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Freediving Above and Below: What I’ve Learned from Holding my Breath

October 26, 2014
My friend and talented freediver, Dena Parsa, at play in the Red Sea. A perfect example of the "autotelic" freediver. Photographer: Annelie Pompe.

My friend and talented freediver, Dena Parsa, at play in the Red Sea. A perfect example of the “autotelic” freediver. Photographer: Annelie Pompe.

Author’s Note: I reluctantly post this piece. It’s personal, speculative, and lets me use just enough of neursocience to be ‘dangerous’. I wrote it largely because I am an external processor, and freediving gives a great deal to process. But then, in the review, I see that the posting of this article is necessary if I am to practice what I believe. I hope this at least provides a little food for thought to those curious about freediving. 

Seven months ago, I took up the practice of freediving – or holding your breath in water. As you can imagine, I’ve fielded a lot of different questions about the activity since that time. Sometimes the questions are implied, such as when I get the blank, uncomprehending stare. Other times the questions are quite clear, and can pertain to the biology, philosophy, pragmatics, and ethics of it all. But for while I have heard many different questions, I have almost always been asked: “Why do you do it?”

The answer I usually give is this. “I freedive because it makes me a better person.”  And if you seem like you can handle it, I’ll joke that “it’s also the only time where burping and peeing your pants are expected, if not encouraged.”

Joking aside, this is in fact the truth.

I’ve never been happier since discovering freediving. But how exactly has freediving made me a “better” person?

Well, I could tell you about the all-around increased relaxation and mental clarity, the surprisingly deep connections you form with other freedivers, or even how it’s helped me reduce the symptoms of an autoimmune disorder, but I really don’t think this would scratch the surface. I say this because I continue to find new benefits, and quite more profoundly, I’ve found that the techniques used to reach new levels of satisfaction and performance in freediving are just as applicable to reaching new levels of satisfaction and performance in other areas of life.

This might sound a little funny, so I’ll do my best to explain what I mean by describing the techniques that I employ. But of course, to do this, I’ll need to go into a little depth about the central challenge posed by freediving. That is, what exactly are we freedivers doing when we hold our breathes for minutes at a time or freefall down into the ocean’s depths?

Reframing the Challenge

To tell you about the practice of freediving, we’ll need to first reconceptualize the challenge that freedivers must overcome.

Most instructors and written materials will frame the central challenge as this: activating the mammalian dive reflex. The MDR is an autonomic response to three stimuli, holding your breath (pressure on vagus nerve), submerging your face in water (receptors of the trigeminal nerve), and, if you are deep diving, subjecting your body to high pressure (physiological mechanism(s) undefined). These impulses then result in a cascade of effects, including bradycardia, vasoconstriction, the pooling of blood in the chest cavity (“blood shift”), and the production of more red blood cells by the spleen.

Thus, the challenge of freediving is conceived of as the activation and improved efficiency of the mammalian dive reflex. And when framed this way, freediving training consists of strengthening MDR mechanisms through repetition and regular dive sessions.

And yet, observation suggests that this framing is incorrect.

That is, observed freediving behavior and training methods don’t seem to fit with this usual explicitly stated model. Most of what I’ve observed from freediving in Dahab, Egypt suggests that the real challenge is not about improving MDR activation and efficiency, but instead, consists of conditioning your conscious mind to facilitate MDR.

Just consider how freedivers must focus on “quieting” their minds before dives. Most divers will engage in restful breathing exercises, meditation, pranayama, and even yoga before going for a dive session. And after trekking out to the Blue Hole, what is the first thing that is done? Divers sit around the table to simply relax for 10-15 minutes.

Similarly, all freedivers undergo some degree of intentional cognitive therapy.

At the most basic, we all are taught at the beginning to consider how the urge to breath (i.e. warmth, possible general discomfort, and diaphragmatic contractions) are merely signals, and that they need not result in an emotional response, such as panic.

Meanwhile, some elite freedivers have shared some of their cognitive self-therapy tricks. William Trubridge apparently employs a mantra while diving (“let go, let go”), and Natalia Molchanova openly advocates for the use of deconcentration exercises (which in fact sounds a lot like “object-less meditation”).

And then of course, there is the perhaps backwards recognition that our personal lives can really disrupt our freediving. Indeed, I found my mind swirling with thoughts and that MDR would simply not activate in the days after a mutual break up with my girlfriend this past summer (e.g. contractions after just 30-40 seconds).

