A trip through Mexico and Guatemala, where family planners learn to practice the art of the possible
by Mary Jo McConahay
Twenty-five years ago I lived in a small town in Mexico, where the oldest women
still spoke the ancient Aztec tongue and families were big and poor. One fine day, young
men started showing up in the market square wearing government-distributed T-shirts
featuring a cartoon character in the unmistakable shape of an erect penis with a happy
face. In the first two frames it pulled a condom over its head and wiggled in, saying,
"Almost . . . almost . . ." until, snug and smiling in the last frame, it
announced "Ready!" About the same time, an authoritative voice declaimed from
battery-powered radios on windowsills: "Small families live better!" I remember
gazing across the dusty plaza with its venerable stone Catholic church, up toward rocky
outcrops where a pre-Columbian shrine stood almost lost in a cloud, and thinking that
something new and different was in the air.
Today in Mexico City (population 21 million), the air is choked with industrial
pollutants and the exhaust from millions of cars. Some days stinging tears drip from your
eyes upon waking, and walking the crowded streets is an exercise in pain. But talk to the
government family-planning officials who, since 1974, have implemented a vigorous state
policy to cut family size, and they'll look you straight in those itchy red eyes and say
that it might have been much worse. Without Mexico's free birth-control services, they
say, the nation's population would be 134 million rather than 96 million.
Population Council has promoted endless "small families" advertising campaigns,
starting with radio spots-like those I heard so long ago-then quickly saturating
television. Mandatory sex-education classes now reach a second generation of
schoolchildren. When I lived in that small town carved from stone and green cliffs, the
average Mexican family had 7 children, rural households even more. Today the national
average is 2.5 children per family, and the council, which oversees what it calls Mexico's
"silent demographic revolution," is aiming for 2.1.
With its numerical goal nearly reached, Mexico is emphasizing other benefits of family
planning, like better relationships between couples. High above Mexico City's din, I found
the Population Council's Secretary General Rodolfo Tuirán in his penthouse office,
delighting in his latest television campaign, a series of mini-soap-opera ads in which two
men argue about whether family planning is "men's business too." A grinning
Tuirán bent forward from the sofa and quietly revealed how the series would end, a few
months hence: "The macho gets a vasectomy."
This earth is now home to almost 6 billion people, but the global population growth
rate is slowing, and is lower today than at any time since the Second World War-thanks
partly to state activism in countries like Mexico. Next door in Guatemala, where the
government does not support family planning, population continues to grow very rapidly,
2.65 percent per year. Even so, effective local programs have taken root. With or without
government support, the most important work is done not in penthouse offices but in the
shantytowns and scrubby outlands where the real decisions about sex and children and
survival are made.
A dirty, trash-laden rivulet on the outskirts of Mexico City-the only reminder
hereabouts of the once great Lake Texcoco-marks the entrance to Chimalhuacán. Rising
haphazardly from the drained lake bed, this community of tin-roofed, jerry-built shacks
and cement-block shops is taking on an air of permanence. Chimalhuacán grew from 60,000
inhabitants in 1980 to 412,000 in 1995, fed by the emptying of rural areas into the
largest city in the world. To jobless newcomers dreaming of work in the capital, however,
this is not a slum but a place of hope. Chimalhuacán is, in many ways, Mexico's future.
"We've just bought a small lot, and will finish paying for it little by little
over time," said a determined-looking Bélen López, a 22-year-old housewife whose
husband had found a job as a microbus driver. Mother of a 14-month-old, López had come to
check out the display of contraceptive methods that is set up daily in the Chimalhuacán
marketplace. "I want two children, but this is an impossible moment to have the
second," she told me as we stood near wooden planks hung with anatomical drawings and
López rejected the condoms, because-in a comment I would hear
echoed everywhere I went in Mexico and Guatemala-"my husband says you don't use those
things between husband and wife, only with prostitutes." She also turned down
birth-control pills, expressing the widespread belief that "pills can make you
sterile." (In Guatemala, they say "the Pill goes to the brain.") A promoter
from Mexfam, a private organization that pioneered family planning almost a decade before
the government unveiled its own policy, carefully explained the intrauterine device.
López said she would think about it, and went off under the grayish sun to finish her
shopping. If López decides on the IUD, she can go to a government clinic for free or, for
a small fee, to a Mexfam clinic where service is more personal.
