Jahrbuch für Geschichte Lateinamerikas

. – This article studies the Centro Paraguayo de Estudios de la Población (CEPEP) when the organization was led by Dr. Dario Castagnino. It considers his personal and professional reasons in starting the organization. More fundamentally the study considers how anti-abortionism drove the philosophy of the organization to educate the Paraguayan public in various methods of birth control and sexual education. Using oral testimony and the surviving documentation of the organization this article aims to better understand how family planning and sexual education was delivered to an eager public.


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Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family dedicated to the scientific study of the "Paraguayan population.". 4 It opened its first maternal-infant clinic in 1967 inside of the University Hospital of Asunción. Later, in September of 1969, the organization was accepted into the International Federation of Planned Parenthood, through which they would receive a great deal of their funding. By 1971, CEPEP was operating 11 clinics, nine of which were in Greater Asuncion, while two were in rural areas. 5 This study will focus on the work of CEPEP during its first 11 years, when the organization was under the leadership of its executive director Dr. Darío Castagnino, and while contraception was handed out at state-run health clinics in Paraguay, in other words, when there was no state control over contraception. 6 During these first few years, the organization published an extensive body of research and informative newsletters which make up the backbone of this study. I am also using oral interviews I conducted with Dr. Castagnino in February and March of 2016 at his home in Asunción. This original interview was later followed up with phone interviews in April and May of 2021.
Castagnino was born and raised in the small rural town of Piribebuy, but attended high school in Asunción. He graduated from the Medical School in Asunción in 1959, determined to go into gynecology and women's health. When prompted to narrate why he chose that field, he noted that in one of his first courses in medical school he was working with cadavers. He was assigned the body of a young woman "23 years of age" who had had a hemorrhage. This "hemorrhage" was, according to Castagnino, caused by an "abortion.". 7 The sight of the woman in the morgue left a strong impression on the young medical student; it was then that he decided to study gynecology. He was encouraged to pursue his studies further by Dr. Edwin Bridge -an American medical doctor teaching at the Medical School in Asunción in the early 1960s -who 135 Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family helped make arrangements for Castagnino to study in Colombia at the Universidad del Valle de Cali. 8 The Colombian population at the time, according to Castagnino, was growing at 7% [annually?] and "it was a terrible thing." As a result of this steep population growth, in 1965, Colombia hosted the first Pan-American Assembly on Population. At this meeting, 75 delegates from around Latin America and the Caribbean met to discuss the growing threat of a Malthusian population bomb. 9 The fears of the Assembly were that the population in Latin America would explode beyond its infrastructure. They noted in their published reports that "in the year 2000 Latin America will have more than 612 million inhabitants, or two and a half times its present population.". 10 These numbers meant that there would not be enough hospitals, schools, or housing for this booming population. As noted in the final words of the Assembly's reports, "solutions to Latin America's population problems requires attacking the problem at various levels and in various ways, from providing more information about modern contraception to those who desire it, to altering intellectuals to the significance of national and regional population growth. At whatever level, more professionally trained people is the first requirement.". 11 To this end, between his experiences in medical school and his observations in Colombia, "I returned to [ Thus began his lifelong interest in family planning, contraception, antiabortionism, and sexual education. 13 More to the point, CEPEP and Dr. Castagnino focused on working with the press and military, later developing a "club de padres", along with the production of sexual education outreach materials, in the end, CEPEP and Dr. Castagnino produced a distinct Paraguay-centered vision of what outreach work was needed in order to best promote family planning in the country.

