Afghan Mullahs Promote Birth Control to Save Lives

(March 2) -- Mullahs in Afghanistan are trying new strategies to prevent an ongoing health and economic crisis caused by high fertility and maternal mortality rates: They're passing out birth control pills and distributing condoms.

The tactics might come as a surprise, given that women living under the Taliban faced centuries of repression and intolerance, including bans on work, socializing and choice of husband -- often in the name of Islam.

But things are changing, and it's that same faith being cited as the motivation behind the bid to improve contraception use and reduce the number of births per family in the country. The average woman in Afghanistan rears six babies, despite a dearth of available medical care.

The progressive stance toward birth control was catalyzed by a World Health Organization project, done in conjunction with local Afghan health agencies. Researchers targeted 3,700 families in three communities. A total of 37 mullahs backed the project and even included safe-sex reminders during their Friday prayer sessions.

Other mullahs used quotations from the Koran that encouraged longer breaks between births, meant as time for breastfeeding and a woman's recuperation from the health struggles of pregnancy and childbirth. The quotations were also included on handouts distributed to women and men in the communities.

So far, the program has been remarkably successful. While an estimated 10 percent of women in Afghanistan use birth control, that number rose to 27 percent in the three targeted locales.

Health experts say contraception is starting to catch on in the country, which is also facing a maternal death rate that's exceeded only in Sierra Leone. Right now, 1,800 women die for every 100,000 live births. By comparison, the U.S rate is 15 per 100,000.

"The main take-home point is that for women who do not want to be pregnant now, it can be a double tragedy for her to die from a pregnancy she did not want -- especially when we could have helped her," lead study author Dr. Douglas Huber told The Associated Press. "The fastest, cheapest, easiest way to reduce maternal deaths in Afghanistan is with contraception."

Mullahs advised women that safe sex was 300 times safer than giving birth in Afghanistan and debunked widespread cultural myths, such as the belief that birth control pills cause permanent infertility. They also encouraged contraception among women at any age, from teens to older adults.

Although sex in the country was once a cultural taboo, the Afghan groups involved in the study now outrank the Vatican on empirical data regarding birth control. Last year, the Vatican's official newspaper published a story that linked birth control pills to unwanted abortions and cancer.

"If it is to regulate fertility, these are not the products required," the article said. "The natural means of regulating fertility, Natural Family Planning, are equally effective and also respect the person."

Despite preconceived notions about Islamic tenets, and Afghanistan's spotty track record when it comes to women's rights, Islam doesn't traditionally oppose birth control, vasectomies or abortions. The WHO report notes that mullahs expressed concerns over the health and safety of women.

The WHO now plans to implement the initiative nationwide. If it succeeds, Afghanistan will represent an Islamic stance that is more unequivocal about contraception than many mainstream American faiths. Among Jewish and Protestant groups, lines are increasingly delineated between sects that oppose contraception and those that prefer to promote safe sex over abstinence.

But the Afghan mullahs are hardly in the global minority. Most major religious faiths, including Sikhism, Buddhism and Hinduism, endorse contraception to reduce family size and infant and mother mortality rates.

Of course, the stance on contraception in Afghanistan is based on saving lives and reducing economic instability -- rather than simply facilitating more sex. That likely explains the difference in slogans between American and Afghan distributors. The oft-heard Trojan tagline, "Pleasure you want! Protection you trust!" has been swapped out by one manufacturer in Afghanistan, for: "Have a more comfortable life, make your family No. 1."