“There are a variety of reasons why women in traditional or less-developed societies give birth to many children: religious, cultural, economic, status and lack of adequate information. But one reason that seems so obvious once you think about it — but which seldom tops the list — is the fear that the children they do bear might not survive,” Jane Otai, a senior program adviser for Jhpiego, writes in the New York Times’ “Motherlode” blog. “In such societies having numerous children is a kind of social insurance, a guarantee that those who do survive will help the parents financially and take care of them in old age,” she states, adding, “For family planning programs to succeed in helping women have smaller, healthier families, it is necessary to vastly improve basic medical care so they can begin to believe that their children will survive.” Otai continues, “Equating family planning to survival is key to effectively communicating the importance of breastfeeding both for the nutritional benefit of the child and in allowing the mother to regain her health by spacing pregnancies.” She concludes, “Only by addressing their needs in the context of their reality can we truly help them find their own way to healthier lives” (12/1).