Historiography
Scholars from several Latin American countries have discussed histories of family planning. Studies into family planning and abortion have come to the fore in English-language Latin American historiography. Of note is the work of Jadwiga E. Pieper Mooney on the Intrauterine Devices (IUDs) and their use by "men of science" and "women in need." These "men of science," as Pieper Mooney narrates were concerned with "the transnational neo-Malthusian scientific paradigm of the threat of overpopulation.". 14 Natalie Kimball in her study of abortion in Bolivia notes, however, that "through the 1950s, domestic [Bolivian] elites were primarily concerned with what they perceived as Bolivia's underpopulation vis-à-vis other Latin American countries.". 15 In many ways the Paraguayan case is quite similar in that CEPEP did not fear overpopulation in Paraguay; but rather than being limited to the 137 Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family 1950s, the idea that Paraguay did not need to fear overpopulation extended into the 1960s and 1970s. This article also answers the call of Raúl Necochea López who "invite[s]… Latin Americanists to think of the regional dimensions of health care, and for the medical historians to consider new facets of the link between health and population, namely through [the] family planning lens.". 16 This article will demonstrate that family planning in Paraguay was much more than just a choice concerning birth control devices and abortion, but also sexual education and outreach.
Paraguayan historiography has traditionally been particularly dominated by glorious tales of heroism during the War of the Triple Alliance (1864-1870) and the later Chaco War (1932)(1933)(1934)(1935). As a result, many early studies into gender in Paraguay have focused on the retelling of the dramatic history of Paraguayan nationalism and resilience in the face of these epic wars. The most influential of these types of texts is Zarza's "La mujer paraguaya, protagonista de la historia, 1537-1870.". 17 Later historiography questions this "heroic" narrative. Of note is Potthast-Jutkeit's beautifully documented text "¿Paraíso de Mohama o País de las mujeres?" which explores women's roles before and after the War of the Triple Alliance and notes that women played an important role in the maintaining of economic, social, and cultural roles even before their experience in the war. 18 More recent work by Chesterton notes how elite female letter writers during the Chaco War (1932)(1933)(1934)(1935) helped foment patriotism with lower-class Paraguayan men. 19 While this letter writing campaign brought women's role to the fore in Paraguayan society, it did not bring political rights. Duarte Sckell outlines how Paraguayan women gained the vote under the dictatorial regime of Alfredo Stroessner  women's rights newspaper El Feminista, Duarte Sckell highlights the journey for women to win the vote in 1961 and to participate in their first election in 1963. However, like Chesterton, Duarte Sckell notes that women "fought in favor of women rights espousing a nationalistic discourse and her role inside of the family, which did not represent a threat to the status quo of the era.". 20 This article demonstrates that while family planning and contraception remained in the hands of educated male elites who controlled access, women who desired still benefited from the efforts of male family planners. While it is challenging to "hear" the voices of women who were the direct object of the gaze of family planners, what is clear through the various reports of CEPEP was that family planning and birth control were actively sought out by both women and men in Paraguay. The success of various events organized by CEPEP, noted in photographic evidence in organization's newsletter Temas Médicas and the quick spread of clinics throughout the country, highlight this strong desire on the part of Paraguayans to access both information and resources offered by CEPEP.
During the middle decades of the twentieth century, Paraguay was under the dictatorship of Alfredo Stroessner; it was a notoriously repressive regime. Well-documented in the historiography of the era, the dictatorship is infamous for jailing suspected communists or other political non-conformists such as students, medical doctors, and businessmen. 21 Targeted for anti-government activities these men and women suffered torture and death at the hands of state agents. The regime, in order to undermine resistance, documented and organized an archive commonly known as the "Archive of Terror.". 22 While 20 Jazmín Duarte Sckell, "Obtención de derechos civiles y políticos para mujeres en Paraguay durante la dictadura de Alfredo political theorists have argued at length about the political situation that led to such a long dictatorship, historians have yet to explore how the dictatorship shaped society and cultural life in Paraguay. 23 This article complicates the study of authoritarianism and family planning by showing that progressive family planning policies that expanded women's choices could be implemented under an authoritarian dictatorial regime, and that societal change was possible in a patriarchal system.

