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As a North Carolinian and an American, I have always had access to the contraception I needed throughout my life. I have used condoms, diaphragms, spermicides, pills, and the intrauterine device (IUD). The appropriate method was always available when I needed it to protect myself from a pregnancy, which I was not ready for or wanted to avoid so I could adequately care for my two growing daughters. That is not true for most women around the world. Today, on the fifth World Contraception Day, I reflect on this inequality. I also reflect on the role that North Carolina and IntraHealth International has served as one of the early champions for the international family planning and the population movement and how that influenced my decision to dedicate my career to reproductive health and, ultimately, global health.
On the year of my birth, University of North Carolina (UNC) established the Carolina Population Center (CPC) to address the “population crisis.” With initial funding from the Ford Foundation, The Rockefeller Foundation, and the United States Agency for International Development, UNC launched the CPC in 1965. It quickly became a preeminent, interdisciplinary center that introduced family planning programs and methods in North Carolina and in countries around the world. This early work put North Carolina on the global contraceptive map—and served as the early incubator for several non-profit organizations based in the Research Triangle in North Carolina such as FHI 360, which spun off from UNC in 1971; Ipas, which spun off in 1973;and IntraHealth, which spun off most recently in 2003. UNC CPC continues to be a top leader in the field, advancing population and reproductive health issues through interdisciplinary research, policy analysis, and academic training—and a source of innovation, scholarship, and collaboration for IntraHealth and others who work in North Carolina and beyond.
As I began my own public health career many years later in NC, I was personally inspired by many of the early champions of this movement. In 1990, when I began work with what was then known as Family Health International, Malcom Potts was just ending his 12-year tenure as CEO. Professor Potts is probably the single most outspoken advocate for the role contraception plays in the future of our planet. And he convinced me. The founding director of the UNC CPC, the late Professor Moye Freymann was still teaching population policy at the UNC School of Public Health when I received my master’s degree. He challenged us to critically analyze how population issues affect economic development, political stability, and the role of women. He encouraged me to consider a career in international reproductive health. With his recommendation in hand, I landed in USAID’s International Population Fellows Program in 1994. When I joined IntraHealth in 1998, I met another stalwart family planning champion, Dr. Marcia Angle. Dr. Angle regularly advised the World Health Organization on the developing evidence-based family planning eligibility criteria that minimized the all-too-common medical barriers to family planning access.
Over the decades, the field of reproductive health has evolved. Much has been accomplished—new contraceptive methods have been introduced; family planning methods are more readily available for many; and fertility rates around the world have declined. At the same time, much still needs to be done: unmet need for contraception remains unacceptably high for women in many countries; there is a dire need for more skilled and equipped health workers to meet the demand for long-term and permanent family planning services; and funding for international family planning is inadequate.
I am very fortunate to have control over my own fertility; and I am equally fortunate to be continually inspired by the many family planning champions who are struggling to eliminate the inequality between those who have access to contraception and those who don’t. Join me in taking a few moments to consider the role that contraceptive methods have played in your own life, to honor the family planning champions of our day, and to commit to advocating for increased access to contraception.
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