Growing up in a Catholic household in Texas, I never would have guessed that I would one day travel around the world talking about the benefits of contraceptives. I certainly never imagined that I'd speak out publicly about my own experience with family planning. But these days, I'm doing a lot of both.
Everything changed when Bill and I started our foundation. I started traveling to places where women were getting pregnant too young, too old, and too often for their bodies to handle. I visited communities where everyone I met knew a woman who had died in childbirth. I visited communities where every woman I met had lost a child. I met still more mothers who were desperate not to get pregnant again because they couldn’t afford to feed and take care of the children they already had. And I began to understand why, even though I wasn’t there to talk about contraceptives, women kept bringing them up anyway.
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After spending time with these women, I found it impossible to turn my back on them. I thought about them all the time. I also started reflecting on just how transformative contraceptives have been in my own life.
It’s no accident that my three kids were born three years apart—or that I didn’t have my first child until I'd finished graduate school and devoted a decade to my career at Microsoft. My family, my career, my life as I know it are all the direct result of contraceptives. And now, I realize how lucky that makes me.
Even as I write this, there are 225 million women in the world who do not want to get pregnant but do not have access to modern contraceptives. A recent change to U.S. global health policy will soon drive that number up even higher. And as we continue to debate this issue, I think it’s important that all of us understand its stakes from the perspective of the women whose families and futures hang in the balance.
For many of these women, the ability to plan their pregnancies is nothing less than a matter of life and death. Last year alone, family planning tools helped avert the deaths of 124,000 women. Healthier women have healthier children, so the impact of contraceptives ripples across generations. When women space the births of their children by at least three years, their babies are twice as likely to survive their first year of life—and 35% more likely to live to see their fifth birthday.
What’s more, contraceptives are often a key determining factor in whether a woman is able to lift her family out of poverty. Research shows that women with access to family planning tools not only tend to have fewer children, they also tend to have higher individual and household incomes. Their kids spend more time in school, increasing the economic potential of the next generation, too.
The stories behind these statistics are powerful and personal. A few years ago, I met a woman in Kenya who had just started a small business sewing backpacks out of denim scraps. She hoped this new income would help her give her three kids a better life, but she was very aware that her ability to keep the business at all depended on her ability to delay her next pregnancy.
A woman I met in India last spring told me a similar story. She was planning to go back to work as soon as her youngest daughter was old enough to start school. And while she was excited about what the extra income would mean for her family, she was also excited simply because she loved her job as a teacher. Contraceptives not only empowered her economically—they empowered her to be who she wanted to be in the world.
These days, when I meet with leaders who still aren’t convinced that contraceptives deserve a place on the agenda, here’s what I tell them: If you care about giving children a chance at a healthy future, if you care about giving women a chance to take their families from poverty to prosperity, and if you care about giving poor countries the chance to become rich ones, then you must care about contraceptives.
Both evidence and experience show that empowered women are drivers of progress, creators of wealth, and the world’s greatest force for transforming societies. The women I met overseas are ready and willing to contribute to a better future for all of us. We should take it on ourselves to make sure they have that chance.
Melinda Gates is co-chair of the Bill & Melinda Gates Foundation. The Foundation released its 2017 annual letter on Tuesday.