• Expert debunks fears that contraceptives cause cancer, infertility, heavy bleeding, etc.

By Chioma Obinna

A new survey carried out in Lagos has shown that over 67 percent of women in the state are not accessing family planning services due to health – related concerns.

In the survey tagged PMA2014/Lagos conducted by the Performance, Monitoring and Accountability 2020, PMA2020, with grant from Bill & Melinda Gates Foundation, it was discovered that despite the availability of free family planning services in public and private health facilities, many women boycott the services for a number of reasons.

Some women in the study claimed that family planning interferes with the natural process while others said their spouses are totally opposed to use of family planning.

The Survey which applied a two – staged cluster design with urban – rural as strata, also revealed that out of stock was still a problem in family planning services in Lagos. The PMA2020 is a tool to monitor progress every six months over the next two years unlike the NDHS which is carried out once in five years.

Speaking to Features Health & Living shortly after the dissemination meeting of the survey in Lagos, Co-Principle Investigator, PMA2020, Dr. Funmilola Olaolorun, listed some method- related problems that hindered access to include excessive bleeding, mixed and misconceptions regarding using long active method.

Olaolorun who is also a lecturer at the Department of Preventive Medicine & Primary Care, University of Ibadan, further stated that some other women claimed family planning could cause infertility even though it is not a permanent contraceptive method while some say the Inter Uterine Device, IUD, can migrate. “Some people also believed that these devices can cause cancer. It is actually a mix of what they think. Some of them, it is just their perception. It is not that they have actually experienced any of them.”

Infertility or cancer

Debunking these fears, Olaolorun explained the family planning does not cause infertility or cancer. “We found that about 19.3 percent are using modern contraception in Lagos State which is higher than the national average. We also found that women are now initiating sex at about 20.0 – 24.5 years and that is about the age of first birth as well. Also they are not using contraception until about 26.5 years which is roughly six years after they have initiated sex and roughly two years after they have got married and roughly after two children.

“This gives multiple intervention points for family planning providers and family planning advocates to find the right message at the right time where she is in her life stage so that she can receive the information that she needs to encourage her to use a modern contraceptive method.

“We also did a survey on among service delivery points. We found out that even though these methods are widely available in most places, there is still stock out in a few places in both the public and the private sector. We also found that integration of services is doing well. Over 95 percent of those that offer maternal and child health services, HIV /AIDS related services, post abortion services integrate family planning services into it.   And this is a very good point because it is minimising missed opportunities for women,” she stated.

Excessive bleeding and contraceptives: Clearing the air on link between excessive bleeding and contraceptives, Olaolorun said: “When there is excessive bleeding the woman definitely needs to go to the hospital for assessment because it is not impossible that she may have some other underlying conditions. Bleeding could just happen and may not actually be related to the family planning method.

“So she needs to be examined in a hospital by a physician. I do know that so many women are unique even though there is excessive bleeding for some women, they are in the minority. Some actually have their menses stopped after they start using a contraceptive. Some women who are on injectables don’t even see their menses for years and once they stop the injectables, their menses comes back.

“There are side effects for every drug not just the family methods. But the few people who experience it make a lot of noise about it. We need to take all these information in context because only a few people experience excessive bleeding. Ffor instance with the IUD , but it is not enough to lead to death,” she explained.

Reeling out benefits of planning, Benefits: Olaolorun said apart from enabling couples to space their children, modern contraception has multiple benefits for both the mother and the child.

“Mothers who use family planning are able to space their children so that there is enough time to ensure exclusive breast feeding for six months and continue breast feeding for up to two years before she becomes pregnant with another child. “When a woman is using modern contraception, she is able to go back to the labour force and that means increased income for the family because if she is having a child every one and half years, she probably will not be able to maintain a job.

Olaolorun pointed out that if women are having only the children they want, they are not likely to have more children than they can carer for, and there will be fewer street children and homeless children.

Apart from spacing, she explained that when a couple is ready to stop bearing children, they can utilise the more permanent methods so that a woman is not getting pregnant in her late 40s and early 50s.

“So it helps families as well to be able to understand their finances and many children they can afford to look after and send to school and ensure that they are well kept.”

Link between family planning and maternal/ child mortality: Family planning helps a woman to recover from one pregnancy before going to the next one.

Infant mortality

“A child that is breastfed exclusively is less likely to have problems of diarrhoeal diseases and more likely to be healthy. There would be less likelihood of upper and lower respiratory tract infections, pneumonia and other infections that can lead to untimely death.

“So when a child is exclusively breastfed if the mother is using that method it helps to reduce infant mortality because breast fed children are healthy children and the mother also has benefits when she is breastfeeding, to reduce the weight she has gained in pregnancy. She is able to burn calories.

“Breastfeeding helps the mother bond with the child and the child is less likely to end up with behavioural problems. Also the mother is more able to focus at work when she resumes because she can express the breastmilk and can actually take the child along if she is breastfeeding exclusively.

“She can spend more time to look after the child thus reducing infant mortality because she is not getting pregnant so quickly and not having to stop breastfeeding because of pregnancy,” she further stated.