Sterilization is an increasingly familiar phenomenon to women worldwide, and it is the most prevalent contraceptive practice in the world. Costa Rica, where the use of contraceptives is generalized, is among those countries in the world with the highest prevalence of female sterilization. In Costa Rica, female sterilization is homogeneously distributed, common among women living in rural and urban zones, as well as among those of diverse educational levels. In contrast to what one may expect given the legacy of abusive birth control practices in Latin America, the “problem” of sterilization in Costa Rica has been framed by women and doctors alike not as the “need” for curbing its use but rather as a “struggle” for broadening access as much as possible. Interestingly, current rates of sterilization have been attained in the absence of a formal program offering sterilization for contraceptive purposes and in the context of a very restrictive legal framework for its provision. It was not until July 1999 that sterilization for contraceptive purposes was explicitly regulated and permitted. Before that year, it was only so-called therapeutic sterilization that was legally allowed. Sterilization was supposed to be offered only for health reasons. Notably, successive moves intended precisely to broaden access to this surgery within the state hospital system have been realized through regulation formally restricting its provision. This sometimes counterintuitive history of the provision and regulation of sterilization in Costa Rica is analyzed.
At its 2015 General Assembly, the United Nations formulated the Sustainable Development Goals (SDGs) to emergize its Member nations and social workers practicing in these countries to engage in environmentally sustainable social and economic development leaving no one behind. At the core of SDGs is the conviction that protecting planet Earth is possible by working collectively and ensuring that all human beings are able to realize their full potentials. The charges include solving a wide range of environmental, economic, and social problems including poverty, hunger, violence, and discrimination by 2030. The SDGs are inclusive of all people; they have galvanized all Member countries and their policy makers and practitioners, including social workers, to strive toward the common goals. Progress has been made from previous initiatives, but there are still challenges ahead. The first five SDGs are particularly relevant to social workers, who have an important role to play in alleviating poverty, promoting health and education, and empowering women and girls.
By the end of the 19th century, the medical specialties of gynecology and obstetrics established a new trend in women’s healthcare. In the 20th century, more and more American mothers gave birth under the care of a university-trained physician. The transition from laboring and delivering with the assistance of female family, neighbors, and midwives to giving birth under medical supervision is one of the most defining shifts in the history of childbirth. By the 1940s, the majority of American mothers no longer expected to give birth at home, but instead traveled to hospitals, where they sought reassurance from medical experts as well as access to pain-relieving drugs and life-saving technologies. Infant feeding followed a similar trajectory. Traditionally, infant feeding in the West had been synonymous with breastfeeding, although alternatives such as wet nursing and the use of animal milks and broths had existed as well. By the early 20th century, the experiences of women changed in relation to sweeping historical shifts in immigration, urbanization, and industrialization, and so too did their abilities and interests in breastfeeding. Scientific study of infant feeding yielded increasingly safer substitutes for breastfeeding, and by the 1960s fewer than 1 in 5 mothers breastfed. In the 1940s and 1950s, however, mothers began to organize and to resist the medical management of childbirth and infant feeding. The formation of childbirth education groups helped spread information about natural childbirth methods and the first dedicated breastfeeding support organization, La Leche League, formed in 1956. By the 1970s, the trend toward medicalized childbirth and infant feeding that had defined the first half of the century was in significant flux. By the end of the 20th century, efforts to harmonize women’s interests in more “natural” motherhood experiences with the existing medical system led to renewed interest in midwifery, home birth, and birth centers. Despite the cultural shift in favor of fewer medical interventions, rates of cesarean sections climbed to new heights by the end of the 1990s. Similarly, although pressures on mothers to breastfeed mounted by the end of the century, the practice itself increasingly relied upon the use of technologies such as the breast pump. By the close of the century, women’s agency in pursuing more natural options proceeded in tension with the technological, social, medical, and political systems that continued to shape their options.
