Dynamic Ideas on Population

Ask Laurie Schwab Zabin ’46 how many people are in her family, and she’ll tell you, “It depends on how you count them.” She has three children from her first marriage, but she also includes the children her late husband brought into her second marriage, all of whom now have children of their own. This might seem ironic for someone who has spent the last 40 years of her career working in population control. But as she’s quick to point out, “Everybody has stayed within the 2- to 3- children [recommended limit]! So we’re all legit.”

Starting her family led Zabin from what she thought would be a career in English literature to her current work. While pregnant with her first child, Zabin talked with her obstetrician, Alan Guttmacher (after whom the Guttmacher Institute was later named), about his work as a leader in reproductive rights. These conversations sparked her interest in family planning, and set her on a different path.

She credits Vassar with cultivating her sense of curiosity and “willingness to strike out in a new field, to explore things I didn’t know anything about.” And it was apparent even when she was a student that no matter what career awaited her, she would be a trailblazer.

At Vassar she wrote her thesis on Dylan Thomas, whose poetry had yet to be published in the United States. (She sent away to England for pamphlets of his work.) Some of the older English faculty were skeptical — “they didn’t think one should be getting a degree in English based not on Milton but on Dylan Thomas,” she says. But she and her adviser, John Malcolm Brinnin, who later became famous for bringing Thomas to the United States, managed to convince them otherwise.

Vassar gave Zabin a graduate school fellowship, which she used for a year at Harvard in a master’s program in English. Then her first husband’s studies took them to Lehigh University, where she became associate editor of the Shakespeare Association Quarterly. When they moved to Baltimore, Maryland, her plan was to finish her Ph.D. in English at Johns Hopkins University — until she discovered that she needed a year of study in Old Icelandic literature to complete the degree. (“I didn’t think that was up my alley,” she says.) Instead she began volunteering at Planned Parenthood — first locally, then nationally, then internationally. Eventually she was on the staff running a clinic in the poorest part of Baltimore. When Planned Parenthood tried to promote her to director, she realized she didn’t want to continue working as an administrator. She missed academia and decided it was time to go back to school.

Zabin went to the Johns Hopkins School of Hygiene and Public Health, where, she likes to recall, she was told, “It’s not that you’re missing a prerequisite, it’s that you’re missing every prerequisite.” Nonetheless, she was accepted into the Ph.D. program in social demography and population dynamics. It turned out to be the right course of study at the right time. It was the late ’70s, and during the previous decade great advances had been made in reproductive health care for teens, and young people had increasing access to contraceptive services. Still, teen pregnancy rates were rising. As Zabin worked on her thesis, the data showed her something interesting: half of all teen pregnancies occurred within the first six months of sexual activity; she later established that on average teens were not getting to clinics until a year after first intercourse. The issue wasn’t that they weren’t getting services, it was that they were getting them too late.

Using these findings, Zabin and a colleague created a clinic that they placed near a local junior and senior high school, with two educators who worked both in the schools and at the clinic providing the necessary bridge between the two. Not only did her work lead to better local services for those Baltimore teens, it also proved groundbreaking in terms of creating the idea of school-based and school-linked reproductive services all over the country. Zabin was hailed as an expert in teen pregnancy.

After finishing her Ph.D., Zabin was invited into the School of Medicine in the Department of Gynecology and Obstetrics — where she founded the Social Science Fertility Research Unit. In the mid ’80s the School of Hygiene and Public Health recruited her to return to the Department of Population Dynamics, where she’s remained ever since. (It is now called the Department of Population, Family, and Reproductive Health.)

In 1997 Zabin’s first thoughts of retirement were set aside after a call from a friend, a Planned Parenthood director in Seattle, who told her, “There’s a man here named Gates who’d like to see you.” It was William Gates Sr., whose name at the time was only vaguely familiar. Gates was working with his son Bill and daughter-in-law Melinda to develop a foundation, and he was interested in exploring ways to focus on population and reproductive health.

Gates was reluctant to work with a university, but Zabin, certain her students would impress, invited him to visit Johns Hopkins. A few weeks later, the School of Public Health had $5 million to fund a program in leadership education. The following year, the Bill and Melinda Gates Institute for Population and Reproductive Health was established. Its mission is to create the capacity in developing countries to create the kinds of reproductive-health programs and policies they need. Oftentimes, Zabin says, “those parts of the world that have the worst problems are exactly the parts of the world that don’t have the potential or professional capacity to deal with them.”

Linking policy, program, and research in this field has always interested Zabin. “Too often,” she says, “the research doesn’t serve the woman in the clinic, or the provider at the bedside, because the academicians often fail to address the questions that are really important to policy or programs. All of them have to work with the government and political spheres to make their work useful in the public domain.” To this end, Zabin makes a point of spending time with the people her research serves — healthcare providers — to find out what questions need answers. “One of the things that happens in academia all too often,” she says, “is that academics go off on questions they think are of interest but which may not really serve the field at all. We have to keep our antennae out,” to make the research truly useful. “That’s why I feel good when I hear that providers are actually using the results of what we’re doing.”

After a couple of years of running the Gates Institute, Zabin, still acknowledged as its founding director, handed the reins to someone else. “My idea all my life has been to start things, and once they become completely accepted and popular — once they are respectable — I prefer to have someone else run them. It gives me a chance to create something new,” she says.

