•Wouldn’t you rather do family planning?
•The myths, the misconceptions, the reality
By Chioma Obinna
Every minute, 380 women become pregnant. Some time, 190 women face unplanned or unwanted pregnancy, 110 women experience a pregnancy related complication and another 40 women have unsafe abortion. On average, 116 women die every day in Nigeria from complications of pregnancy, labour or childbirth. Is there no end to these needless troubles?
Chioma Obinna highlights the myths, misconceptions and the importance of family planning in child-spacing and preventing complications of pregnancy and births.
When 18 year-old young Stella Ogu demanded contraception, her mother thought she had committed the worst offence. She was almost ostracised in her family. After a long battle over her demand, she gave up. She did not return to her mother until months later. Unfortunately, she had continued to have sex and was not consistent about using condoms. Stella is not unique. Globally, about 70 percent of teenagers will have had sex by the time they are 19. Barriers to contraception, financial or otherwise, do not change people’s sexual behaviour.
But these barriers only increase their chance of pregnancy and these are the reasons every minute, 190 Nigerian women face unwanted pregnancy.
Like any other teenager, Stella was ready to explore. She had just finished secondary school awaiting result for her university education when the devil came knocking. According to her, it was an activity of few minutes that ruined her life. “If I was given opportunity to settle for one of the various methods of family planning, I would not be lying in this hospital today.”
Fate dazed Stella a big blow when she discovered she was three months pregnant. Coming from a Christian background, she was scared. She could not summon the courage to tell her parents, apparently due to the reaction she got when she went to her mother for contraceptive. She decided to have it her own way but little did she know that it was the beginning of her woes. Armed with counsel from her best friend, she decided to take the option of abortion. Unfortunately, in Nigeria, abortion is yet to be legalised. Then, she and her friend decided to patronise a quack doctor. The abortion was carried. Two days later, she developed complications, bleeding heavily.
Stella’s mother became worried and rushed her to a nearby hospital where it was discovered that she just had an abortion. Stella lost her womb. It was also discovered that she had developed Vesico Vagina Fistula, VVF.
Unlike Stella, Mrs. Eunice Agboola may have taken the right decision but failed to apply one of the major features in Family Planning, FP: counselling. Eunice had lived with her husband happily. Things were moving on well. They had two children. But the marriage that was once the envy of residents in their neighbourhood has gone sour, no thanks to inappropriate counselling. Eunice had committed series of abortion after the birth of her two children. Tired of going through abortion all over again, she decided to go for FP. Unfortunately, Eunice failed to get appropriate FP counselling as a married woman. “I was tired of having abortion, so I decided to take out my womb without my husband’s consent.”
Eunice was able to stop the series of abortion but, in the process, she lost her husband.
She took ill. On getting to hospital and, after series of tests, it was discovered that her health issue was due to the surgery she did to remove her womb.
Her husband began to ask questions. Eunice confessed what she did to the husband. The marriage of 10 years collapsed.
Eunice is among thousands of Nigerian women who failed to patronise approved family planning experts.
According to experts, FP counselling is a process by which a provider uses appropriate communication skills to provide correct, adequate and unbiased information on available options of family planning to individuals, couples and groups to help them understand and accept family planning.
The information provided will enable the client or couple accept family planning and choose a method.
Joyce is enjoying the benefits of family planning because she had FP counselling. She has an understanding husband.
“I will say family planning is an essential part of the journey out of poverty. Initially, I was very afraid to use family planning listening to what people say about it but I am happy I did family planning. It has helped me space my children and gave me opportunity to avoid pregnancy long enough to get gainful employment and stable family relationships without depending on public assistance,” she said cheerfully.
Family planning success rates
According to experts, FP refers to the use of natural or modern contraceptive methods to delay, space or limit future pregnancies. If a woman uses a method of family planning, she will not be able to get pregnant again, unless she wants to.
There are various methods of FP. There are long, short term measures and permanent methods. Some of the methods include pills, injectables, condoms, implants, IUD, tubal ligation and vasectomy and lactational amenorrhea.
A family planning expert with FistulaCare plus Project, Mrs. Amina Umma Bala, says family planning methods have success rates of about 97 percent.
“What we mean by that is that in every 100 women using FP, seven can become pregnant”.
She added that although FP is safe, there is individual difference in usage. “This is because individuals tolerate family planning differently. There are some people that can use family planning without showing any sign of adverse effect while using it and there are some women that very easily you can notice that they are using it”.
Clinical Associate with EngenderHealth, Dr. Suleiman Zakariya, says an estimated 220 million women worldwide want to avoid pregnancy and plan their families but lack access to modern contraception.
Zakariya explained that family planning does more than help women and couples determine the size of their families.
To him, FP safeguards health and rights, preserves natural resources, and has the capacity to improve economic outcomes for families and communities.
“Family planning also saves lives—up to one-third of all maternal deaths and illnesses could be prevented if women had access to contraception”, he stated.
“More than 1.2 billion young people, aged 15 to 24, are entering their reproductive years, comprising about 18 percent of the world’s population—the largest adolescent contingent in human history.
Eighty-eight percent of these young people live in the developing countries like Nigeria”.
Myths and misconceptions
However, despite obvious benefits of FP to protect these 1.2 billion young people from complications of pregnancy or death, various myths and misconceptions have continued to fuel low family planning uptake.
Dismissing the myths and conceptions, family planning expert, Umma Bala, said spacing of pregnancy increases the chances of healthy outcomes for both mother and baby.
“There are instances that women believe that they space their children naturally, because their husbands do strenuous work which weakens their sperm”, Bala said.
“Some say, `I know I can only become pregnant three years after my last delivery, from previous experience. I am afraid to resume sexual relationship while breastfeeding, because it may harm my baby’. She does not want to space because she is concerned about inheritance. Some people believe that if a woman uses a method of family planning, she will not be able to get pregnant again, when she wants to, all these are all lies”.
She maintained that family planning gives couples the ability to choose the number and spacing of their children.
The FP expert regretted that many women like Eunice were not provided with appropriate information on family planning before usage.
Family planning and obstetric fistula
Explaining that FP is one of the measures used to treat and prevent obstetric fistula in women, she explained that FP helps to prevent unwanted pregnancy. Bola added that it is only when a woman is pregnant that she would have prolonged obstructed labour.
Stating that the uptake of FP is now on the rise in Nigeria, particularly in states like Sokoto, she said men understanding and involvement in family planning would go a long way in reducing deaths due to unwanted pregnancy. “Family planning should be a collective responsibility and not a woman affair. It should be a shared responsibility.”
For a better family, better health, better community and a better nation, family planning should be accepted to ensure good spacing of children.
Single ladies and family planning
Umma Bala explained that once a woman is exposed to sex, family planning is next.
“Age came into bear because the woman has to decide for herself. But if under 18, there should be a relation that can testify she really needs it. But at age 18, she can walk into any provider and have it whether married or single because you would have to weigh the implications of not allowing them to access family planning”, she added.