In the late 19th and 20th centuries, massive numbers of African women, poor and rich, educated and uneducated, were deeply involved in resistance to European colonialism/imperialism and male domination at both the national and local levels of their nations. The 1890 rebellion led by Charwe in present-day Zimbabwe, the 1929 women’s rebellion in eastern Nigeria, the 1940s women’s marches in Senegal as part of the strike of African male railway workers so beautifully chronicled in Ousmane Sembene’s God’s Bits of Wood (1960), the Mau Mau rebellion in Kenya, the revolution against the French in Algeria, and women’s roles as troop support and combatants against the Portuguese in Angola and Mozambique and against apartheid in South Africa are among the many examples of women centered in African resistance to colonialism and African nation-building. In all of these struggles women did not isolate their struggles as women from their struggles as oppressed people. Born Frances Olufunmilayo Olufela Abigail Folorunsho Thomas, but best known as Funmilayo Ransome-Kuti (and later Funmilayo Anikulapo -Kuti), is the best-known Nigerian woman anti-imperialist, pan-Africanist, and feminist. She struggled for the independence of Nigeria and the empowerment of Nigerian women to vote, be educated, and be included in the governance structures of their nation. She also identified herself as a human-rights activist who struggled on behalf of the poor and disenfranchised of all nations. She was among a small number of West African women (such as Adelaide Casely-Hayford, Constance Cummings-John, and Mabel Dove Danquah) who traveled widely internationally and who were active in international women’s organizations such as the Women’s International Democratic Federation (WIDF) and the Women’s International League for Peace and Freedom (WILPF). At one point, when Amy Ashwood Garvey visited Nigeria, FRK wrote to ask about affiliating with Garvey’s United Negro Improvement Association (UNIA) Women’s Corps. In addition to her travel to many countries on the African continent, FRK traveled to Eastern and Western Europe, the Soviet Union, and China. Though invited to participate in a conference in San Francisco in the 1950s, she never visited the United States because she was unable to secure a visa due to her travel during the Cold War to eastern bloc nations and China, for which she was accused of being a communist. She was never a member of the communist party, but she did embrace the socialist ideal that all people were entitled to their freedom, education, medical care, and housing, and her activism was firmly rooted in grassroots organizing. She is best known for having led the struggle that deposed the Alake (king) of Abeokuta, for leading women in their struggles against taxation by the British colonial government without the vote or representation in government, and for her work with the nationalist party the National Council of Nigeria and the Cameroons (NCNC) and with the Nigerian Union of Teachers (NUT). She founded two women’s organizations within Nigeria, the Abeokuta Women’s Union (AWU) and the Nigerian Women’s Union (NWU-which was the basis for the formation of the Federation of Nigerian Women’s Societies), and a short-lived political party, the Commoners’ People’s Party (CPP). Internationally she worked with the WIDF (of which she was elected a vice president), the WILPF (that listed FRK as president of its Nigeria section), and the West African Students’ Union (WASU) of London. She authored articles on women in Nigeria in the WIDF journal, and one (“We Had Equality ’til Britain Came”) in the Daily Worker published in London. During her lifetime as an activist, she received many honors: the Order of the Niger (1965—from the Nigerian government for her work on behalf of the nation); honorary doctorate from the University of Ibadan, Nigeria (1968); an appearance in the International Women’s Who’s Who (1969); and Lenin Peace Prize (1970). On her death in 1978, FRK was hailed in headlines in major Nigerian newspapers as the “Voice of Women” and “The Defender of Women’s Rights.” She is also considered a pioneer in the articulation and practice of African feminism and an important figure in the rise of Nigerian radical political philosophy. Analyses of 20th-century African and transnational feminism will continue to be informed and complicated by her story.
Jadwiga E. Pieper Mooney
The official histories of family planning and reproductive rights in Chile started in the 1960s, with initiatives by Chilean doctors to reduce maternal mortality due to self-induced abortions; Chilean women’s mobilization for rights surged in the 1970s, and the concept of reproductive rights became the focus within health policy debates only by the 1990s. Specific Chilean political developments shaped these trajectories, as did global paradigm changes, including the politicization of fertility regulation as a subject of the Cold War. These same trajectories also generated new understandings of reproductive rights and women’s rights. The goals of preventing abortions and maternal mortality, of controlling population size, and of protecting families all contributed to the public endorsement of family planning programs in the 1960s. Medical doctors and health officials in Chile collaborated with the International Planned Parenthood Federation (IPPF) and founded the first Chilean family planning institution, the Association for the Protection of the Family (APROFA). Since 1965, APROFA, affiliated with the IPPF, has remained the primary institution that makes family planning available to Chilean women and couples. The concept of “reproductive rights” is relatively new, globally, and in its specific national representation in Chile; questions of women’s rights gained unprecedented international prominence after the United Nation’s designation of the International Women’s Year (IWY) in 1975. International conferences, and the extension of IWY to a Decade for Women between 1975 and 1985, stimulated debates about policy norms that linked human rights, women’s rights, and the right to health to nascent definitions of reproductive rights. Just as international gatherings provided platforms for debates about rights, unparalleled human rights violations under military rule (1973–1990) interrupted the lives of Chilean citizens. Women in Chile protested the dictatorship, mobilized for democracy in their country and their homes, and added reproductive rights to the list of demands for democratic restructuring after the end of dictatorship. While family planning programs largely survived the changes of political leadership in Chile, the dictatorship dealt a lasting blow to quests for reproductive rights. The military’s re-drafted Constitution of 1980 not only compromised effective political re-democratization, but also imposed such changes as the end of therapeutic abortions, which have remained at the center of political activism against reproductive rights violations in the 21st century.