In the News, June 2024

Vast reproductive health and rights inequalities persist

UNFPA’s State of World Population 2024 report published in April showed that while significant achievements have been made over the past 30 years, major barriers to sexual and reproductive health and rights remain. The landmark 1994 International Conference on Population and Development (ICPD) in Cairo launched an ambitious Program of Action that aimed to address the needs and rights of all women and girls, but progress has been uneven and falls far short of what was promised.

For example, despite reductions in the maternal mortality rate, around 800 women still die from pregnancy-related causes every day, and progress on maternal mortality has stalled since 2016. One in 10 women globally still have no choice in whether to use contraception, while a quarter of women are unable to say no to sex with their husband or partner. The poorest countries and communities continue to experience the worst inequalities and injustices.

The report also warns that 13 out of 32 countries analyzed have, in fact, regressed on reproductive rights, driven in some cases by anxiety over low fertility rates. The authors point out the enormous return on investment that could be achieved by adequately funding family planning and education.

New global fertility projections may be too optimistic, considering current rate and recent pace of decline

A new set of global fertility rate projections by the Institute for Health Metrics and Evaluation (IHME), published in The Lancet, have been portrayed by media outlets as a shocking impending crash in the number of births worldwide. The study does not show this, however.

Using sophisticated models, the authors projected that the global fertility rate (the number of births per woman) will likely decline to 2.1, the replacement rate, by 2030, and to 1.8 by 2050. This contrasts with the authoritative UN models, which project that replacement fertility won’t be reached until 2055.

Another IHME study, published in 2020, projected a global population peak of 9.7 billion in 2064, followed by a slow decline to 8.8 billion in 2100 (over 700 million more people than exist today), while the UN projects over 10 billion people by the end of the century. It should be noted that some researchers believe even the UN projections are too optimistic, arguing that they overestimate the pace of fertility decline (see our interview with Dr. Jane O’Sullivan in our December 2023 magazine issue). Due to the difficulty of forecasting fertility, mortality, and migration trends, all population projections should be taken with a grain of salt, and we have no way of knowing which ones will come true.

While the new IHME study points out the socioeconomic challenges presented by very low fertility rates, it also highlights the fact that some of the poorest countries (most of them in sub-Saharan Africa) will likely continue to experience challenges from high fertility and rapid population growth for a long time to come.

Water woes: U.S. rivers impacted by overextraction, pollution, and development

The iconic Colorado River is of critical importance to over 40 million people and more than two million hectares of cropland, but decades of overextraction have depleted water levels to the point that the river now barely reaches its outlet in the Gulf of California. A new analysis published in Nature Communications Earth and Environment found that irrigated agriculture is responsible for 74% of direct human uses, which amounts to three times all the other direct uses combined. Cattle feed crops such as alfalfa and other grass hays are the main culprit, accounting for almost half (46%) of all direct water consumption.

The America’s Most Endangered Rivers of 2024 report by the organization American Rivers spotlights an additional 10 rivers threatened by human activity. At the top of their listed rivers this year are those in New Mexico, which lost all federal pollution protections in a recent Supreme Court ruling. Sackett v. EPA stripped national Clean Water Act safeguards for rivers and streams that only run during the rainy season or after snowmelt, which applies to many water bodies in arid New Mexico. Also among the top five most threatened are the Big Sunflower and Yazoo Rivers in Mississippi, due to large-scale drainage plans; the Duck River in Tennessee, due to excessive water use; the Santa Cruz River in Arizona, due to climate change and overuse; and the Little Pee Dee River in North and South Carolina, due to highway development plans.

Increase in young Americans opting for sterilization after losing constitutional right to abortion

According to new research, the number of 18–30-year-olds who underwent tubal ligation or vasectomy increased abruptly after the Supreme Court overturned Roe v. Wade in 2022, with a much larger increase in the number of tubal ligations. The paper, published in JAMA Health Forum, is the first to compare the permanent contraceptive choices of women and men after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which ended the constitutional right to abortion. As of early May, 41 states have abortion bans in effect with no or only limited exceptions.

The researchers found that after the Dobbs ruling, there was a substantial increase in sterilization procedures for both women and men, and that the increase in tubal ligations was more than twice as large as the increase in vasectomies. According to the authors, the fact that the increase in sterilization procedures was twice as high for female patients reflects the “disproportionate health, social, and economic consequences of compulsory pregnancy on women and people with the capacity to become pregnant.”