Mexfam's outreach operation is on the porch of a state-subsidized milk shop, where a
thousand poor families line up daily with buckets. Such strategic placement, a key element
for success, would be impossible without state support. Indeed, Mexico's shrinking rate of
population growth (from 3.5 percent in 1974 to 1.88 percent today) is widely cited by
international planning experts as an example of what can be done when there is political
will at the top.
It wasn't political will, though, that made López want to limit her childbearing; it
was Mexico's terrible economy, which has suffered one crisis after another since 1982. In
1994, the year Mexico joined the United States and Canada in the North American Free Trade
Agreement, the peso was worth about 33 cents; today it's worth a dime.
Milk-shop manager José Manuel Villegas, 44, nodded toward the display. "People
submit themselves to this because of the price of living," he said. "My brother
has fifteen children, but you can't afford to have more than three today." Two
decades ago fewer than one in five Mexican women worked outside the home; today more than
one in three do. A mother of four who labored as a laundress told me: "I took the
IUD. I knew if I had more children, buying shoes for one meant the others would go
barefoot. I don't enjoy my lousy job and low salary, but I work because if not, we don't
survive." Another reason for Mexico's slowing growth rate is the emptying of the
countryside. Today seven out of ten Mexicans inhabit communities of 15,000 or more; of
these, 70 percent live in two dozen major cities, all of which have scrappy Chimalhuacáns
on their fringes. Soon after the turn of the millennium, half the people on Earth will
live in cities.
"Urban life implies individual control of decisions such as birth control,"
said Rodolfo Tuirán. In the city, he said, a couple who decides against a traditional
large family meets "less stigma and fewer social sanctions." No overbearing
relatives, no whispering guys you grew up with; instead, neighbors on both sides who have
only two kids and are not ashamed of it.
Seven hours north of Chimalhuacán, I stood on top of the world, 8,700 feet above the
Guana-juato River, breathing the cold, crystalline air of the Santa Rosa forest. Around me
were 14 species of oak, a sea of dark trees that met the clouds. Ruth Peacock, copresident
of the Mexico Audubon Society, boasted of 135 bird species: northern flickers,
gray-breasted jays, yellow-eyed juncos, acorn woodpeckers, and enough hummingbirds to fill
We descended hairpin curves to villages that are as much a part of the forest's future
as its seed-dropping birds. Our odd caravan included environmentalists from Guanajuato, a
team of young sex educators from the Center for Adolescents of San Miguel de Allende
(CASA), and two river-restoration experts from the U.S. Forest Service, Bill Zeedyk and
Chuck Troendale-all part of a collaboration between environmentalists and family-planning
groups that is all too rare. "Environmental organizations toot their horns about
population and environment," said CASA founder Nadine Goodman, "but they don't
want to get involved with s-e-x."
We left the cars behind in a small community called Calvillo and walked up the stream,
most of us slipping and getting our boots wet in an effort to keep up with the foresters.
"You could move this road-that'd be a good start," said Troendale.
"Planting a few trees over there would eliminate the problem of that deteriorating
bank," mused Zeedyk. "Nice sinuosity though-got to keep that." The young
sex educators dutifully scribbled everything down. Here in the countryside, successful
family-planning programs rarely begin with a stark display of devices like the one in the
Chimalhuacán marketplace. Rather, they look at more concrete and immediate concerns, like
disappearing wood for cooking fires, and vanishing rivers.
"If we are going to work in this community, we must know its specific
problems," said Alejandro Vega, coordinator of CASA's Ecology and Sex Education
program. Aware that rural communities are suspicious of outsiders, Vega and his team spent
days beforehand knocking on doors in Calvillo, assuring housewives and the local priest
they were not evangelical missionaries and passing out leaflets about CASA's offerings
such as medical care, courses on sexuality and ecology, and free HIV testing. Next they
invited the women to classes; the teenagers come first, then their mothers, shyly but then
enthusiastically, to learn recipes for healthful, cheap foods, even how to make medicinal
ointments and cosmetics from wild herbs and fruits.