In sum, I think this means that the real challenge of freediving is properly conditioning your conscious mind so that it does not “get in the way” of your natural autonomic functions, collectively referred to as the mammalian dive reflex.

Why is this not the standard framing of the challenge in discussions on freediving? I’d argue that it’s because the framing offers little practical direction for the freediver.

Every formal mental conditioning technique that I’ve encountered suggests a different destination for the freediver. “Mindfulness”, “deconcentration”, “meditative state”, “state of calm”, are but a few of the terms that I’ve heard used. But if this new framing is to have value, it should offer a common goal, while allowing for a variety of techniques. Thankfully, neuroscience offers us a common way to understand the brain (or “brain-mind” as some call it), and in turn suggests that there might well be a common goal for this mental conditioning.

Introducing the Default Mode and Task-Positive Networks

Perhaps one of the more important insights available to us from neuroscience is that the brain operates much like a computer with overlapping programs and networks of programs. Among these higher order networks, we have two primary brain systems that should be of particular interest to the freediver: the Default Mode Network and the Task-Positive Network.

The Default Mode Network can generally be understood as that which coordinates the functioning of certain regions of the brain when we are at rest. Or in other words, through observation, we have found that it is most metabolically active when “at rest”. By contrast, the other primary system – the Task Positive Network – is the system that activates when the brain is engaged in problem-solving or goal-achievement.

Default_Mode_Network_Connectivity

The regions of the DMN are in yellow and the connections are color coded by directionality. Quite a pretty image. From wikipedia.

Now, a lot more can be said about these two networks, but perhaps the most important thing is that the two are not mutually exclusive. During waking states, the two networks operate simultaneously and interact. That is, activation of the DMN and TPN is not an “either/or” situation, but instead one of degrees and variations. While these degrees and variations continue to be debated and explored, I think we have enough evidence to meaningfully assume that proper mental conditioning for freediving will teach you to better utilize the DMN.

This may sound like a wild intuitive leap, but I believe the evidence is quite compelling. Consider this:

  • Daydreaming. Most freedivers I know will compare a good dive to that of a waking dream. And what network is active during daydreaming? DMN.
  • Rest. Most divers will similarly claim that, in spite of the hypoxic experience, a good dive is mentally restful. Again, DMN.
  • Physiology of the Mammalian Dive Reflex. The MDR consists of both sympathetic and parasympathetic functions, but we might argue that activation of parasympathetic function (bradycardia) is much more important to successful freediving than sympathetic function (vasoconstriction). Why? Because for as much as sympathetic function helps us, it can also hurt us. Consider that “fight or flight” is also a sympathetic function. Which network is associated with parasympathetic function? DMN. (Or more generally, you can think of DMN as vital in achieving homeostasis; just consider your heart beat and respiration during rest vs. highly-involved task states.)
  • Techniques. Trubridge’s “letting go” and Molchanova’s “deconcentration” could reasonably be understood to be ways to engage the DMN (as well as possibly the TPN in Trubridge’s case). Meanwhile, meditation has been shown to modify Default Mode Network connectivity.
  • Chronic Pain Management. Finally, again and again I found that regular freediving helps with the management of the pain associated with my autoimmune disorder, ankylosing spondylitis, if not also the disease itself. And what is one result of chronic pain? Functional maladaptation of the Default Mode Network.

Hacking the Default Mode Network: Relax

It is through this reconceptualization of freediving, from activation of the Mammalian Dive Reflex to the improved utilization of the Default Mode Network, that I believe we ultimately get a much richer theory of not only what occurs when freediving, but also how we might be better freedivers, either in terms of satisfaction, performance, or both.

With regards to this new theory, knowledge about the DMN suggests that improved utilization requires two parallel processes: 1) increased activation of DMN regions and 2) down-regulation of TPN regions. And based on my observations of variable training methods, it may well be that a freediver needs to regularly consider which process represents their binding constraint. That is, sometimes an individual should focus more on DMN activation, while at other times, on TPN down-regulation.

If in the case that activation of DMN regions is the binding constraint, I believe we already have a diverse array of techniques and principles available to us. Some of the most popular techniques include: meditation, yoga, pranayama, and deconcentration techniques. As for our principles, most go unstated, but based on my experience in Dahab, I’d argue that key pro-DMN activation principles include “rest days are training days” and “quiet and calm before training”. In essence, hacking the DMN requires you to find ways to relax.

