BIRTH CONTROL, FAMILY PLANNING AND ABORTION IN

DEVELOPING COUNTRIES ON THE CASE STUDY OF SAMOA

Dominika Pawlina1*
1
Instytut Stosunków Międzynarodowych, Wydział Nauk Politycznych i Studiów Międzynarodowych, Uniwersytet
Warszawski, Warszawa)
* d.pawlina@onet.pl

Abstract:

Complex analysis of current situation of family planning, birth control and abortion trends in
Samoa. As a small country situated in the Oceania with around 140 000 inhabitants that gained the
independence in 1997 is still struggling with social issues. According to newest data as one of the
most religious Christian counties consider family as important part of social life. Although big
families are part of the cultural structure of the country it is essential to discuss the lack of family
planning and birth control knowledge especially among young part of the population. Government
social programs that tends to help young people in the subject of starting family are insufficient and
often poorly exercised.

Keywords:
Abortion, family planning, inequality, Samoa

Introduction

In this paper I would like to discuss the issues of birth control policy, family planning, abortion
and general reproductive issues of a developing country on the example of Samoa. It is a very
interesting case for a research because of the isolation of the islands, history, customs and culture of
the people inhabiting this region, also the religion plays an important role in the lives of Samoans.
The aim of this essay is to address the struggles, solutions and predictions for the future that
Samoan people and government are coming across in the field of birth control policies. As a
developing country, with relatively high population growth and expected rise of the birth numbers
in accordance to death rate, improving policies considering the household outlining are an important
matter.
Education and development of country’s facilities, schools, hospitals are important but also
knowledge and sexual awareness are key elements for maintaining conscious society. That is why I
want to present current level of education and awareness about birth control methods among people,
especially in their reproductive age which is between 15 and 49 years old.
In this short article I would like to gather the most essential information related to sexual
education in the field of birth control, family planning and abortion. As for such small nation the
idea of family and having a descendant is really important in their tradition. Customs, culture and
religion impacts the decision on the new policies or upgrading the old laws, for example the issue of
abortion and it’s almost total prohibition.
Samoa as a developing country

Samoa, with its capital in Apia is an islands nation in Oceania in the South Pacific Ocean. It has
two official languages: English and Samoan. It is consisting of two, big, main islands: Savaii, Upolu
- with 3/4 of the population living there [1] - and a couple of smaller sized land parts that are mostly
periodically inhabited such as Manono, Namua, Aleipata, Apolima [2]. It functions as a first
independent country of South Pacific islands since 1st January 1962 [3].
Till the year 2014 Samoa was on the United Nations list of Least Developed Countries. With its
GNI per capita being 4,124$ for year 2018 and constantly growing Samoa’s economy is expanding
and improving each year [4]. Also, with its Human Development Index being 0.713 ranks it at
104th position worldwide [5].
Samoa has a majority of the characteristics of developing country economy such as low levels
of living and productivity, low levels of industrialisation and manufactured exports, adverse
geography, underdeveloped markets, colonial impacts and unequal international relations [6]. That
is also why economy is based on international overseas aid. As an island country, geographically
situated in a region of tropical downpours and tsunamis, with the last one that had hit east coast of
both Upolu and Savaii on 29th September 2009 [5], main focus of the economy is on agricultural
sector. Most of crops are coconuts and copra, which are also the main products of islands export. To
harvest those almost 80% of natural rainforest were cut out and reversed into tillage. Taking into
account that the entire land area is 3000 sq. km big, that is a massive loss for the unique natural
environment of the archipelago.
Low level of industrialisation, with only one developed industry branch which is the production
of auto-motive wire harnesses and closed market, are not only the outcome of geographic issues but
also an impact of the colonial times. Especially when we take into account that from the middle of
nineteen century till beginning of twentieth century the decision-making countries about the future
of Samoa were Great Britain, Germany and United States. In the year 1914 New Zealand took over
the influence at the archipelago, what was changed in 1947 when League of Nations established
Samoa as its trust territory.
As a developing country on the other hand Samoa is slowly but effectively expanding its
industrial potential. This development, on the other hand affects badly natural environment of the
island and unique and wild coastline [7].

Samoa’s population and its growth

Back in the year 2011 Samoa was inhabited by 187 820 people. The division of man in
accordance to woman are on the level of 90,830 females and 96,990 males. Percentage of people in
their reproductive age (which is between 15 and 49 years old) was measured and set to be 47% of
all women and almost 48% of all men inhabiting the archipelago. Total Fertility Rate was set to be
4.7 child per woman, which is the highest number among all of the Pacific Ocean islands. All this
numbers and measures gave the equation in which the number of people entering the reproductive
age in next years will be higher than the number of the population past this period. Scholars
assumptions were predicting the increase of population to 190 000 till the year 2015 [8]. This
numbers shows that the current situation of the archipelago is the demographic growth.
Referring to July 2017 demographics of Samoa which was over 200 000 [1] inhabitants shows
that the number is constantly growing. Also, the disparity between births and deaths still remains
big. Taking it all to the account the statistic shows that for every 1 000 people there are 20.4 births
per year [9] (birth rate) and 5.3 deaths [10] (death rate), which still gives the increase of
approximately 15.1 people for every 1 000 inhabitants.