Such classes are held on the edge of dirt playgrounds so children can occupy
themselves, or under spreading trees because it's the only place shaded from the sun. The
women learn new dishes (soybean salsa) and how to make avocado face masks. ("Don't
make her laugh while it's drying!") But they also learn self-esteem and how to make
independent decisions-all precursors to taking family planning out of the realm of fate
and tradition and putting it into the women's own hands.
In Calvillo, helping townspeople keep their river flowing, in addition to the dividends
for the land and its bird and animal life, is a way of building trust. It does no good to
say (and indeed may not even be true), "You're having too many children and this is
why your mountains are degraded and your lives are falling apart. Here's the answer: birth
control." Instead, said Vega, "Our idea is that sexuality is not only about sex,
but has to do with how we live and interact with each other. And that's what you could say
about concern for the environment, too."
This vision started 18 years ago when Nadine Goodman, then a Columbia University
social-work intern, came to Mexico to learn Spanish, fell in love, and stayed. (She and
her Mexican husband, Alejandro González, now have three children.) First she traveled
alone in a beat-up VW bug, giving sex-education classes in schools and gaining an intimate
acquaintance with the interminable ranchos of central Mexico. Her program now reaches
50,000 people a year, mostly in the hardscrabble region surrounding its headquarters in
the colonial town of San Miguel de Allende. Facilities there include a sunny,
well-equipped 12-bed maternity hospital and a new professional midwife school and
At the heart of the program, however, are the peer counselors
like Vega and his team. They include school dropouts, girls who became pregnant too young,
or men who, as one said, "once thought like everyone else, that women were there to
serve me." At CASA, they are trained to be sex educators and to speak to couples
about domestic violence. They are heeded because they carry the authority of their own
Counselor Teresa Acevedo is a 33-year-old single grandmother. (Now that's authority.)
"We look like ghosts sometimes when we arrive, with the white dust covering us from
top to toe," she said laughing as we walked a hot, powdery road with her 24-year-old
partner, Edgar Francisco Galindo. We were some 25 miles northeast of San Miguel in a
dry-season universe of harvested cornfields and miles of yellow sunflowers turned to
millions of brown stalks. Only the maguey and the cactus brought green relief. Acevedo and
Galindo were making their weekly round to teach sex education to fifth- and sixth-graders.
Few kids here, especially girls, go beyond primary school, and marriage and babies come
early. "Your sex-man or woman-doesn't depend on what you wear or how you talk, but on
what you are physically, how you were born," Galindo said in the classroom, as
Acevedo unrolled anatomically correct drawings. The kids were rapt, with only an
"What am I?" Galindo quizzed. "A man!" the kids cried out.
"Look, I wear an earring," he said. "A woman!" shouted a couple of
boys. "We'll talk about that later," he said firmly.
The countryside remains the domain of big families. But when I asked dozens of young
women how many children they thought ideal, not one gave the once-standard response:
"The number God wants." Instead, all wanted fewer-often less than half-than the
number their mothers had. And often their mothers were right there, supporting their
"It's a matter of justice to the children themselves, not to have so many,"
said 52-year-old Maria Ramirez, who had brought two teenage daughters to a rancho meeting.
"I married very late [at 27], so I had only eight, but still we couldn't afford the
bus fares to send the girls to school. In my time, no one said anything like this to us,
about how to avoid it."
A CASA team had hung teaching posters from the branches of a huge tree. Ramirez, a
weathered-looking woman, elevated her feet on a rock to ease pain in legs riddled with
varicose veins. She fixed her eyes on her daughters, beautiful young women who studied the
posters, occasionally nudging and whispering to each other, digesting information.
"For them it can be different," she said.
Guatemala is next door to Mexico, but worlds apart in its social policy. There is no
state support for family planning, and important sectors of society-especially some
ultraconservative Roman Catholic religious associations and evangelical Protestant
sects-intend to see to it that there never will be. (Mexico's revolutionary history
relegated the church to a far less powerful position there.) In 1994, Guatemala joined a
handful of countries siding with the Vatican at the United Nations International
Conference on Population and Development in Cairo, refusing to sign chapters of the final
agreement that committed governments to support planning and reproductive rights. One
result of this posture is that many people equate family planning with abortion while
others see it as a euphemism for darkly manipulative "population control" of the
Yet the desire for a better life is still there. As in rural Mexico, Guatemala's
successful family-planning programs link information and services to activities that give
women greater autonomy. Outside the city of Quetzaltenango in southwestern Guatemala, in a
valley formed by volcanoes where massive pine forests are giving way to new villages, I
visited a workshop where boys weld wrought-iron creations. In another workshop an hour
away, girls embroider their own designs onto full cotton aprons. At both places,
adolescents spoke animatedly not only of the products they might sell for cash but of the
weekly sex-education classes that came with the package.