Down-Regulating the Task-Positive Network: When the Task is to Have No Task (aka “Flow”)

Meanwhile, sometimes the binding constraint to a good freedive is not the activation of the DMN, but instead the down-regulation of the Task-Positive Network. That is, sometimes our active minds keep us from fully tapping our natural mental resting state. And if this is the case, then down-regulation must itself become a task.

As mentioned above, in the “hacking” of the DMN, I think the average freediver has a great range of techniques and principles to tap into. But in the down-regulation of the Task-Positive Network, I have found little in the way of practical techniques with the exception of yogic philosophy (e.g. Kundalini as taught by Sara Campbell). But here, the yogic approach is not for everyone, and typically requires a considerable amount of time investment.

Similarly, it seems that other freedivers manage to down-regulate their Task-Positive Networks not through techniques but instead through radical changes in their environments. That is, they take up freediving as a lifestyle, eschewing other modern goals and living minimally for months on end in tropical locales with but the freediving as their objective. Though it would be lovely if we could all do this, most of us cannot. And is this method really sufficient? Even professional divers still have good days and bad days, and no one wants to become a mindless freediving zombie.

Thus, it appears that freediving training methods offer us little with regards to tackling the “TPN down-regulation” challenge. But this does not mean we cannot come up with a meaningful technique of our own.

Indeed, I think we have a lot of material to draw on from the field of positive psychology. In particular, the research of Mihaly Csikszentmihalyi with respect to Flow experiences. Flow experiences can be described many ways, but most importantly for this discussion is that they involve the loss of time and dissolution of the “self” in pursuit of a singular task. It is only after a flow experience has concluded that a person is aware of time having passed, that they might reflect upon the experience, and – typically – that they feel the experience had been quite enjoyable.

“Flow” sounds a lot like TPN down-regulation to me, and the many descriptions of flow experiences in the literature fit quite well with how many freedivers describe a “good” dive. If we then reframe down-regulation of TPN as the pursuit of “flow experiences”, we begin to see an opportunity for using flow theory to improve our freediving (if not other areas of our life as well!).

Principles for Autotelic Experience Design

In seeking flow, the literature implies that we have two options. We either chase after those experiences that reliably put us in a state of flow, or we redesign our mental framing so that we are more likely to enter a state of flow. Since we probably wouldn’t be considering our flow states if had no problem achieving them while diving, let’s consider the latter option.

As Csikszentmihalyi defines it, the mental framing conducive to flow is called the “autotelic personality”, which he defines in two ways: 1) the internal disposition of an individual to do something for its own sake, or 2) the internal disposition to manage a rewarding balance between the work and play aspects of an activity.

While it may be difficult, if not impossible to change our personalities, it is clear that we can prime ourselves for certain behaviors through consideration of concepts and even higher order principles immediately preceding an activity. Thus, it appears that while we might not be able to adopt a new personality, we can manipulate ourselves to behave differently, specifically in a more autotelic fashion, for a given activity.

So what might be the basic principles of designing an autotelic experience, and thereby increase our chances of down-regulating our TPN through flow?  The work of Csikszentmihalyi and Nicola Baumann implies that we might use three principles to prime ourselves before any freediving session.  These principles are:

1. Goal Oriented with Medium-Difficulty. The individual should have a specific goal for a dive session, and the goal should should be seen as hard enough to maintain focus, but easy enough to have a reasonable likelihood of success. And what is hard or easy should be based upon the matching of the challenge with the individual’s skills to overcome that challenge. A medium-difficulty would be when the challenge and skill are roughly in balance.

2. Hope in Lieu of Fear. The goal should be associated with a positive affect, or feeling. Psychological research has long indicated that individuals who are primarily motivated by the fear of failure avoid tasks of even medium-difficulty, which would complicate principle 1.   

3. Internally Motivated Activity. Finally, autotelic individuals appear to find flow experiences best when they are internally motivated, such as when fun, curiosity, and the desire to see what is possible are the motivations. Importantly, what is not considered an internal motivation is an internalized standard of excellence (i.e. competing with others or yourself).

If you are are a more visual learner, here are two figures that may be of use:

This figure captures principle 1, that we must be goal oriented (have a challenge) and balance that challenge against our skills to enter and remain in a flow state.

Screen Shot 2014-10-30 at 10.45.21 AM

This figure examines different states as a function of positive/negative affect (principle 2) and internal/external motivation (principle 3).

