Family Planning

The past century has seen great advances made in the area of family planning as a public health issue. In spite of this, public dialogue on family planning in many settings especially at the community level remains taboo. In addition, there are many myths and misconceptions about family planning. ESTHER KIRAGU sheds light on the subject.

The modern woman today wants one, two, or three children at most, which is still fewer number of children in comparison to those, women in the past generations had. This woman is informed and wants to plan for her family.

Family planning, according to the World Health Organization (WHO), allows individuals to control the spacing and timing of births, and to attain their desired number of children. In the short-term, this can create the potential for lower maternal and infant mortality rates through fewer unplanned pregnancies, and also reduce HIV/AIDS transmission, unsafe abortion practices, and enhance education and employment opportunities for women.

Research has shown that when parents and especially women plan their families, they are more likely to realise their education goals and have fulfilling careers that raise family income. The Bill & Melinda Gates Foundation is of the view that long-term family planning policies eventually lead to reduced pressure on natural resources, improved national economic growth and enhanced status for women. So why is the practice still viewed as strange and foreign in some communities?

Addressing key restrictions to family planning…

Acceptance and use of family planning is strongly shaped by social and gender norms including the perceived acceptability of family planning.Religious beliefs, limited involvement of male partners, poor access to family planning services, and public misconceptions are some of the key factors that determine whether family planning is acceptable in the society or not.

In traditional societies, family planning is seen as a preserve of the woman. This is partly blamed on the limited birth control options available for men, leaving the responsibility of preventing pregnancy automatically to the woman. But as times change, both women and men are now more actively involving themselves in planning for their families through the use of contraceptive compared to before.

Contraceptive methods available to men include use of condoms, which prevents sperms reaching and fertilizing an egg, and vasectomy, which is a minor surgical procedure that permanently stops sperms from being ejaculated during sex. Other natural birth control options for men include abstinence, withdrawal method, which entails withdrawing the penis from the vagina and away from a woman’s external genitals before ejaculation to prevent pregnancy. Scientific and research information available is that a male contraceptive pill is in the process of being developed.

Lack of adequate and consistent supply of contraceptives and effective dissemination of accurate family planning information still limit many women’s ability to plan for their pregnancies especially in rural areas and slum dwellings.As a result many women are ill equipped to prevent unwanted pregnancies.

According to the Population Services International (PSI), a global health organisation dedicated to improving the health of people in the developing world by focusing on serious challenges like lack of family planning, less than half of married couples in Kenya use modern family planning methods. To address this gap PSI/Kenya has implemented campaigns such as Tunza Family Network, Femiplan and C-Word to help distribute quality family planning products at highly subsidised prices, educate communities and distribute education materials, as well as improve the knowledge, skills, attitude and performance of health care providers in the provision of quality family planning services.

Jhpiego, a nonprofit organisation that works in developing countries to train health professionals in modern reproductive health care, especially family planning, leads a project known as the Tupange project. The project which is supported by Bill & Melinda Gates Foundation is one of the initiatives that works with the Kenya government and private health providers to reach some of the country’s most vulnerable people through increasing the capacity of local health workers to provide family planning options and services, as well as support Kenyan mothers.

Religious customs deeply rooted in the society play a role in influencing people’s view of family planning due to myths on family planning. Some of the myths include the belief that contraceptives cause abortion, which is murder and thereby ethically and religiously immoral.

The Catholic Church has been particularly strict on the use of contraceptives and condoms amongst believers saying it is against their values. The Islam belief on the other hand only allows women to use natural family planning such as safe days.

The United Nations Population Fund (UNFPA), an international development agency whose objective is to ensure that every pregnancy is wanted, safe, and every young person’s potential is fulfilled, launched a family planning programme in 2012, focusing on youth within the Muslim communities in Malindi in Mombasa County. The aim of the programme was to use innovative approaches to demystify myths and misconception around family planning and Islam.

Which is the best option?

At the end of the day, family planning includes both natural and artificial methods. Individuals can decide for themselves which of the two methods works best for them in consultation with a gynaecologist. While some people prefer natural family planning methods others prefer artificial ones.

Natural family planning involves the use of self-control to regulate one’s sexual activities, either by abstaining from sex or having it at specific times by examining a woman’s body functions and menstrual cycle to determine when she is least likely to conceive. Observing a woman’s cervical changes can help determine her fertility by looking out for variations in the position, firmness and openness of the cervix that relate to fertile and infertile days. This enables one to time when to have intercourse to avoid or achieve pregnancy.

While natural family planning works for many people, it is vital to note that the method requires accuracy in examining and interpreting a woman’s bodily and menstrual cycle for it to work. This method is not recommended for women with irregular monthly cycles, inability to interpret the fertility signs correctly, or persistent infections that affect the signs of fertility.However, she can still use natural birth control but is advised to seek consultation with a gynaecologist so as to use the method most effectively.

There are many artificial family planning methods to prevent the sperm from coming in contact with the egg, which in turn prevents its fertilization. Some popular ones include condoms. Today both male and female condoms are available.

Some women prefer inserts such as a diaphragm, a dome-shaped cup made of either silicon or latex that is inserted into the vagina to block the sperms from uniting with the egg.

Intrauterine devices such as copper IUD (a small T-shaped device) and hormonal IUD can be inserted by a doctor into a woman’s uterus to block the joining together of sperms with an egg. Once inserted an IUD normally stays in place for 5 to 10 years and inhibits the entry of sperms into the inner recesses of the vagina, which in turn prevents fertilisation. It should be inserted and removed when pregnancy is desired by a qualified medical professional to avoid complications.

If a couple has indulged in unsafe sex, the woman can take emergency pills to reduce her chances of getting pregnant. Emergency pills, also known as oral contraceptives, stop the development of the egg and also thicken the cervical mucus in the uterus. This restricts the passage of sperms to the egg and can be an effective method if the pills are taken regularly, and in the correct manner.

You can also consider hormonal shots, which are given every three months to block the joining of sperms with an egg and also to prevent the entry of the egg into the uterus. Some surgical methods to consider are vasectomy for males, or tubal ligation for females. These are permanent surgical procedures to avoid future pregnancies especially for couples that do not want to have any more children.

The results of using artificial family planning methods vary from person to person. It is, therefore, important to talk and discuss the matter as a couple with your gynecologist and gather accurate information about all the contraception options. It is also important that you learn about the possible side effects and effectiveness of family planning products before choosing one for yourself. Remember, just because a product worked or failed when used by one person doesn’t necessary mean it will work or fail when you use it.

Family planning enables people to make informed choices about their sexual and reproductive health. Additionally, it offers women an opportunity for enhanced education and participation in public life, including paid employment. The truth is having a manageable family allows parents to invest more in each child. As a result children with fewer siblings tend to stay in school longer, eventually transforming the economic and social impact of a country.

Myths versus truth about family planning…

Contraceptives have been linked to health issues such as cancer. This is a myth. Contraceptives do not cause cancer and have been proven safe for use worldwide after many years of research.

Some people are opposed to family planning for religious views. For instance some argue that major religions such as Islam and Christianity forbid contraception. This is not true as Islam and most Christian denominations allow couples to use modern and natural methods to plan their families.

Of great importance is the need to have adequate sex education as studies prove that age-appropriate sex education and contraceptive provision REDUCE sexually transmitted infections, DO NOT cause promiscuity, and even DELAY sexual experiences among youth.