"I come because I learn to make the aprons, to be with others outside the house,
and I get my questions answered," said 16-year-old Jacinta, a Quiche Maya Indian.
"I come because this is something I can do for myself," said her friend
Angélica, age 17.
"Here girls are married and having babies by age fourteen or sixteen, so the goal
is to delay the onset of sexual relations for both boys and girls," said Dr. César
López Tellez, cofounder of the Institute of Integral Education for Health and Development
(IDEI). "But if we say we're going to give a class in rights and respect, or sex
education, no one will come." In his modest Quetzaltenango office, López rose to
stand before a small window, and spread his arms. "Imagine if this window were this
wide, how much bigger the panorama would be, how much more you could see! That's what we
are doing dying of diarrhea and respiratory infections," Huinil said.
is Amalia Bautista, a 32-year-old mother of four whose father, José, was assassinated in
the 1980s, like so many Indian leaders. Huinil, Bautista, and others have introduced
safer, more efficient wood stoves to 200 houses ("our greatest success so far,"
says Huinil), have held freewheeling women's group discussions (including about birth
control), and manufactured inexpensive natural medicines against intestinal worms,
diarrhea, and parasites. They don't have the ubiquity of Mexfam, or a link to fine medical
care like CASA's, but for the first time, Cajolá women are hearing that sex with their
husbands-especially when they are drunk and abusive-is not obligatory. They are learning
"We are destroying the idea that only prostitutes know how to take care of
themselves," said Huinil. She and Bautista distribute "necklaces" of red
and green beads to women who want to keep track of their fertility cycles. I think back to
the words of a planning expert: "If clients believe only natural birth control is
acceptable, then tell them how to do it well."
Five hours east, in Guatemala City, I met Dr. Karen Slowning, program officer for the
United Nations Fund for Population, who explained how not to promote family planning.
"Don't impose," she said. "Don't carry the message 'reduce population,' or
your program dies; instead, you are there to improve the quality of life. And don't, don't
In Mexico and Guatemala, the church hierarchy is unmovable in its opposition to birth
control by other than the rhythm method or abstinence. But respect for religion does not
necessarily lead to large families-as in Mexico, where nine out of ten identify themselves
as Catholic. In Guatemala, women who would like to use birth control but do not do so
rarely blame "the church." Instead, they say, "My husband won't allow
it." I commonly heard stories about village padres who preach responsible parenthood,
Pap tests, and the benefits of later marriage. Program officers told me about places where
they could not operate without such support. "I see the Church opening slowly,"
CASA volunteer Abel Suaste, a 27-year-old catechist, told me. "When the local priest
is more with the people, like the one here, we speak of such things."
What do successful family-planning programs share? Outside Mexico City, in central
Mexico, and in western Guatemala I heard the same answers: link planning to other
problem-solving activities. Make sure men see themselves as stakeholders in smaller
families. And, as planning pioneer Peggy Curlin put it, "What's most important is
nurturing support groups among women themselves."
These ideas are woven through successful family-planning efforts as surely and tightly
as local Indian women weave brightly colored threads into their clothes. No one has to
create the desire for these services because most parents already want to give the best
possible opportunities to children already born. In the valley outside Quetzaltenango,
carpenter and evangelical preacher Matías Santos Pérez, a 45-year-old father of nine,
loans his dirt-floor workshop to the iron-welding and sex-education program.
"Before, to speak of sex wasn't done," he said. "That's why I support
the project." Santos watched as his 11-year-old son, Luis, lowered a 60-pound load of
gathered firewood from his head, so the family might have heat and hot food tonight.
"They have to be able to live better," he said quietly, "than the life I
have been able to give them."
Mary Jo McConahay writes frequently on Central American and international-
The Sierra Club's International Population Stabilization Program supports increasing
access to family planning and reproductive-health programs, equity and empowerment of
women, and efforts to reduce consumption. For more information, see http://www.sierraclub.org/population.