The Freediver in Flow

So how might we operationalize principles as a freediving technique?  To demonstrate, I’ll provide a short case study of how I checked in with these principles prior to a diving session last week in a pool in Copenhagen. The session was remarkable for three reasons: 1) I was physically exhausted from jet lag and limited sleep, 2) I had not actively trained in three months, and 3) I easily and unintentionally finished the session with a 3:30 static hang at 4 meters, which represented a 10-second improvement on my personal best.

Prior to the session, I checked in with these three principles of “autotelic design” as I realized my head was swarming with thoughts and emotions, which is none-too-surprising given my exhaustion. I reflected and saw that I might operationalize the principles in the following way.

1. Goal-Oriented with Medium Difficulty. I established as my goal the performance of three static hangs, and I established a “medium” difficulty by deciding to hold each hang for 10, 20, and 30 diaphragmatic contractions respectively. Since my exhaustion would likely lead to early contractions, I figured this would not keep me down for very long, while still providing me with some challenge.

2. Hope in Lieu of Fear. I decided that there would be no failure. If I needed to come up early, I would come up early with no internal reprobation. I also recognized that I had a very caring and responsible friend as my dive partner, so I did not perceive any real danger if I were to have need of assistance.

3. Internally Motivated Activity. Finally, I reflected upon what I most wanted out of the session. Thankfully, because I did not think I could challenge my personal records, I decided upon a more philosophical approach, and so I used the opportunity to reflect upon what it really means to separate fear from a risky activity (an “oldie but goodie”). That is, what does it suggest about my essential nature when such a fundamental part of me may be made separate?

Taken together, I’d argue that these principles helped me freedive far more comfortably than if I had just slipped into the pool and sought to actually “achieve” something.

The Benefit of Freediving

And so now we come full circle. By seeing that the freediving is not about activating an autonomic process, but instead in the mental conditioning of the conscious mind, I’ve been able to learn a tremendous amount about how to live a more restful, “autotelic” life, not just in regards to my freediving hobby, but in other areas as well.

In sum, why do I freedive? It makes me a better person. And how does it make me a better person? Because I feel I’m finally overcoming one of the central challenges of modern life: finding that rewarding balance between work and play (the secret to which appears to lie in how I manage my task-positive and resting states).

A New Research Collaboration: The Irrationality of Marine Conservation

October 26, 2014
BehavFish

BehavFish Workshop, ICES, Copenhagen, Oct. 21-23

This past week I had the distinct pleasure to participate in a new, collaborative research endeavor. The event was the “BehavFish Workshop” hosted at ICES in Copenhagen. (Tangentially, ICES has perhaps the best name in marine science – the international Council for the Exploration of the Sea…eat your heart out, Steve Zissou).

BehavFish had as its purpose the identification of ways to harness human irrationality for the purposes of marine conservation. Now while that might sound worryingly manipulative, it was the the pro-social irrational impulses that we were interested in, and foremost among among our findings was the recognition that trust is a fundamental element of successful conservation. So maybe a better way of saying it is that the BehavFish workshop was about waking up to reality. Conservation is ultimately about behavior change, and so we need to stop thinking that the world operates according to a basic economic calculus (as so many of our policies assume).

The three-day workshop was divided into discussion sessions on essentially-commonsense truths about human nature that social science has relatively recently “discovered”. I’ll exercise some editorial license here and summarize them as the following:

1. We think about more than just ourselves when we make decisions. (i.e. altruism and social capital influence our behavior)

2. We all live with competing desires and struggle to prioritize them in the face of life’s uncertainties. (i.e. risk, uncertainty, and heuristics influence our behavior)

3. In a perfect world, we would all want to be “good” people. (i.e. we evolved in collaborative groups and our emergent self-identity influences our behavior)

4. We are hard-wired not to trust “strangers”. (i.e. communication, negotiation, framing, and reframing of the issues are essential processes of modern social institutions, which in turn influence behavior).

So what exactly does this mean when the pie-in-the-sky idea hits the real world pavement of MS powerpoint? Well, for one example, I provide here my own PowerPoint that was meant to kick-start the session on fisheries compliance.


(FYI, you’ll need to download it if you want the slide notes)

Of course, even more important than the numerous discussions were the policy ideas that were generated and – indeed – that continue to take shape as our group now works on the workshop report and a plan for moving forward. I’ll be sure to share more details soon as they emerge.