Birth control policy and family planning

Given the fact that almost 1/4 of Samoa’s population are women in their bearing age the
awareness about variety of birth control is relatively low, numbers show that this occurrence is
visible in both groups - male and female. Contraceptive methods can be divided into two groups:
traditional and modern.
The traditional list is consisted of periodical abstinence method, withdrawn method, the lactational
amenorrhea method (LAM) and other folk methods.
The modern one contains oral birth control pills and injectable contraceptives, male and female
condoms, sterilisation (both for women and men), contraceptive implants, emergency contraceptive
pill, intrauterine device (IUCD) and the lactational amenorrhea method (LAM) [8].
Statistics shows that even if majority of the population in the reproductive age - around 70% of
females and over 80% of males - are aware of at least one modern birth control method only 30% of
female and 15% of male respondents admitted using them. Surveys also showed that among young
women (at the age of their twenties) prevention of pregnancy is much lower than in the age range of
30-40 [8].
Most common method of birth control are male condoms. Numbers shows that percentage of
man that knows and use this method is even 20% higher than females [11].
The method of intrauterine device is the least common long-term methods of contraception,
both because of the lack of the spread of the awareness and also the cultural issues and beliefs. Only
7% of the respondents can name it [11].
The use of sterilisation, especially female one, cause in the case of males it was used rarely, is
slowly disappearing. Started from 1990’s usage of this method is fading [8]. Speaking of male
sterilisation only 1% of man ever used it, it is also connected with traditional values and customs of
man-empowerment and status [11].
When it comes to the emergency contraceptive pill numbers are very low both when we talk
about the usage and the awareness. Only 0.1% of women of reproductive age admitted that they
used the so called “the day after” or “emergency pill” and less then 5% of females in their
conceptive stage acknowledge the existence of this method of pregnancy prevalence [12].
The education, location of living and wealth level is also an important issue when speaking
about birth control methods. Statistics shows that highest awareness and knowledge about
prevalence of unwanted pregnancy or just postponing the family planning time have women that
are: educated, from urban areas and also with highest material status in the permanent 5th quintile
[8].
Researches shows that with the passing time the number of women using contraceptive
methods is dropping in all age groups. That can be caused by various factors such as:
- health/family planning policies do not satisfy or convince the society
- it is the issue of bad sexual education and the low level of spreading the awareness of birth
control methods [8].
Usage and knowledge of traditional birth control methods, such as LAM or withdrawn method,
is higher among married woman. But in general usage of contraceptive methods is larger in the
group of married women that already have children. Research shows that over 37% of women with
5 or more kids use any birth control method in comparison to only 1% of married females that
haven't conceived a baby yet [11].
Accessibility to birth control methods is wide and government centred. Most contraceptives are
prescribed in government hospitals - 67% of all the prescriptions. It is followed by government
health centres and family planning clinics around Upolu and Savai’i. When it comes to private
sector the percentage of woman using private health care to get contraceptives is around 2%, so it is
relatively low. Also, the outlay for the most methods are covered by government or are not higher
than the fee for the medical consult [11].
Family planning initiative is one of government’s main concerns for now and for the future.
The knowledge and issues concerned with awareness of people and possibilities are spread by lots
of official governmental programmes but also NGOs programmes or Samoan Red Cross. Most
common and effective way of spreading the information are media. Television commercials and
radio ones are the most efficient, the least effective ones are commercials in magazines and
newspapers. In general knowledge and exposure to the family planning information and initiatives
rise proportionally to the level of education and wealth quintile [11].

Abortion in Samoa

Abortion is prohibited in Samoa. In the light of law there are only two cases when it can be
done: “An authorised abortion is an abortion performed by a physician upon a consenting woman
under the following conditions:
(1) the life of the patient would be endangered by continuance of the pregnancy; or
(2) the continuance of the pregnancy would substantially impair the physical or mental health of the
patient.” [13].
Apart from this 2 cases impregnation can be terminated not after the 20th week of the
pregnancy [14].
According to Samoa’s prime minister, that is a representative of government, admission of that
act is a sin [15]. Taking into the account that this country is very closely tied with religion,
Christianity is the major religion [1], so as in many other developing or even some developed
countries with religious background, abortion is prohibited. Also, any medical practices or doctors
providing or helping with proceeding the abortion on demand are prohibited and can be punished by
law [13]. According to “UN Human Rights Council Independent expert group on the issue of
discrimination against women in law and in practice” the unsafe abortion still takes place in villages
and especially rural areas and are done in a risky way [16].
Conclusion

The aim of this term paper was to examine how Samoan government is working on family
planning activities and how this action influence society in the area of outlining a household.
Authorities are popularising knowledge about birth control methods and family planning
programmes. This is an important matter because reports show that Samoa is an archipelago with
the majority of people in their reproductive age and the numbers will grow during the next years.
Traditional model of big family is still a strong cultural issue. That’s is also why young people,
especially women, do not use that often birth control protections. On the other hand, the occurrence
of usage of contraceptive is much more visible in the age section of women in their thirties or
among those that have already 5 or more kids. Traditional values, culture and religion has huge
impact on family planning in Samoa, but that doesn't impact education about birth control methods.
Although it affects perception of people about abortion which is prohibited, excluding only 2 cases.
That on the other hand do not stop people, especially in the rural areas of the archipelago, to
perform illegal, hazardous abortions. Reports shows that majority of young people are aware of at
least one of them, but also same numbers shows that only 1/3 of research participants are using any
contraceptive method.

Literature

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