugenics, with its promise to attack the most basic causes of poverty and conflict, and in the 1930s she and others forged a broad alliance between feminists and eugenicists under the banner of "family planning"--a slogan that left unspecified who would do the planning.
At first, family planning involved purely voluntary efforts, but that approach looked increasingly inadequate as the Cold War began and national security arguments came to the fore. …