Finally, I want to thank Sarah Kraak, the driving force behind the workshop; Ciaran Kelly for his gifted facilitation; ICES and the Fisheries Society of the British Isles (FSBI) for their generous support and funding; and the many other clever and inspiringly open-minded behavioral economists and fisheries scientists that made the workshop possible: Chris Anderson, Dorothy DankelMatteo GalizziDiogo Gonçalves, Katell HamonPaul Hart, J.J. MaguireJeroen NieboerAndy Reeson, David ReidAndries RichterAlessandro Tavoni, and Ingrid van Putten.

Financing Fishery Transitions to Sustainability

September 2, 2014
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EDF has put together this excellent video on the California Fisheries Fund, an innovative financial institution that has helped California fishermen finance their transition to sustainable fishing practices. It’s a great model, and it needs to be replicated elsewhere. 

Update: Michael posted a great question as to what the loans are used for. Here’s a little more info.

As of June 2006, the fund has made 23 loans – ranging from $50,000 to $350,000 – that total more than $2.6 million. The permitted uses for the loans are:

  • Gear purchase or modification
  • Vessel purchases or improvements
  • Fishing permit or quota purchase
  • Capital equipment upgrades for dockside infrastructure, processing capacity and transportation
  • Working capital for business growth

If you’d like a brief case study, here’s an excerpt from a CFF briefing document:

Steve Fitz, captain of the F/V Mr. Morgan, will continue his family tradition, operating the only commercial fishing operation in the United States that uses Scottish Seine gear, a selective and eco-friendly way to catch groundfish. Steve’s loan from the CFF helped him buy the Mr. Morgan from his uncle and start up Mr. Morgan Fisheries, a fishing business based in Half Moon
Bay, CA, specializing in sustainably harvested groundfish and Dungeness crab.

 

Mr. Morgan Fisheries is known for its sand dabs, Petrale sole and chilipepper rockfish—all species sustainably managed under a catch share program. Like all other participants in this catch share, Steve receives an individual fishing quota for several groundfish species that may be harvested throughout the year, with requirements for full accountability of every pound of fish harvested, and a human observer on every fishing trip.

For more information on the program, check out the California Fisheries Fund website

Fighting Illegal Fishers with Satellite Intelligence

September 1, 2014

This is an exciting time for marine law enforcement. A number of NGOs and research groups are now working on ways to monitor fishing vessels via satellite data. Where previously this was just a pipe dream for environmentalists, we’re now starting to see real movement.

World Wildlife Fund was arguably one of the first movers with its construction and analysis of open-source AIS data, and I blogged on this two years ago. Meanwhile, it seems that the Pew Charitable Trusts’ Campaign to End Illegal Fishing has moved into the clear position of leadership since then. There is a very excellent article on this over at Grist. Here are the highlights:

1. Pew has teamed up with Oxford group, Satellite Application Catapult, to create a big database of identifying information on fishing vessels with satellite trackers (mostly large fishing vessels).

By combining satellite-gathered signals from ship transponders with other data, whether crowdsourced or supplied by fishing enforcement agencies, Catapult can piece together a cheat sheet that identifies any vessel by name history, ID number, and the details of its fishing license.

Once the relevant authorities have access to that information, they will be able to spot illegal or unreported fishing in even the most remote areas, then zoom in to make the arrest. That big Ukranian ship hanging out in the marine protected area? Probably not a tourist.

2. This comes on the heals of a smaller, successful collaboration between Pew and a Virginia based group called Sky Truth.

Last year, the group partnered with a small but spunky nonprofit located in West Virginia, SkyTruth, to use open-source satellite data to detect and document illegal fishing around Easter Island, a smidge of an island in a tuna-rich corner of the South Pacific, about 2,000 miles off the Chilean coast…

Without reliable IDs, the SkyTruth team instead tried to narrow in on the likely suspects by using low-res radar imagery to detect the presence of a ship, and sometimes even its speed and direction, then cross-referencing that with the transponder signal (or lack thereof). The boats that did not identify themselves and could not otherwise be accounted for, SkyTruth surmised, were probably up to no good.

After a year of watching Easter Island, SkyTruth had enough data to estimate the total amount of fishing that was going on, and had singled out more than 40 unidentified vessels that had been unknown to Chilean maritime authorities.