Family Planning versus Birth Control
According to an editorial in "Temas Médicas", nothing can be more dangerous than a program of family planning that… distributes indiscriminately and massively, contraception.". 24  understanding of what birth control did, is unclear. However, what is clear, is that according to the unnamed author, there was a major difference between "family planning" and "birth control". That said, the major argument of the editorial was that "family planning" was within the political sphere which "governments could assume in exercising their sovereignty;" while "birth control was in the familial sphere "where the couple can make a free and conscientious decision about the number of their offspring.". 25 These definitions, that allowed for decisions to be made by families, guided the organization's policy making. This approach certainly allowed medical doctors to discuss birth control methods openly, promoting "traditional families." As a result, what makes the Paraguayan case unique was the depth of the outreach and education that CEPEP produced. 26 The hope behind this outreach and education, was a desire for vigorous and strong children and families. According to Castagnino, "we [at CEPEP] always said that we wanted healthy populations, that children developed well, [and] that the mothers and fathers had the resources to feed [their children] and take care of their health." When asked directly "if [the organization] feared overpopulation in Paraguay?" Dr. Castagnino replied "no, because we had sufficient territory compared to other nations…. When we were working there were [only] six million [inhabitants in Paraguay]". When pushed to clarify that Paraguay was an exception to the trend of neo-Malthusian fears, Castagnino replied "the only thing we wanted was for the population not to grow at an accelerated pace" so that parents would be able to take care of their children properly. 27 These concerns for the well-being of the family with a traditional male head of household were of the utmost concern for CEPEP in its early years. This policy is outlined clearly in a 1973 report entitled CEPEP HOY. In the introduction to the study, Dr Restricting births would have been unconceivable to Castagnino, CEPEP, and the Paraguayan public at large. Paraguay's catastrophic history and in particular, the need to rebuild after the devastating War of The Triple Alliance that pitted Paraguay against its larger and more powerful neighbors Brazil, Argentina, and Uruguay had left the country devoid of a population. According to a 1974 study by the Centro Paraguayo de Estudio Sociologicos (Paraguayan Center for Sociological Studies), entitled "La población del Paraguay" (Paraguay's Population) notes that there were three different pre-war population studies which noted a high estimated population in 1846 of 1.1 million to a low of 600,000. This wide gap in estimates reflect the reality of poor census records and challenges in counting. A post war census recorded 263,751 persons "in the entire country." Thus, the war estimates of population loss according to these figures is somewhere between 50 and 85 percent. Newer studies by the historians Thomas Whigham and Barbara Potthast, comparing census reports from 1846 and 1870 noted that population loss from the conflagration "seem to be at between 60 and 69 percent". 29 Such catastrophic loss of human life in war, with males suffering the greatest loss, meant that in some towns "women… regularly outnumber[ed] men of military age by four or five to one". 30 It would take until the 1950s for the population to rebound to about 1.3 million. 31 As a result, family planners such as Julio Manuel Moreals could write in 1968 in Temas Médicas "because of low population density" in Paraguay, there is no requirement for "intensive family planning". 32 But 28 Darío Castagnino, "CEPEP Hoy", pp. 9-10. 29  these statements need a caveat. It was not that there was no population stress in the country. Rather the population stress, according to Dr. Domingo Marcial Rivarola, was centered on the city of Asunción. As a result, the population of the city was growing too rapidly and as a result there were not enough "public sector jobs, educational [jobs and opportunities], and the service [industry], etc." to meet the demand of a growing [urban] population. 33

Anti-Abortion
