The Crisis Brewing Around Women’s Access to Birth Control


There is a crisis brewing, and it’s about women’s access to birth control around the globe.

Due to cuts in funding, NGOs and pharmacies are struggling to provide African women with effective birth control.

Enter a pharmacy in Uganda, for example…

You will see shelves full of condoms that nobody wants to use. And pills women can’t use for safety reasons.
Yet the contraceptive shot? Nowhere to be found.

This is the reality the women of Kirindi face right now. It is representative of a crisis rippling across the entire developing world.‘s Founding CEO, Siobhan Neilland, explains, “The pharmacies are not stocked up with adequate birth control. We spent the last 10 years working to ensure that women had access to birth control, specifically, the birth control shot because it is safer for women to use due to domestic violence issues, and it is now difficult to get a hold of.” Since the Global Gag Rule passed in 2017, access to contraceptives has become a challenge.

It is a real crisis that is not getting a lot of attention. And it’s having a dire impact on African women, specifically.

Since the introduction of contraceptives by the OneMama Clinic in 2009, the birth rate in Kirindi steadily declined. But in the last year, it has started to rise again.

Siobhan explains, “When I first arrived in Kirindi, we were averaging ten to twelve deliveries a month, and then with the introduction of contraceptives and education around family planning, it gradually decreased to an average of four births per month. In the last year, it has risen to an average of five births per month.”

What’s happening in Kirindi is a microcosm example of a problem rippling across developing nations.

“When you take away women’s rights to birth control and family planning, you increase their poverty and decrease their power.”

Uganda Birth Clinic

Sarah Boseley, health editor at The Guardian recently wrote, “The effects will be felt most keenly in the tiny, front line clinics run by small NGOs struggling to help women and children in crowded townships, refugee camps and remote rural villages. There are no abortion doctors in such places (in most African countries, abortion is banned unless the woman’s life is in danger). These clinics instead offer contraceptive injections and condoms for those who struggle to feed their numerous children. But they also treat children for malaria and malnutrition and their mothers for HIV. This integrated care is now under threat.”

Siobhan reflects, “When you take away women’s rights to birth control and family planning, you increase their poverty and decrease their power.”

Access to birth contraceptives is the first step in women’s empowerment and poverty prevention. When that access is threatened or curtailed, it is an assault on women. And it is poor women who suffer the brunt of the attack because they already lack access to resources.

OneMama Clinic - Births on the Rise

Whether they are in the US or in Uganda, the poor are marginalized, and their access to power is limited.

In Melinda Gates’ new book The Moment of Lift: How Empowering Women Changes the World, she writes, “It took us years to learn that contraceptives are the greatest life-saving, poverty-ending, women-empowering innovation ever created.”

Unplanned pregnancies create obstacles in the path to economic security for women. Raising children requires an enormous amount of resources, time, and care-giving. A woman’s ability to work and pursue an education are challenged in developing nations where multiple children are the norm and poverty is widespread. Additionally, women are forced to take on the majority of unpaid labor. Women face further restrictions through domestic violence, sexual assault, and abuse, which are prevalent in places such as Uganda. Furthermore, women are still unable to own property in rural Uganda. It is not uncommon for women to face beatings by their partner if they get caught taking birth control pills. This is one of the reasons contraceptive shots are so popular among the women. They are able to conceal their use of birth control from their partners preventing physical violence from their partners.

Gates writes, “In my travels, I’ve learned about hundreds of millions of women who want to decide for themselves whether and when to have children but they can’t. They don’t have access to contraceptives. And there are many other rights and privileges that women and girls are denied.”

From ending domestic violence to ensuring the education of girls to economic empowerment, access to birth control is the single factor that makes all of that possible.

Siobahn Neilland explains, “We see that when women lack access to birth control, it directly affects OneMama’s economic and sustainability programs. Women drop out of our programs due to the onslaught of obstacles created through unplanned pregnancies.”

Contraception is the grounds for economic empowerment. Access to birth control allows women to postpone childbearing and to take up previously unattainable education and career options. In a largely Agrarian society such as Kirindi, the ability to space out pregnancies allows women’s bodies to recover before returning to the grueling work of farming. Otherwise, they go from pregnancy to pregnancy while working in the field with no time to recover physically or financially.

OneMama’s mission, in part, is to provide access to contraception for the local women the OneMama health center serves. Women’s economic progress benefits society as a whole.

Contraception has arguably been the most liberating technology for women. It is the key to self-determination for women. It empowers them economically to be able to take control of their destiny as men have always been able to do and take for granted.

In a recent Washington Post op-ed, Kathryn Kaufman, the Managing Director for Global Women’s Issues at OPIC, wrote: “Full sexual and reproductive health rights are a key factor in achieving women’s empowerment. We know that when we can choose whether to have children and how many children to have, their lives are improved. They are more likely to participate in the labor force and more likely to stay in school longer. They increase their earning potential… My own experiences and the overwhelming research data on the topic have convinced me that women must have full sexual and reproductive health rights to have full control over their lives.”

Stigma to Contraceptives Uganda Africa

There is also cultural resistance to condoms, they carry a stigma. For many Ugandan women, there is a negative stigma associated with condoms because of their role in HIV prevention. Using a condom is considered to suggest that your spouse is unfaithful. The contraceptive shot is practical, convenient, and doesn’t have a negative stigma. It is the preferred method of birth control among many women in developing nations. Yet, access to the shot in recent years has been restricted. And we are starting to see birth rates rise again due to this restriction.

According to the Center for Global Development, “Development is about more than improved living standards or a better quality of life. It is being empowered to make choices about one’s own life.”

Self-determination for women begins with reproductive rights, and the struggle to achieve gender equality is global.

The solution begins with access to contraception.

Gates writes, “How can we create a moment of lift in human hearts so that we all want to lift women up? Because sometimes all that is needed to lift women up is to stop pulling them down…When we lift up women, we lift up humanity.”


We here at the OneMama Health and Community Center feel that if we can empower every woman and her family in her maternal health choices, it changes the life of each baby born and also changes the mothers’ ability to be a working economic sustainable community member. This changes the emotional, physical and economic dynamics of what each child is born into, as well as the family as a whole. Thus impacting a community to become thriving as a whole over time. Creating a holistic approach of looking at the family and community seems to always start with the girls/women who will become the mothers of that community. The next thing is to give them the tools they need. The number one tool is birth control.

Donate directly to’s Birth Control Program here:

OneMama is a 501(c)3 nonprofit organization and your donations are tax-deductible.



  1. […] Our OneMama Health Center was fortunate to secure about 1 month’s worth of medical supplies such as antibiotics, birthing kits, gloves, pain medication, birth control (pregnancy rates have already increased due to the pandemic and access to birth control is an ongoing challenge for OneMama — read about that here). […]

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