POOR CONTRACEPTION UPTAKE

Is contraception illegal as abortion? Then, why do some women not use any form of pregnancy prevention method? What remain a fact here is, you cannot eat your cake and have it; if you must have sex, keep it in mind that pregnancy might be inevitable without any form of contraception. I can tell you categorically that, there is no country in the world where contraception is illegal. Even if you know one country, I will still convince you that it is not entirely true. I will let you know why it is not entirely true in this post. Contraception maybe accepted partially; for some, it is for cultural or religious reasons, while for others it might be personal or are compelled by the laws of their region.

Even if there is a country where contraception is illegal, I am certain the legality will lie with the method of contraception use. The law will certainly not follow you to your home or bedroom to know if you practice any natural methods of contraception. By this, I am not in any way advocating for natural methods because of their high failure rates though, no contraception is 100% effective. Moreover, the failure rate for the most effective pregnancy prevention method is < 5 in 1000 women who use the method per year.

WHY THE QUESTIONS?

So, why the query whether contraception is illegal as abortion? And why do some women not use any form of contraception?

In the course of my training as a resident, I was fortunate to be directly involved in the management of four women who were not fortunate. They all have a lot in common; they were not on any effective contraception, three of them were married and one single but sexually active, they were pregnant and procured an illegal abortion, their womb or womb with one or both ovaries decayed inside them, they all had operation with removal of the womb or womb with one or both ovaries, ended up in the intensive care unit. Three of these women died. This would not have happened if they had access to safe abortion and after abortion care.

In Nigeria, there are laws that prescribe punishment for procuring or performing abortion, except the pregnancy threatens to take the life of the mother. However, there are reasons that affect the uptake of contraception as outlined below. The danger of having an unsafe abortion is so scary for any sexually active female not to consider any form of contraception, even the most ineffective one.

WHAT IS CONTRACEPTION?

Whether you like to hear it or not. You are most likely using a contraceptive method even without your knowledge. At times, I often get responses like, ’’I do not use any contraception’’ during consultation at the gynaecology or post-natal clinic when I ask the patient if they use contraception. What then is contraception? Contraception involves all the measures, whether temporary or permanent, that are designed to prevent pregnancy due to sexual act.  

If you know what contraception really is, then you will realize you are already using one. If you never knew you were using any method of contraception until you read this post, then you should know the method you are using is most likely not very effective. Unless what you are doing or taking is not for the purpose of pregnancy prevention then it is not contraception. Yes, I know, you have been getting results and your children are all spaced at least 3years. Remember I said, ‘not very effective’, I did not say it does not work. It means it has a higher chance to fail than other methods.

FORMS OF CONTRACEPTION

There are different forms of contraception and this are broadly classified as natural and artificial methods.

The natural methods consist of measures not involving the use of any device, barrier or medication. It involves taking note of the woman’s fertile periods; using the menstrual calendar, some symptoms and signs. Then, avoiding sex during the fertile period. Naturally, a woman’s sexual receptiveness increases during her fertile period, hormones don’t lie.

The artificial methods involve the use of barriers, devices, medication and surgical occlusion of the fallopian tubes (bilateral tubal ligation) or the vas deferens in males (vasectomy).  

POSSIBLE REASONS FOR POOR CONTRACEPTION UPTAKE

Like I mentioned earlier, the uptake of contraception is influence by both personal, cultural, religious and scientific reasons. The number of children a man has used to be a symbol of his greatness and wealth in Africa. These children serve as his main labour force in his farms. This reason is fast becoming an idea you can only find in the museum. However, it might baffle you to know that a certain traditional title come with the number of children a woman has in some states in Nigeria. From the religious point of view by the two most dominant religions in the world, sex seems to be an act purely for procreation hence, nothing should interfere with the sperm getting into the female reproductive tract.

Therefore, certain contraceptive methods are preached against; like the natural withdrawal method, the hormonal and non-hormonal methods of contraception might not be accepted, depending on the religious sect or denomination. Also, the debate by some of the religious denomination is backed by some scientific publications on the effect of contraceptives on aquatic life. The life of animals that live in water is affected by a component of the contraceptive pills that is not completely broken down by the woman’s body when she takes the combine pill. This can get into bodies of water through the disposal of non-treated sewage into the water body.

Maybe, there will be no fish left in our water bodies in the future if we keep emptying our untreated sewage into our rivers or streams. Just imagine a world without a fish as a meal or part of a meal (that’s on a lighter note). Some individuals may not be aware of some of the most effective hormonal methods of contraception. Those who are aware and may want to use them, may not be able to afford them. Also, some women believe that using hormonal contraception will interfere with their future fertility. Therefore, they only subscribe to its use after they have completed their family size.

For detailed description of the various natural and artificial methods of contraception including infertility, subscribe to get notification on the series as soon as they are published.