Abortion was criminalized in Paraguay in 1937, almost two decades before the rise of Alfredo Stroessner. According to the legislation, abortion was limiting the growth of the nation. Specifically, the legislation noted that there was "a lessening of the population in the country because of the lack of births. In Paraguay, with a population of barely a million people, there could be in the [national] territory millions of more souls.". 34 The document continues explaining the reasons for the criminalization of abortion is because it "constitutes an antibiological and antisocial fact that endangers the health of the woman, exposing her to grave dangers, including death… abortion destroys human life… [and] abortion constitutes an attack on the good values of the country, killing the moral direction of its inhabitants.". 35 The legislation continues noting that the various causes of abortion "economic, pshycological, moral, etc." required more than simply legislation to fix the problem, it also required "that the government had the indelible responsibility to take up the study of the problem and adopt measures to avoid the wicked [abortion]". 36 While the legislation criminalized abortion, it did not penalize the women who sought out abortions. Rather the new law outlawed the practice of abortion by midwives in all circumstances, and only allowed for the procedure to move forward if the life of the mother was at stake under a physicians supervision. For our purposes however, the most important part of this legislation is that it carried heavy financial burdens for those found guilty of providing illegal abortions. 37 Even with this strict legislation, according to Dr. Castagnino, in every town there was an [female] abortionist. "In the outskirts of towns in rural areas, that is where there were abortionists." He also noted that public sector employees of the Ministry of Health offered [clandestine] abortions. He states authoritatively that the members of CEPEP "were aware of this". 38 Statistics offered by Castagnino at the "First Seminar on National Planning" bear out these observations. On the front cover of the report, it notes that this will be a "study of 1[,]951 patient histories that practiced criminal abortion" between the years of 1961-1965. 39 Of this number, 1[,]295 women reported that they had had previous abortions. Methods used to induce "criminal" abortions included "[vaginal] probes," "homemade remedies," and unspecified "pills" to name a few. 40 However, we must be careful with these statistics as they are based on the memory of one individual and that statistics are clearly biased towards women who sought out medical help.
As noted above, of course, the women in this study were selected because they had had complications from their current abortion. 41 These complications, include, at the top of the list, unsurprisingly, "infection." This is followed by "acute endometritis" (an inflation or irritation of the lining of the uterus,) and "anexitis" (inflammation of one or both fallopian tubes.) Other complications that the medical professionals in Asunción were observing were "anemia," "phlebitis," and "uterine puncture." Also attributed to abortion were "ectopic pregnancies;" how exactly ectopic pregnancies were associated with "provoked" abortion is unclear. 42 144 Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family Another consequence of obtaining a clandestine abortion, death, was studied in yet another article by CEPEP. This article written by Dr. Antonio M. Ruoti, noted that the fifth most common diagnosis in the Hospital in Asunción was abortion, in step with diagnosis of cardiac illnesses in the period from 1958-1967. All in all, about 20% of maternal deaths "recorded in their service" were from abortion. 43 The article continues with a statistical breakdown of the dangers posed by abortion and concludes that there were six factors that led to this high level of maternal death. Issues with work." Consequently, if each of these issues were addressed through education, "case by case, above all with sexual education… abortion would take less lives of mothers.". 44 Castagnino shared this belief and noted that there was a solution for all of these abortions in Paraguay: "sexual education and medical-social assistance for couples.". 45 In particular Castagnino was concerned with "chronic abortionists" -the language he used to describe women who had had multiple abortions. 46 These women needed to be offered a "medical solution to their problem.". 47 As a result, Castagnino desired "a campaign of education and contraception that banishes -for women in their fertile years -this harmful moral and physical practice.". 48 In this case, abortion is seen as a double sided evil. It is both a moral transgression and it is a dangerous practice for the female body. Controlling these two dangers was the responsibility of family planners who worked "to construct a prophylactic device for abortion.". 49 As Castagnino noted in his interview "we offered a solution to abortion;" that solution was education. 50 145 Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family Education came in many forms. One of the ways in which women were educated was direct contact with a physician. While it was fundamental for Castagnino for women to knowledgeably select their own type of birth control, men's opinions always mattered. While waiting in a clinic a woman would be given a selection of methods "explained to her by a [male] doctor. A doctor would explain 'this works like this' and it has a 'chance of failure of ten percent or five percent or one percent'... The woman would then explain what method she wanted, then that method would be explained to the husband, because a husband is entitled to know." While appearing to give women a choice in the method of birth control, men ultimately controlled the flow of information and the ultimate selection of a birth control method. According to Castagnino the most common method used by women during this era was the birth control pill. 51

