Tafelberg Short: The Politics of Pregnancy: From 'population control' to women in control

By Rhoda Kadalie

South African women's fertility poses a puzzle: despite immense poverty, our population is growing very slowly, against all international experience. Sadly, this cannot be attributed to the empowerment of women... Activist and analyst Rhoda Kadalie and her daughter Julia Pollak take a hard look at the politics behind our low fertility rate and related quandaries: low use of contraception and staggering rates of teen pregnancy. A wake-up call and a call to action.

• Language: English
• Publisher: Tafelberg
• Release date: Nov 5, 2012
• ISBN: 9780624057116

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Introduction: Pregnant teenagers and falling fertility

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When it comes to demography and fertility, South Africa is an outlier. Fertility rates tend to fall as countries get richer. But South Africa saw dramatic fertility declines among all racial groups far earlier than is usual in developing countries, and far earlier than its sub-Saharan neighbours, despite persistently high levels of poverty. Even today, South Africa’s fertility levels and population growth rate are remarkably low, compared to the rest of the region.

The Apartheid government’s family planning policies are partly responsible. But South Africa’s demographic ‘exceptionalism’ is also largely an accident of history – a by-product of the devastation Apartheid wrought on black and coloured families before 1994 and the impact of HIV/Aids on families since then. Sadly, this cannot accurately be accredited to the success of our reproductive health programmes and services, or to the empowerment of women, where we continue to fall short.

Over the coming decades, South Africa can expect its population growth rate to slow down even further thanks to a combination of continued fertility declines and mortality increases. According to a study by the South African Institute of Race Relations, birth rates have decreased from about 26 births per 1 000 people in 1996 to 21 in 2011. They are expected to drop yet further to 18 by 2025, according to the Actuarial Society of South Africa.

Meanwhile, the Institute for Futures Research at the University of Stellenbosch reports that the death rate has doubled since 1985 and is projected to increase by a further 17% between now and 2040. HIV/Aids is the main culprit, and its related deaths are mostly among women of child-bearing age.

Despite South Africa’s relatively low fertility rates, there are still alarmingly high rates of teenage and unwanted pregnancy. These threaten the status of women and compound the problem of female poverty by restricting women’s education and career prospects. A staggering 40% of all pregnancies in South Africa each year are among teenage girls, for example.

There is a long list of reasons: the lack of access to contraceptives; the lack of sex education; high rates of alcoholism and drug use, which dispose people to risky behaviour; the stigma contraceptives carry in traditional communities; men’s aversion to condom use; and the high rates of sexual violence and rape. Inadequate and mismanaged health-care services, brutish attitudes of men towards women, and a poverty culture of short-sighted and self-destructive behaviour remain indelible obstacles to the advancement of women’s health and reproductive freedom.

Many of the South African government’s efforts to date have had only minimal effects on contraceptive use and on the rates of teenage and unwanted pregnancy. There are some glimmers of hope, but achieving better outcomes will require government and civil society organisations to mount a herculean and multi-faceted effort. This will have to be aimed not only at improving women’s sexual and reproductive health,