By Diana Wells

An eye-catching blurb on page 13 of the April 1, 2001 New York Times Book Review reads: "Welcome to [North] America, the land where having a child is the worst economic decision a woman can make." That is, unless she is a farmer. The book under review is Ann Crittenden's book entitled, "The Price of Motherhood: Why the Most Important Job in the World is Still the Least Valued," and the reviewer, Business Week's Catherina Arnst.

Crittenden's economic argument makes sense only within a social and cultural environment where value or status is defined in economic terms. Simply put, when women in North America bear children their value in the employment market goes down, perhaps irrevocably, because the United States' employment market privileges full-time over part-time work and penalizes those seeking to return to the workforce after periods of unemployment. Many use this fact to justify why, in North America, women earn 76 cents for every dollar that men make. The discrepancy in earning power illustrates that in North America, women's status is determined not only by their status as mothers but also by the potentiality of their child-bearing capacity.

In other parts of the world, such as India and Zimbabwe, where social entrepreneurs and Ashoka Fellows Harini Kakkeri and Betty Chishava are working, we see that women's status is also defined by their ability to bear children. In these societies where family forms or gender relations are defined differently from North America, and differently from each other, what remains strikingly similar in all three locations is that motherhood is directly related to women's status – be it economic, social or ritual.

From Family Planning to Reproductive Health

Since the 1970s the international women's movement has made access to family planning a priority, recognizing that women's status can be improved by giving women the opportunity to define womanhood in their own terms, whether or not it includes motherhood.

In the mid and late 1980s, feminists the world over critiqued the explosion of state-run, and frequently foreign funded, "population programs" designed to limit population growth through means such as forced sterilization, distribution of free condoms and other contraceptives – often with insufficient instruction and follow-up.

The problem with these programs, feminists argued, was that they failed to take into account the particular social and economic realities of the countries in which the programs operated, such as high child mortality rates that encouraged multiple pregnancies, or the benefits of several children for parents in the agricultural sector. This critique made a compelling case that women's bodies were seen merely as pawns "in the struggles among states, religions, male heads of households, and private corporations" (Sen and Grown 1987: 49).

That is, women's bodies – quite literally through their reproductive capacity – came under the scrutiny and manipulation of governments' population control programs, pharmaceutical companies' profit margins, religious platforms, and power inequities between men and women. The various players' agendas had one thing in common, argued feminists; they defined women first and foremost by their reproductive potential, yet women's voices were given little space in these struggles.

In 1994, the United Nations' International Conference on Population and Development (ICPD) brought representatives from more that 180 nations to Cairo, Egypt. The resulting agreement and 20-year Programme of Action marked a significant shift away from a family planning focus of contraception delivery to a concept of reproductive health that includes contraception and fertility, safe motherhood, reproductive tract infections and sexually transmitted diseases, and sexuality free from coercion and violence. There was also an explicit recognition of the "need to integrate population and development policies in ways that support women in both their reproductive and their economically productive roles" (ICRW 1999).

Since 1994, there has been an international mandate to recalibrate reproductive health care delivery systems to include explicit recognition that successful family planning necessarily includes a broader range of women's concerns including domestic violence, HIV/AIDS, sexual and reproductive rights and services. It is in the context that Harini Kakkeri began working in India and Betty Chishava working in Zimbabwe, fulfilling the Cairo mandate in very different ways.

In so doing, both Kakkeri and Chishava have taken an additional step and one that many reproductive health and population programs have ignored. It is a simple principle: that "motherhood is powerful" and gives women who bear children a social identity and status that they would not otherwise achieve (Sutton 1998).

Motherhood as a Social Identity

When women become mothers, they gain a new social identity, which is rooted in the particular social, economic, cultural and religious contexts in which they are situated, and which brings many such situated implications along with it. For instance, as mothers in India, Hindu women may perform rituals that they cannot practice until they have a child. As the mother of a son, a widow in India is ensured an inheritance that may be denied her if she has only daughters. Furthermore as mother-in-law to her son's wife, an Indian woman is no longer at the bottom of the household hierarchy.

In Zimbabwe, like India, motherhood has direct implications for inheritance. And as we see from Chishava's work, a childless woman in Zimbabwe is viewed with a superstitious eye and may be considered to bring bad luck – much as a childless widow is viewed in India.

Despite the ongoing challenges such as health risks and responsibilities that include providing for the child that this new identity presents, there is little doubt that access to family planning and reproductive health has revolutionized women's lives. It has allowed women to better handle their lives by reducing the number of children they have, and when, and to better provide for those they already have.

This still remains a difficult message to get across, however, in contexts where children offer economic gains either through their own earning power, or through the support of extended family members who contribute on account of kinship obligations to a child's rearing and well-being. Particularly in rural and agricultural settings, more children translates practically into more hands for labor or farm work. High child-mortality figures in these environments compounds the problem as it necessitates the need for more children so as to maintain the 'more hands' equation.

Apart from either ritual or economic arguments, women who become mothers also benefit socially. On the other hand, women who are unable to bear children – or those who make the choice not to have children – may suffer social stigma. Chishava and Kakkeri (featured in this month's Changemakers) address both sides of this issue. Their focus is not limited to the reproductive health concerns of women unable to bear children, but is also targeted at changing mindsets and a system that defines women according to their child-bearing abilities.

The Status Ladders Concept

Kakkeri and Chishava are building measures into their programs with an understanding that women gain social, economic and ritual status in motherhood. If women have no other source of gaining status, arguments in favor of "fewer mouths to feed" may fall on deaf ears.

The two social entrepreneurs address this issue by ensuring women the ability to achieve new statuses apart from motherhood. Their methods include access to education, information, and adequate and appropriate reproductive health care. They have also served to build a social network or social safety net around these women by introducing them to each other. Furthermore they have taken up the mantle of building awareness of these issues beyond the individual women that they service through their outreach and media programs. In so doing, they are, no doubt, making women better mothers.

FIGURE THIS OUT Some demographics from India that will make you sit up Since independence (1947), India's population has tripled to 1.027 billion Poverty (i.e., less that $1 per day earned) has declined from 36 percent to 26 percent Illiteracy has increased from 52.5 percent to 65.4 percent Literacy Figures By Gender 562 million men are literate (3/4 of male population) 337 million women are literate (only one-half female population) Cause for Concern Between the age 0-6 years, India's female-male ratio stands at 927:1000 The census lists the following as causes for this: sex-selected female abortions, female infanticide and neglect of the girl-child (e.g., giving girls less food and less medical care than boys) SOURCE: India 2001 Census figures from Gardner (2001)