The Press, Armed forces, and CEPEP
In the early years of CEPEP, the organization found great support among the members of the press and armed forces. But that support came after CEPEP started working in Asunción's poorest districts. Castagnino went to these neighborhoods looking for women to help in accessing contraception. As he noted, he "went to the marginalized neighborhoods", including "la Chacarita," one of Asunción's most infamous "rancherío" (slums). In this particular rancherío, "we rented a room, we added some other rooms, and it is from there that a medical doctor works, the pediatrician, the gynecologists, the obstetrician, and the other people. It was then that we had an extraordinary acceptance and [even] the press was supporting us.". 52 Because of the support of the press, Castagnino hosted the "First Forum for Journalists on Population and Family Planning" in April of 1971. In attendance were 36 members of the national press, including the most important media resources at the time, comprising the largest and most established newspapers in Paraguay, ABC en Color, La Tribuna, and Patria. Radio journalists were invited from all over the country, including the immensely popular Radio Ñandutí from Asunción, and 146 Jahrbuch für Geschichte Lateinamerikas | Anuario de Historia de América Latina 59 | 2022 Bridget María Chesterton, Beyond Contraceptives: Family other radio stations from the interior including, but not limited to, Radio Guairá and La Voz de Ñeembucú. 53 According to Temas Médicas the final suggestions were made at the forum included: "to always have a representative of the press at the scientific acts celebrated by CEPEP, so that there can be a definitive educational expansion about Family Planning and that it has ample distribution in the national public opinion.". 54 This success brought the attention of the dictatorship. But it was not negative attention. According to Castagnino the Director of Military Hygiene, General Tito Velilla, became interested in the work of CEPEP and asked him to lead a seminar for the different branches of the military. Almost a year to the date of the forum for the press, April 29 through May 30, 1972, there were a series of conferences held that focused on family planning for military personnel. Clues as to why the military had taken an interest in family planning are hard to find, but one may have been to deal with domestic tranquility. In bold lettering and surrounded by quote marks, the article that summarized the conferences noted: "TO EXTEND FAMILY PLANIFICATION SERVICES TO THE POPULATION REQUIRES THE LEAST [AMOUNT OF] RESOURCES." While no individual is named as giving this quote, it is possible to imagine that it was from General Velilla, who gave the opening remarks at the conference. Two of the themes of the conferences fit with the objectives of the military dictatorship of Alfredo Stroessner and they were "Demographic Characteristics of the Paraguayan Population" and "The Correlation between Future Expansion of the Population and the Development of Our Country." These themes tie in directly to Stroessner dictatorship's larger concern with long term economic and political stability.
In attendance at least at one of these events was Division General Andrés Rodríguez, Stroessner's right hand man. In other words, the work of CEPEP had garnered the attention of Paraguay's most important leaders. CEPEP used that position to educate a great many members of the armed forces in methods of Family Planning. Also in attendance were a great deal of women. Dr. Castagnino had made sure to invite the wives of military officers. 55 As visible in a surviving photo, seated behind the military officers, are several women dressed in winter clothing. Thus, women were encouraged to listen to the various speakers on topics such as "Objectives of Family Planning," "Contraceptive Methods," "Responsible Parenthood," and "General Characteristics of Man and Woman and Matrimonial Adjustment." Those at the conference also heard a talk by General Velilla about "The Cost of a Child." While none of the texts from the conferences' speeches survive, it is still possible to get a sense that the talks revolved around the idea of educating members of the military about how to control the size and make up of their families. "the participants gave excellent assurances on the excellent quality [of the programming] in terms of their ability to take advantage of the knowledge that was instilled upon the participants.". 56

Rural Programming
