Have you seen Obianuju Ekeocha's open letter to Melinda Gates? If not, go read it now. It's a powerful example of the fact that what women in developing countries actually want is not always the same thing as what wealthy women from first-world countries think they might want. An excerpt:

And of course there are bound to be inconsistencies and failures in the use of these drugs and devices, so health complications could result; one of which is unintended abortion. Add also other health risks such as cancer, blood clots, etc. Where Europe and America have their well-oiled health care system, a woman in Africa with a contraception-induced blood clot does not have access to 911 or an ambulance or a paramedic. No, she dies.

It reminds me of a discussion I had recently in which a woman approached me after a talk and demanded to know how I could support the Church's teaching against contraception. She explained that she had worked in an impoverished part of the world. Not only were women there struggling to get the most basic necessities, but they also lived in a culture where it was frowned upon for wives to reject their husbands' sexual advances. She scoffed at the idea of Natural Family Planning, explaining that it would never work in these situations. Contraception, she said, was the only hope for these women.

Unfortunately I didn't have the time to flesh out the issue with her, and she had to leave before I could give more than a couple of words in response. But I have thought of our exchange often, and have pondered this most difficult of issues in the months since our chat. If our paths were ever to cross again, here are the points I'd like to discuss with her:

First of all, if it's true that these husbands care so little for their wives that they disregard their wishes to avoid sexual activity, what makes us think they'd use contraception? If these husbands wield that kind of power, and if their consideration for their spouses is that nonexistent, then it's absurd to imagine that they would faithfully use condoms. Even if the wives had access to female contraceptive methods, is it likely that their husbands would approve the time and expense necessary to acquire these things? We are probably not talking about people who have cars, extra cash, and a drugstore down the street. Would such a husband be okay with his wife being gone from the house for hours at a time to walk down to some clinic to get her birth control? That image seems more preposterous to me than the image of these men abstaining occasionally to practice NFP.

Also, what message does the contraceptive "solution" send to women in these situations?: We are aware that you are in unhealthy relationships that veer into sexually abusive territory...so here are some condoms! It seems that a truly compassionate solution would be one that works to address the root of the problem, rather than throwing a Band-Aid over the situation in the form of condoms or the Pill.

My biggest concern, however, is the one that Ms. Ekeocha articulates so well in her letter: We need to be very, very, very, very careful about assuming that women in developing countries wish they had fewer children. Even in cases where women are not considered equals in marriage the way Western women are, are we sure that they yearn for small families? In places without stable social services programs or reliable police forces, a woman's protectors are her kids. If her husband's behavior goes downhill and he becomes violent or unstable, or she faces trouble of any other kind, her mostly likely defense is older children who can intervene on her behalf.

In a similar vein, her children are also her retirement plan. Women in these kinds of areas don't have 401Ks or state-run nursing facilities to fall back on. When they get too old to work, they are utterly dependent on their kids for survival. And when nobody has extra money and everyone toils all day just to get by, it's far easier for, say, eight children to share the duties of caring for their aging mother than it would be for two children. (I often wonder if these organizations that push contraception on impoverished women also set up retirement funds for them.)

Our family is friends with an immigrant family in which the seven children grew up in utter poverty. They didn't own beds, pillows, or even blankets. The kids dug through the local landfill to find toys. It was a brutally hard existence, one in which starvation was a reality that they worried about regularly. Though their mother didn't face the abusive situation that women in some cultures do, she had her crosses in her marriage. I've had many discussions with them about what life was like back then, and every time one thing is abundantly clear: This woman's children were her only earthly blessings. When she gazed at each newborn baby she didn't see another mouth to feed; she saw a new friend and companion, a fellow pilgrim to hold her hand as they walked toward their final destination through the vale of tears.

It's easy for those of us who are surrounded by comfort and endless entertainment options to overlook the true value of children. We see the sacrifices and all the hard work that's involved, and we think of how much easier life would be for us if we were done with all of that. We imagine going to the movies and taking vacations and dining at restaurants or even just taking a long bubble bath instead of dealing with diapers and screaming babies. But plenty of women in the world have none of these options. Their lives consist almost entirely of work and struggle, every day a challenge just to get by. Sometimes they don't even have positive relationships with their husbands as a source of happiness. Yet it is in these bleak circumstances that many women come to celebrate their sons and daughters, often the only gifts they've ever been given. Before we citizens of the first world push our outlook on developing countries, we should first stop and listen hard to their perspectives. Because it is often women who have no other blessings who understand best of all that our children are our most precious gifts.