Choice and the Age of Peak Child

Planning for a better future and believing your child will live is an afterthought for most American parents. Most American mothers are free from worrying that their child will die an untimely death from injury or disease -- much less a preventable ailment like diarrhea, which kills over 2100 children every day.

But imagine your motherhood held no such promises. Imagine having to take into consideration the fact that it's likely at least one of your children will die before the age of five. How does that affect the family that you plan for? How does that affect the future that you plan for your daughters or sons? How would it affect your own sense of the future, and of plans for your life?

These are the realities faced by our world's poorest mothers. And though the child mortality rate is at its lowest ever, it is a reality no less painful for the mothers who live it.

In their annual letter, Bill and Melinda Gates outline three popular myths that block progress to the poor. The third myth, outlined by Melinda, is that "saving lives leads to overpopulation" -- the belief that some people in poor countries have "too many" children and that if we saved all of them from dying, the world would become overpopulated.

At first glance, it's a bit of a brain twister, and a shock to the sensibility of many American parents. But think back again to the mother who must plan for the untimely death of one of her children. In places where child mortality rates are high (the chance of a child dying before the age of 5 is at or above 20 percent), women tend to have more children. As history has shown us, as child mortality rates decline, the size of families declines as well. A woman no longer needs to have more children to make up for the ones she might lose.

It comes down to education, and to choice.

Women's empowerment and access to contraceptive care that they need is the key to lifting families out of poverty and stabilizing our world's population. Women who marry older, stay in school longer, and are provided with reproductive education and access to contraceptives and family planning needs have families that are more stable and healthier. Having children you plan for, children with a strong chance of survival, actually creates smaller families.

The Gates' letter includes a great video from Hans Rosling, a professor at the Karlinska Institute in Sweden. By his estimation, we are in the time of "Peak Child" -- there are more children on the Earth now than there ever will be again. As governments and organizations like the Gates Foundation continue to make even greater progress toward lowering the child mortality rate, women will have fewer and fewer children. And as women's empowerment increases as well, the effect will be even greater.

The idea that we could enter into a time when a majority of the world's women (and men) have their children by choice, and plan for each child with a sense of hope, will surely create a new era. Even in the U.S., access to family planning is an economic determinant: A recent study from the Guttmacher Institute found that the majority of women say they need birth control so they can finish their education, keep a job, or support their families. Unintended pregnancies, on the other hand, are linked to economic hardship.

Of course, we are very far away from that: over 220 million women want but do not have access to contraceptives.

We need to trust women; we need to empower women. Whether that be at home in the United States or in the world's poorest nations. We must insist that our daughters receive an excellent education, that they are able to marry when they want, that they have access to the health care and reproductive education they need to make their own decisions. Poverty will persist without these things.