In 1972, Dr. Castagnino reported on who were the users of the services of CEPEP in the towns of "Villarrica, Coronel Oviedo, Pedro Juan Caballero and Kilómetro 81." While noting that the first three locations were "urban" in nature and the final was "rural" the statistics also noted that 26 percent of users of CEPEP in the survey identified as "urban" while 74 percent identified as "rural." In other words, while the offices of CEPEP were located in these smaller urban communities outside of the capital of Asunción, the vast majority of women who were using these services were still "rural." Fundamentally, 82 percent of the women spoke Guaraní -"63 percent exclusively" -while the other 19 percent spoke a combination of Spanish and Guaraní. 57 This concern for reaching Guaraní speakers, and being aware that he did not have the staff to "reach the entire country," manifested itself in one of the more unique programming ideas for CEPEP: using radio to educate those in rural locations. 58 Entitled "Ñandeminte" in Guaraní, which roughly translates to "just between us," the program was designed to teach family planning to large groups of radio listeners in three Paraguayan towns that had radio stations, Coronel Oviedo, Villarrica, and Caaguazú. CEPEP likely selected the people of Caaguazú to be the intended audience of such programming, because as they note "this region, previously almost unpopulated, has been effected by a large migration… and its current population density per square kilometer is high.". 59 This high population is tracked with hard statistics by noting that in 1962-1972, the population of the nation grew by 31 percent, while the 56 "Quinietos jinetes en un curso sobre Reproducción, Educación Sexual y Bienestra Familiar": Temas Médicas, Número Extraordinario (1972), p. 19. 57 Temas Médicas, Número Extradordinario (1972), p. 8. 58 It should be noted that CEPEP was not the first attempt to use radio in Paraguay for the purposes of public health. As noted by Castagnino, radio was first used to help with malaria eradication in the country. Castagnino, Interview, March 18, 2016. 59 "CEPEP Hoy", p. 91 population of Caaguazú increased by 80 percent. It is unclear why the other two towns were selected. According to Castagnino, however, the radio programing focused on a "dialogue with the father, the man, the old man of the family," discussing family planning. 60 Thus, the focus of radio broadcasts -like most programming for CEPEP -was male centered and nuclear. Women were to be the recipients of the knowledge given by male authority figures, in this case, in Guaraní. When asked if the radio programming was effective, Castagnino replied, "we were able to reach more people with that radio program, and in those clinics we began to receive [more people.]" In conclusion he opined, "we did some very creative things, but with great results.". 61 Like all CEPEP projects there were surveys given to radio listeners in order to determine the program's success. These surveys were backed up with statistics that noted the use of contraception increased dramatically in the areas that heard the programming. In Villarrica, contraception use was up ten percent, in Colonel Oviedo, six percent, and in Caaguazú, contraceptive use was up a stunning 22 percent. 62

Parent's Club
One of the more interesting phenomena to come out of CEPEP was the "Club de Padres" (The Parent's Club). This was a space, maintained within the auspices of CEPEP, that was designed to integrate parents (including fathers) into the discussion surrounding family planning and child raising. Dr. Castagnino led this effort, and his success was met with accolades at the "International Conferences of Parental Education" in Caracas, Venezuela held between the 21 and 30 November 1970. Moreover, the program designed by Dr. Castagnino was so innovative that the outline and plan for the program was selected to be distributed to all the attendees of the conference. 63 By the early 1970s, CEPEP had "19 offices, 16 of which were in the capital [of Asunción] and 3 others in the interior of the country.". 64 While most of these offices were in Asunción it is important to note that CEPEP clearly meant to target those "on the periphery of the city" where most of the clinics were located. 65 These offices were there to help couples "space the birth of their children, [offered] couples the possibility of having children in the case of matrimonial sterility, the prevention of cervical cancer, and pediatric assistance.". 66 But most importantly, The Parent's Club was designed by men to help fortify the imaginary ideal of a stable nuclear family. Couples were chosen to participate in the Club because "the wives were users of the medical services [offered by CEPEP]" and "because of their "social-economic condition." In effect CEPEP was trying to reach Asunción's less fortunate population. In the end, there was hope that these families would transmit their knowledge to "their neighbors and the community at large.". 