This freed her up to focus on her current work, a research project spanning Hanoi, Shanghai, and Tai Pei — three Confucian-based societies that are going through dramatic changes as they move away from traditional behaviors and values. “We all know that adolescence is a time of individual change,” Zabin says, and to have that occurring against a background of social, economic, and political change, makes her work in these countries particularly challenging. “The question we’re trying to answer,” she says, “is how do those kinds of change translate into changes in sexual attitudes and behaviors?” She is looking at the role of family, traditional values, media, and technology in the attitudes of young people there — and noticing trends similar to the ones with which her research dealt in the ’70s here in the United States, namely that teen pregnancy rates are on the rise.

“Have I thought about retiring?” Zabin wrote in her 50th reunion book in 1996. “Not really, but it would be nice to cut down to full-time!” More than a decade later, at 81, she has just cut back to working three-quarters time. “But as somebody pointed out to me,” she says, “you still do 100% of your work, the only difference is that you get paid for 75% of it.” Still, she says, “I don’t want to get up in the morning and wonder who I have a date with for lunch. That’s never been my life, and I don’t think it’s going to be now.”

She claims — though it’s not evident to anyone who meets her — that she does get tired a bit more easily than she once did, but her passion for her work shows no sign of waning. Part of the reason for that, she says, is the people she works with. “Associations with wonderful people and wonderful minds are one thing you get from being in a career like this,” she said. “I’ve often said to younger people who have talked to me about choosing a career to look at people in their forties, fifties, sixties, and think, ‘Are these the kind of people I want to be around?’ Because when you choose a career, you’re casting a die as to who your associates will be.” From the way Zabin discusses her coworkers — it’s rare to hear her utter a colleague’s name without the word “wonderful” first — it’s obvious she has chosen well.

Even more important to Zabin is the knowledge that her work can have such a broad impact. While a doctor is focused on the individual, a public-health worker is more interested in “preserving health, saving lives, millions at a time,” as the Johns Hopkins School of Public Health’s motto says.

Still, when you ask Zabin what makes her passionate about her work, she doesn’t quote statistics; instead she tells stories that have stuck with her for decades, of people she met while running that clinic in East Baltimore in the ’60s. She describes, for example, a woman she noticed in the waiting room with her five-year-old son one day. “The doctor in his white coat came through, and the boy said to his mom, ‘I’m going to be one of those.’ And she swatted him across the face and said, ‘Shut your mouth.’ Then she looked at me, and seeing I was shocked, said so sadly, ‘I’m not going to have him hurt the way I was.’ If there’s been complete deprivation of hope, of power, of choice all your life, then you think that’s the way it’s got to be. It’s one of the reasons we find such a huge gap between young people’s aspirations — which, no matter where they come from, are usually high — and their expectations, which can be very low. We have to close that gap.”

An antithetical story Zabin loves to tell is of a young woman she met at that same clinic, who, when asked why she was so excited about getting birth control, replied, “I’ve just been admitted to the job corps, and nothing is going to stop me.” Zabin says, “It is that kind of passion for getting control of one’s own life that I’d like every young woman to have. I think there can’t be any real empowerment of women until they have their fertility under control.” To Zabin, the decision of whether and when to have a child is the most important one anyone can make. “So the idea that it would happen by chance,” she says, “is just not consistent with the kind of society I’d like us to live in.”

The walls of Zabin’s office are covered with art — a Chinese tapestry made by the mother of a former student, sculptures from her trip to Africa, a caricature by a favorite artist — and awards, from the National Family Planning and Reproductive Health Association, the ACLU of Maryland, and Planned Parenthood, among others. In February, Zabin received the 2008 Award for Distinguished Acheivement from AAVC. She’ll show them to you with pride, but nothing lights up her face like the numerous photos of her grandchildren scattered around the room. “Somebody once asked me what was I proudest of, thinking it would be something at work,” she says. “It’s not; it’s something at home.” Her father, she explains, was one of nine children born in France. This meant that she had many cousins, some in France and some in the United States. “I realized how lucky we all were to know each other, and when the generation before us was gone, I knew we could lose contact.” So she organized a family reunion. By that time, her father, his living siblings, and their descendants numbered 112, and 108 of them met at her home, on a day the mayor of Baltimore declared, in their honor, Schwab Family Reunion Day. Five years later they met in Alsace, greeted by the mayor with banners reading “Bienvenue Family Schwab.” The Schwab family has continued to reunite every five years — in New York, near Paris, in the Boston area, and, most recently, in Switzerland, where more than 150 of the now 200 relatives turned out.

While women have been scratching their heads for decades about how to juggle both a career and family, Zabin has been quietly having it all and thinking nothing of it. In her 45th reunion book, she wrote to her classmates, “I can’t see any of us being willing to give up any of the happiness that either family or work or children bring. So, life will either have to be over-full, even mad, or else it will involve the kind of choice-making that I, for one, have never learned to make. As long as we stay greedy, it’s going to be hectic, and women can argue all they wish about their rights, but it all really comes down to what they — we — have the stamina to do!”

Pardes is a sex educator and freelance writer living in New York City. Her first book, Doing It Right: Making Smart, Safe, and Satisfying Choices About Sex, was published last year.

Watch extended interviews, lectures, and Dr. Zabin's '46 acceptance remarks for the 2008 AAVC Distinguished Achievement Award online.