We arrived in Guatemala late on Friday–my sister Patrice, Olivia, and I–and checked into (where else?) the Camino Real, the hotel where I met Olivia for the first time. Saturday morning we woke for a great breakfast, followed by a quick swim for Olivia and me, and then we were off to Antigua to catch the shuttle to Panajachel.
Right here I’ll pause for a commercial endorsement to recommend my friend and travel agent, Nancy Hoffman, founder of Guatemala Reservations, who made our arrangements. With Nancy’s help, everything was set up in advance, which I find essential when traveling in Guatemala, especially with children.
The shuttle ride, as always, was an adventure. People who travel to Guatemala are happy to be here, and we love sharing stories about where we’ve been and where we are headed. This past summer, heavy rains caused devastating landslides on the road to Panajachel and in surrounding areas. The damage has been cleared, although piled-up boulders and heavy machinery remain as evidence. We arrived in Pana with enough daylight to wander around for a few hours; afterwards, we settled on a chicken-and-french fries dinner at a restaurant we like. As we sat eating, a woman selling handicrafts approached us at our table. She introduced herself as the mother of eight children. On her back, in a sling, she carried her youngest baby, fifteen days old.
We’ll be in-country for a week, and I’ll write more about the trip, but this seems like the perfect opportunity to link to a great PBS NewsBlog by Ray Suarez, “Reporter’s Notebook: The Family Planning Frontier in Guatemala.” As our experience tonight demonstrates, family planning is a complex, layered subject in Guatemala, not easily summarized. But this article gives an excellent overview. Suarez writes:
…After two years on the global health beat, I sometimes shake my head in wonder at how some of the most beautiful places on the planet can also be the hardest places to live.
Guatemala has one of the fastest population growth rates in the Western Hemisphere, about 2.4 percent a year. The population is pushing 14 million, and there is not enough arable land to support the rate of growth.
Our team from the NewsHour visited villages where it has long been common to have 8 to 10 children per family. Women made their way along rural roads or up hillside paths with one baby on their backs, a toddler in hand, and a four-year-old pulling up the rear.
Children are valued and loved here. At the same time, big families exact a tremendous toll. The maternal mortality rate – 240 deaths for every 100,000 live births, according to the World Health Organization– is the highest in Latin America. Malnutrition is epidemic. In highland indigenous communities the tiny stature of children and adults is not solely hereditary. The short supply of food guarantees for now that Guatemala will not see the gains in height and weight, or the children towering over parents, seen in newly prosperous places like South Korea and China.
However, encouraging families to reconsider what the optimal number of children might be is more complicated than a quick lesson in microeconomics. To enter into the Guatemalan dialogue on family planning means taking history, gender relations, and religion seriously, and requires consideration of how each shapes the debate.
Guatemala is a deeply religious country. Even those who are not active church-goers grow up surrounded by Christian worldviews. No longer monolithically Catholic, the country has seen the grown of a vibrant, elbows-out Evangelical presence, which accounts for at least a quarter of the population. The Catholic Church, with its profound, 500-year old roots, and the energetic, emotional worship and deep cultural conservatism, make Guatemala’s consideration of family planning a far different one from that of North America or Europe.
Abortion is viewed as a terrible sin. Birth control pills, intra-uterine devices and diaphragms are suspected of causing illnesses in the women who use them. Implanted, slow-release contraceptive chemicals are catching on, but they are expensive and provide only limited-duration protection. Condoms are unpopular among men, and discouraged by the Catholic Church, which only advocates natural methods for family planning.
Women often begin having children as teenagers in Guatemala, and continue with regular pregnancies into their 40s. At one mobile clinic I met a mother with eight children ranging in age from 28 years to 16 months. She said the last few births had taken an escalating toll on her body, and her husband agreed with her decision not to bear any more children.
Accompanying her that day at the clinic was her daughter-in-law with an 18-month-old. Both women had bandaged upper arms, where contraceptive implants were just inserted. The young mother wanted more children down the road, she explained, but thought it best to give her first child the best possible start in life by spacing her next pregnancy.
We were told across the week that the acceptance of men was a vital part of making this all work. Big families confer status on proud fathers. That sense of pride discourages birth control, but contraception also has a darker side in the relations between men and women: When women try to get men to agree to their use of birth control methods, the men often accuse them of infidelity or promiscuity.
We visited the grave of a woman who died at 43 giving birth to what would have been her ninth child. Accompanying us to the graveside was the dead woman’s oldest daughter, Concepcion, and her husband, Diego. The couple said the death of the family matriarch did not cause them to reconsider their rejection of artificial birth control.