It is almost 6 p.m. in San Diego, a town one hour west of Caracas, Venezuela, and Flor Peña is exhausted. Peña is 40 years old and has four children. She’s been out all day searching stores for food – and she’s come home empty-handed.
“You can’t find anything,” says Peña. “Food, medicine. Nothing. I lined up for hours. Just as I was about to enter a store, there was suddenly nothing to buy.”
Venezuela has the world’s largest oil reserves, but thanks to collapsed crude prices and gross government mismanagement, the South American country is suffering the worst economic implosion in modern Latin American history. There are chronic shortages of everything, even condoms and birth control pills. Peña’s youngest child is a result of that particular scarcity.
“I couldn’t find birth control pills,” says Peña, “so I got pregnant again.”
But she’s made sure it won’t happen again. Last year Peña got sterilized.
“It was at a clinic here in San Diego, the 1st of July,” she says. “I feel happy and relieved. Now I don’t have to be scared about getting pregnant when I can’t find birth control.”
In Venezuela, that fear keeps getting darker. For many Venezuelan women, having children today is far more stress than joy. It’s hard to feed them when the inflation rate is 800 percent. To care for them when the health care system is wrecked. Or protect them when Venezuela has the world’s second-highest murder rate.
As a result, more and more Venezuelan women are opting to be sterilized. One health clinic in Miranda state, just outside Caracas, reports that 500 women are on the waiting list. At Concepción Palacios, a state-run maternity clinic in western Caracas, the waiting list is 300 long.
Third-year Concepción Palacios resident Dr. Rosabel Campos says the days she performs sterilization surgeries are often her most difficult.
“One recent day the patients started coming in at 6 a.m.,” Campos recalls. “I performed 35 or 40 sterilizations that day.
“We tell them explicitly beforehand that this is an irreversible procedure.”
But social scientists say this isn’t all that surprising in a country where an estimated 82 percent of the population now lives in poverty – and a fifth of its children are malnourished.
Many Venezuelan women fear that if they give birth in such poor health, their children will inherit it.
“Like increases of cardiovascular disease or type 2 diabetes,” says Marianela Herrera, a professor of development studies at the Central University of Venezuela in Caracas.
“If a woman has now a newborn in these conditions, her body will have imprinted these consequences. In terms of [future] public health and cost, that would be huge.”
Herrera says those women are also staring at a scarier specter. In just a few years, Venezuela’s infant mortality rate has grown to almost 20 per 100,000 – even higher than war-torn Syria’s.
“And the projections of maternal mortality for 2016 is almost 100 per 100,000 [births],” Herrera adds. “I mean, a normal country like Chile would have something around eight per 100,000. So that’s really, really alarming.”
In Flor Peña’s neighborhood, other women too are choosing sterilization. Her neighbor and friend Sulay Rodríguez is 34, and she desperately wants the procedure – especially since her situation is more complicated.
“I have eight children,” says Rodríguez. “It would be too difficult for me to have another one. We can’t even find diapers. I really want to be sterilized.”
Religious institutions are speaking out against the wave of sterilizations. Venezuela’s Roman Catholic Church leaders call it “a barbarity.” Still, most people blame the socialist government of President Nicolás Maduro for Venezuela's economic crisis – and for consequences like the sterilization boom.
Unlike the church, the government has been conspicuously silent about the trend. But the fact that so many women are ensuring they don’t have babies is one of the loudest statements yet about conditions in Venezuela.