Opinion> Hillary Clinton> Talking It Over 1996 12 03

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Talking It Over

The pregnant woman wore an alpaca shawl over her blouse and full skirt, the traditional Indian dress in Bolivia. She looked about 35 and was attending a prenatal class at a health clinic I visited this week in the Bolivian capital, La Paz. She was nursing a 3-month-old baby and expecting her eighth child, who she hoped would be her last.

I was in Bolivia to attend the Sixth Conference of Wives of Heads of State and Government of the Americas. Women from countries throughout the Western Hemisphere got together to talk about strategies to eliminate measles, promote education reform and improve maternal health in our region.

Bolivia, a country of majestic beauty in the heart of South America, was an auspicious location for such a discussion. More women die in Bolivia during pregnancy and childbirth than in any other country in South America. But in the face of this human tragedy, Bolivia has become a model of how one nation can respond to the crisis of maternal mortality by galvanizing the government, non-governmental organizations and the medical establishment to launch a nationwide family-planning campaign.

In a country where half of all expecting mothers go through pregnancy and childbirth alone — without medical attention of any kind — Bolivia's aggressive effort to educate women about their own health and their options for childbearing is resulting in safer pregnancies, stronger families and fewer abortions. Without access to family planning, women in Bolivia — and in many developing nations — often turn in desperation to illegal, unsafe abortions that can end in death or serious injury. Deaths from abortion complications account for half of all maternal deaths in Bolivia.

As Bolivia has ably demonstrated, voluntary family planning teaches women about the benefits of spacing children several years apart, breast-feeding, good nutrition, prenatal and postpartum visits and safe deliveries. It also decreases the number of abortions.

Bolivia's success at preventing mothers from dying and lowering abortion rates has been possible, in part, because of help from the United States and other countries. The U.S. Agency for International Development has provided financial and technical assistance to help Bolivia establish a network of primary health care clinics.

The clinic I visited in La Paz is one that the United States helped start.

Called PROSALUD (which, loosely translated, means "for the good of health" in Spanish), the clinic has doctors and nurses who offer round-the-clock prenatal, obstetric and pediatric services, as well as counseling about family planning in a poor neighborhood of 15,000 people. In the first six months of this year, the clinic staff provided 2,200 medical consultations, delivered 200 babies, registered 700 new family-planning users and immunized 2,500 children.

There are obvious benefits of such a program to Bolivian women, children and families, but health and family-planning services also help alleviate poverty and contribute to the economic stability of a democratic ally in our hemisphere. Yet opponents of foreign assistance and particularly of family planning in Congress are trying to eviscerate U.S. funding for programs like the one I saw at PROSALUD. Some argue that the United States has no national interest in the health and well-being of other countries' citizens. Others mistakenly suggest that family planning is being used to encourage — rather than decrease — abortions. In fact, our government has prohibited funding of any overseas project that promotes abortion since 1973.

Ignoring this, Congress last year approved draconian cuts in family-planning assistance amounting to a 35 percent reduction in funds. To add insult to injury, the cuts were accompanied by new restrictions that delayed delivery of aid for the first nine months of the fiscal year.

Similar harsh cuts and delays are included in the current budget, meaning that many organizations could again be denied assistance for months and then receive it only in monthly installments.

According to a recent analysis by five population organizations, the funding cuts alone will result in an increase of 1.6 million abortions, more than 8,000 maternal deaths, and 134,000 infant deaths in developing countries.

Family-planning campaigns at work in Bolivia and elsewhere represent sensible, cost-effective and long-term strategies for improving women's health, strengthening families and lowering the rate of abortion. My husband's administration remains committed to the continuation of these investments. And I will do everything I can to ensure that U.S. support for these initiatives continues. If you share my concern, I hope you will add your voice to mine and give all women everywhere the same opportunities for their lives we take for granted in ours.