Reproductive Rights?

The photo is of Ana Maria, one of the mom’s in the nutrition group we work with. She is posed with her fifth child, the only girl. Ana Maria is always looking for money. Her kids walk around with mismatched flip-flops and snotty noses. Her husband works harvesting wood and comes home about twice a month and leaves her with about $6 USD until he comes back the next time. Sister Benedicta, one of the nuns who works at the chapel who sponsers the program, apparently would often bring up birth control in her visits to Maria when she had four children, proposing that perhaps four was enough. One of Ana Maria’s sons died last year of a flu that just wouldn’t go away. And before the sister could get her a date with a doctor to discuss some kind of birth control, Ana Maria was once again pregnant. This time sister benedicta was not going to let it happen again. She went and visited with Ana Maria in the hospital and talked with the nurses, who handed over some papers with a date to come back for an IUD.
But it still wasn’t quite so easy. The doctor had operated on a hernia that Ana Maria had aquired during her pregnancy, and according to Ana Maria, just tied her tubes while he was at it, so in her opinion, she didn’t need to get an IUD. Benedicta just assumed that she was lying because she was afraid of the IUD, so I went one day and visited her. “Oh, I’ve had one before,” she said, “it’s just that it gave me really bad cramps and I couldn’t go to my monthly check-ups because we lived out in the country. The doctor told me he tied my tubes, I don’t know why I’d need an IUD also.” The sister was not convinced. Her papers said come back in a month for the IUD, nothing else appeared in the care instructions. It is rumored that in order to do tube tying, the doctor must get the signature of the woman’s husband (which never happened). So, they took a trip to the doctor’s office to get the story. Apparently the doctor, upon hearing about Ana Maria’s life, took advantage of the fact that he was so close in the hernia surgery and just tied her all up at once. “And the papers, you ask”. Well, apparently the nurses filled them out upon talking with the Sister, unaware of what the doctor had already done.
I’m sure this story is not all that rare here, and in other places in the world. We tend to think about poverty and overpopulation being an issue of lack of access and bad information. But here, three blocks away from my sand filled street, there is a clinic that puts in IUDs for free. It seems though, there are problems in the administration, because I have heard horror stories of IUDs here, in one case a baby born with a T imprinted on his face (which I cannot confirm)! Anyway, I wonder what we should do when a mother is well informed of her options and still wants to continue having children. In the long run, I think the doctor did Ana Maria a favor. But in such a shady process of just using the power he had as a surgeon to decide the future of Ana Maria and her family, I’m not convinced it was the right thing. When it comes to a person’s will over their life, I don’t think it matters if it’s a doctor a nun or a northamerican volunteer with the best intentions, it isn’t our job to decide the fate of others.