August 2008

Barbara J. King


Of Pregnancy, Pessaries, and What Women Want

Another book to tell about what women want, and another male to tell it. If Island Press’s marketing crew inserted the what women want phrase in More’s subtitle to boost sales the cute way, let me tell them, it’s more wearying than witty, more off-putting than playful. Let’s lose the essentialism already. Who thinks anymore in terms of women -- or men or gays or Republicans or Muslims -- as a demographic with cookie-cutter-designed desires?  

Yet, in More, I discovered, Robert Engelman makes a fascinating case that a universal desire can be identified in women: the ability to determine the number of children they birth. Engelman, vice president for programs at Washington DC’s Worldwatch Institute, reveals on the preface’s page one that his thesis came from Sharon Camp, an American population activist, in the 1980s. Camp told Engelman “that if all the world’s women could determine for themselves when and when not to have children, population problems would resolve themselves with no need for governmental ‘control’.”More makes a grand sweep from humanity’s prehistory to its present in support of Camp’s idea. Engelman crafts an account of global population issues that is as tantalizing in its directness and optimism as it is, at times, frustrating in its execution.

(Ethical note: Engelman credits Camp generously, and many others in science and publishing too. I am acknowledged briefly for comments he invited me to make on short parts of the book in draft form; my own work is not cited.)   

No discussion of population trends succeeds without statistics, and Engelman hits the educational-but-entertaining bulls-eye with his. Does the August heat and haze thicken your brain and stultify your conversation? Share these tidbits from the book, and friends will snap to attention:   

The strongest support for More’s focus on the “three-way connection between individual women’s lives, world population, and the health of the planet” comes from another fact: Wherever women are truly able to control their own fertility, average family size settles at two children or fewer.

When Engelman dips into the past, support for his ideas weakens. It’s a detail thing. He makes good use of anthropologists’ explanation that with the advent of bipedalism, our ancestors probably invented midwifery. Walking upright changed women’s pelvic bones so that babies began to present facing down rather than up. In turn, this position made it harder for women to guide the baby out by themselves (because pulling upwards could have caused injuries to the infant spinal cord). He may be right, too, that “the firecracker blasts of artistry and technology” that punctuated human prehistory are best explainable by the push of population density. This one’s arguable, though. The record of human creativity is more gradual than Engelman suggests. For him, the “most interesting questions” about our cousins the Neanderthals may involve “sex and violence,” but for me they’re about the origins of symbols, art, ritual, and religion.

And not everything in our prehistory is best explained through pregnancy, birth, and population. It’s unlikely that humans began to migrate out of Africa because of “a prehistoric version of crowding.” It’s easy to think of our Homo erectus ancestors, first leaving Africa, speeding across continents at a good clip and making for a better life. But estimates show that these early people might have wandered relatively few miles per generation, perhaps in pursuit of game.

In any case, it’s no good mapping today’s psychology onto these two-million-year-old migrants. Engelman, writing about how ancient travelers on long journeys would have been forced to choose pair-bond partners from familiar individuals, notes jauntily, “If they were anything like the teenagers I’ve known, they would have much preferred meeting new members of the opposite sex.” When writing for the public, it’s a fine line between enlivening the science and betraying it: Engelman veers close to crossing that line here.

Most compelling of the prehistoric passages are those that show how women in antiquity, minus the pill, the diaphragm, or even a reliable condom, innovated in attempts to control their conception. This section could have been titled “pessaries in the past.” When a woman places some substance or item inside her body in order to block sperm’s passage into the vagina, that thing is called a pessary. Ancient pessaries included plugs of seaweed, oil of acacia, or -- here’s an image I prefer not to dwell on -- clumps of crocodile dung.

Engelman effectively lays out needs and choices of women in the modern world. Women and their partners today are “making a calculus about their lives, livelihoods, and relationships at any given moment. They’re aiming to maximize the satisfaction and pleasures of sex while minimizing its risks. Although intensely personal, collectively these childbearing decisions shape the dynamics and structures of human populations -- assuming the intentions are realized.”

Intentions are only realized where resources are available, as Engelman knows: “In sharp contrast to the herbs and practices women used to prevent pregnancy in the past, modern contraception requires quality control, global distribution networks, and careful and empathetic counseling from trained personnel.” He writes about reproductive health clinics with insight and ease. And in the “benefit of the doubt” section of this column, I don’t think he meant to propose a cap on schooling for girls worldwide at “nine or ten years.”

Engelman endorses making “reproductive health care for all… a public and political priority.” He goes after the media for their willingness to be seduced by the news topic of the day: declining family size in places like Germany and Japan. The global problem, he argues convincingly, is not population decrease.

Great, as far it goes. But Engelman’s optimism about the change-making potential of reproductive health care is a double-edged sword. The environmental damages of global warming, and the losses of animal-plant extinctions, are already considerable, and worsening. “We’ll still have to learn,” Engelman writes in a great understatement, “how to moderate our consumption of materials and energy and to jumpstart new technologies that conserve them.” Yes, I’d say so.
I started off with a comment aimed at Island Press’s marketers, and I will close with remarks for its editors. More is marred by too many typos, and other small errors. Spelling mistakes are numerous. “Hunter-gathers” appears for “hunter-gatherers,” more than once; “descendant” and “descendent” grace the same page. Anthropologist Tattersall becomes “Tattersal” and religion scholar Pagels is, once, “Pages.” Pessaries are introduced eight pages before they are defined. These are only examples.

Sometimes the mistakes are amusing. The Biblical, gift-bearing Wise Men become “The Wise Man.” The rhythm method is defined as when “couples refrain from sex at the time of the month when women are least likely to conceive” (uh, don’t try that at home -- the results might not be so funny).  

What do readers want? A book that works to empower women’s reproductive choices worldwide, even while it induces exasperation at times -- yes. Sloppy errors -- no.

-- Barbara J. King speaks at the Chautauqua Institution on August 20.