67 The expectation of Castagnino and his colleagues was that these clubs would help the Paraguayan population "overcome the 'cultural barrier' that oppose the objectives of family planning.". 68 While it is unclear what these "cultural barriers" were, one can infer that they had to do with women directly receiving education about family planning. As previously highlighted, most of the programming for CEPEP was directed at men who were then, it was hoped, would share this information with female partners. However, with the Parent's Club, it becomes clear that the audience for the information provided by CEPEP was also directed at women. In photographic evidence from 1972, a meeting of the Parent's Club in Barrio Ricardo Brugada, demonstrates that most of the individuals in the room participating in the discussion were women, while the accompanying article notes that there were "approximately twenty couples who participated.". 69 There were several stated goals of the Parent's Club. Two that stand out are "Family Planning" and prevention of abortion. As noted in CEPEP's manual for the study of the efforts of the Parent's Club was "the adoption of Family Planning on the part of participating couples." However, what was also made clear was that families were "assured absolute liberty in the selection of such methods.". 70 The exception of course being abortion, which as previously noted, was morally reprehensible to Dr. Castagnino and CEPEP's founding philosophy. As noted later in the same study the planners shared information about "newly discovered consequences about abortion.". 71 While the programming notes do not detail what those "consequences" were, it is apparent from other publications that they were writing about infections, ectopic pregnancies, and death.

Sexual Education
In December of 1969, the newspaper, ABC en Color printed a brief, but telling article about sexual frustration in women. The article notes, "when asking a woman if her marriage leaves her completely satisfied, in the majority of cases, the women will say no." This was because women can be left unsatisfied with "sexual relations" with her partner. According to the article, "the majority of women need sexual education." Beyond blaming women for their sexual frustration, the article notes that this can be fixed with "sexual education for both [partners].". 72 One of the functions of CEPEP was education and the teaching of sexual pleasure. 73 72 "La mujer necesita educación sexual": ABC en Color (Segunada Semana de Septiembre, 1969), p. 6. 73 It should be noted that this program was ahead of its time in Paraguay. To this day there is not national program for sexual education in Paraguay. In 2006, a law was proposed that would have allowed for sexual education, but it did not become law. Sarah Patricia Cerna Villagra / Liz Lorena Soto / Adriana Edith Rojas Benegas, "Conquistas de los movimientos de mujeres y deudas pendientes del Estado hacia ellas: un análisis de la políticas sensibles al género en la democracia Paraguay (1989-2019): Sarah Patricia Cerna Villagra / Sara Mabel Villaba Portillo (eds.), While using coded language for this type of education, it is clear that CEPEP was interested in teaching about sexual pleasure; the title of one of their workshops was "Marital Sexual Education.". 74 While limiting sexual pleasure to the marital bed, CEPEP still informed its participants about the importance of sexual pleasure. In an editorial in Temas Médicas the unnamed author noted "CEPEP has been the first institution in the country to establish that Sexual Education is part of everyday activities. This effort… entails a great amount of responsibility.". 75 Even with these efforts, however, it appears that the public demanded more about sexual education. After holding a conference for 40 "female educators" in October of 1972, participants in the surveys filled out after the conference noted thirteen participants that there should have been more emphasis placed on sexual education. Six others noted that there should have been more information about contraception." Even considering these complaints, the educators left feeling that they were now in a position of leadership in the community about "sexual issues and family planning.". 76 The Parent's Club was self-funded through a series of initiatives including traditional Paraguayan bottle dances, a food fair, a clothing fair, raffles and barbeques, screening of films for entertainment, and membership fees. 77 These activities also brought awareness of the work of CEPEP as members of the Parent's Club were working closely with other community members. Outreach to the community was also conducted through the giving of gifts at both Christmas and Three Kings Day, camps for children, and vaccination campaigns, to name a few. 78 Beyond reaching out to the adult community, CEPEP also worked with outreach to adolescences. While there is little documented record