3. We still lack the necessary incentives for most fishing vessels to submit to satellite monitoring technologies.

If retail chains demand traceability from their suppliers, and can promise them a premium price at the counter, then it’s in fishermen’s best interest to opt into a monitoring system. Instead of putting the onus on enforcement agencies, this is a way to shift the burden of proof to the fishermen who want to do business legitimately. Then, if the good guys keep their transponders on, it will be even easier to spot shady behavior from afar. (You get a better ocean! You get a better ocean! Everybody gets a better ocean!)

Climate Change Impacts on the Seafood Industry

September 1, 2014

The IPCC has put out a report detailing how the seafood industry will be severely impacted by climate change. The latest MEAM newsletter has this useful summary.

Among its forecasts:

-  A loss of US $17-41 billion in global fisheries landings by 2050 with global warming of 2°C;
-  An increase in fishery yields of 30-70% in high latitudes and a decrease in fishery yields of 40-60% in the tropics and Antarctica with global warming of 2°C; and
-  Reduced access to marine protein for 400 million people.

The briefing “Climate Change Implications for Seafood and Aquaculture” is available here.

Underwater Photos

September 1, 2014

mark10103 as Smart Object-1

From March through July I took time off to pursue a longtime interest to learn how to freedive in the waters of the Red Sea off the coast of Dahab, Egypt. If you don’t know, freediving is a magical sport that allows you to reach what first must surely be thought of as impossible depths of the ocean and the mind. (Health and Spirituality Magazine has a terrific overview of the physiological and mental aspects here.)

In my own case, I learned how to far better manage fear and to better trust myself. The body flexibility required also led me to break up a lot of scar tissue in my back from an autoimmune disorder I’ve managed for the past 8 years. Frankly, I’ve never felt healthier or more relaxed, and that’s saying something when you’ve just started a PhD program. 

I also ultimately ended up posting some impressive depths for a complete noob. My greatest depth was 47 meters/154 feet and I reached that with bi-fins. But the dive I’m most proud of was a “no fins” dive (exactly what it sounds like) of just under two minutes down to 42 meters/144 feet during a competition in a rather chilly lake in southern Germany. 

Will I keep up the freediving? Well, certainly for vacations, but it now looks like I’ll be entering “early retirement” from the competitions. My new home of Michigan isn’t exactly the best place to train. I’ll always have the memories though…oh…and of course I’ll also have the very cool photos taken by my friend and underwater photographer, Nanna Kreutzmann. It was not an easy photo session, but I am really happy with the results.

 

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The Link between Human Health and Marine Ecosystem Health

September 1, 2014

 

The latest edition of the Marine Ecosystem and Management (MEAM) from the University of Washington has a great interview with Alasdair Harris, executive director of Blue Ventures, on the link between human health and marine ecosystem health. 

In particular, Blue Ventures has found that by tackling public health needs, they improve the human security of coastal Madagascar, and in turn reduce the human stressors to the marine environment. Here’s the skinny:

The unmet health needs of the country’s semi-nomadic Vezo fishing communities are particularly acute, with clinics located up to 50 km away from some villages. In coastal western Madagascar, the fertility rate is nearly 7 births per woman. Fewer than 10% of Vezo women have access to contraceptives, despite up to 90% wanting to be able to plan their pregnancies. With the population doubling every 10-15 years, Vezo communities are finding it increasingly difficult to provide for their growing families. And overfishing and destructive fishing practices pose significant threats to the marine ecosystems upon which their livelihoods depend.

Our community health program, called Safidy (http://goto.blueventures.org/health), meaning “the freedom to choose” in Malagasy, has been operational since 2007. Safidy was established in direct response to the unmet family planning needs of Vezo communities. It upholds reproductive rights by offering couples the information and contraceptive options they need to freely choose the number and spacing of their births. Results from this program have been published in both conservation (http://bit.ly/Safidy1) and public health journals (http://bit.ly/Safidy2).

 

As for impacts, Blue Ventures has seen general fertility declines of up to 40% in the communities it has served. Now that’s impressive.

We now provide community-based health services to around 20,000 people and are scaling up across two additional LMMA zones. Within the 40 communities that we serve in and around the Velondriake LMMA in southwest Madagascar, the Safidy program has led to an increase in the proportion of women using contraception from under 10% to 55% in just six years. This has averted over 800 unintended pregnancies, leading to a decrease in the region’s general fertility rate by 40%. We know that addressing unmet reproductive health needs within this kind of context can also reduce maternal and child mortality by up to 30%.

Read the full interview here.

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