Available data shows that one in four pregnancies in the country is unplanned for. Experts say using family planning would prevent them as well as save lives. APPOLONIA ADEYEMI reports
Mrs. Teniola Fadairo, 54 years, a mother of four had set out to embrace family planning (FP). As soon as she got married in 1985, at the age of 24 years, she conceived without delay, prompting the delivery of her first baby two years after, prescisely in 1987. “It was the preference of spacing the arrival of the next baby that made my husband and I to embrace FP after the birth of our first baby, Mrs Fadairo told the New Telegraph during a field trip to the Lagos Island Maternity last week.”
After counseling by health workers, she adopted the intrauterine contraceptive device (IUCD) which was inserted in her uterus through the vagina, she disclosed.
An IUCD is a small, “T-shaped” contraceptive device which is placed in a woman’s uterus (womb). It is also known as the IUD, loop or copper coil.
IUCDs are made of flexible plastic with a coating of thin copper wire. It has one or two soft threads on the end. These thin threads hang through the opening at the entrance of the womb (cervix) into the top of the vagina.
An IUCD works by stopping sperm reaching an egg. It does this by preventing sperm from surviving in the cervix, uterus or fallopian tube. It may also work by stopping a fertilised egg in the woman from implanting in the uterus.
Relating her experience about the IUCD, Fadairo said: “I was not feeling fine when I was using the IUCD; I was not comfortable with it at all. I did not feel pain or discomfort, but I was experiencing some discharge from my vagina.
“After some months, I went back to the health facility and informed them about this. Although, they assured me that it would be over soon and that I would feel normal again, but I insisted that it should be removed.”
When the medical doctor on duty at the private facility where I sought the service, checked me and asked if I wanted to continue with the IUCD, I said, “No,” and it was promptly removed.
Fadairo who abandoned the use of FP due to the highlighted discomfort, later had three more children, using natural method only throughout the period of her reproductive years. “I thank God today that things went well. It was not by my power,” she told the New Telegraph.
For another housewife, Mrs Tayo Olubi, also a Lagos resident it was a different scenario. She got pregnant four months after the delivery of her first child. Olubi who did not breastfeed her son exclusively found that she had become pregnant four months after delivery.
She was not only confused, but had challenges coping with nursing the first child and going through another pregnancy at a time that it was too close to the previous one.
Convinced that she could not cope with this challenge, she visited a traditional medicine practitioner who prescribed a local herb with which the pregnancy was terminated. Within days of administering the herb, the five months pregnancy was terminated leading to days of profuse bleeding. Although, she was rushed on emergency to a nearby public health facility, Mrs Olubi died before getting help in the hospital.
The World Health Organisation (WHO) defines family planning as a voluntary measure that “allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods.”
FP enables couples and individuals to exercise their rights to determine whether to have children, when and how often to have children, and when to stop; and provides information and services to act on the right. This is vital to safe motherhood, healthy families and prosperous communities.
Contraceptive use remains very low in Nigeria. The Guttmacher Institute (GI) estimates that in 2013, only 16 per cent of all women of reproductive age in Nigeria,15 to 49, were using any contraceptive method, and only 11 per cent were using a modern method—levels that remain virtually unchanged since 2008.”
Besides, available data from GI shows that in 2012, about one-fourth of Nigeria’s 9.2 million pregnancies were unintended —a rate of 59 unintended pregnancies per 1,000 women aged 15 to 49.
According to the data, more than half (56 per cent) of these unintended pregnancies ended in an induced abortion; 32 per cent ended in an unplanned birth and 12 per cent in a miscarriage.
Based on the highlighted statistics, it is very clear that abortion arising from unintended pregnancies remain high in spite of the restrictive abortion laws in the country. In Nigeria, abortion is legal only when performed to save a woman’s life. Still, abortions are common, and most are unsafe because they are done clandestinely, by unskilled providers or both.
However, these unnecessary abortions could easily be averted if Nigerians of reproductive age use FP services which experts said could help prevent unintended pregnancies as well as space births for mothers, a measure that would boost their health.
One of the major problems hindering the implementation of FP is the barriers that are making women not to uptake services, said Dr. Ejike Oji, chairman of the Advancement of Family Planning (AAFP).
Oji who is also the chairman, Coalition for Maternal, Child and New Born and Adolescent Health Accountability in Nigeria (C4MAN), said, “The most important barriers we have seen are misconceptions. People feel that when they uptake FP services they won’t be able to have babies again or that something bad will happen to them.”
On the contrary, Oji described such claims, most of which were based on traditional and religious believes as misconceptions and myths.
On the issue of negative reaction to FP use in some women such as the one experienced by Mrs Fadairo who ultimately dumped FP, Oji said FP was such medical services that were personal. “What is good for you might not be good for the next person and that is why we are saying that practitioners must be properly trained to provide the services.
“You shouldn’t just go somewhere to access FP. You must be properly counseled. There are so many methods. It is during the counseling that practitioners will identify the one that is good for each person and give that one that is specifically for you and you won’t have any problem.”
When side effects were experienced, Oji advised clients to report to the facilities. Often, side effects could be temporary and often fizzle out, with normal situation returning. Sometimes, it may be necessary to change FP methods in individuals to address side effects, he added.
On the prevention of unintended pregnancies, he lamented that Nigeria’s maternal mortality rate is 576 deaths per 100,000 live births.
Every day about 111 women and girls in Nigeria die due to preventable pregnancy and child birth related complications (every hour five women die), according to data from the Nigerian Demographic and Health Survey (NDHS). Nigeria accounts for one in nine maternal deaths world wide
Thirty-four per cent of such deaths can be prevented by increasing access to and uptake of FP, he asserted.
Oji described FP as key in terms of child survival and women’s health. “What we are saying is that women should be able to space their children appropriately, limit the number of children they want and also not start their reproductive health production too early.”
Medical experts said pregnancies that are too early, too close, too late or too many carry extra hazards not only for the health of the woman but also for the child.
Previous research shows that the greater number of women that died during child birth in Nigeria is below 18 years. In fact they have the second highest number of deaths, estimated at 70 per cent, from pregnancy and pregnancy related cases.
A recent study by the United States (U.S.) Centers for Disease Control and Prevention’s National Center for Health Statistics also shows that using FP is beneficial and could stem unintended pregnancies.
According to findings of the study released on June 22, 2017, although, more than half of American teens had sex by age 18, teenage pregnancy and birth rates extended their two to 1/2-decade decline because of increased contraceptive use.
Most of the 55 per cent of teenagers who had sex by 18 used some type of protection, typically a condom, the study of more than 4,000 teenagers showed.
Some 80 per cent of teenagers employed a contraceptive method during their first sexual encounters, according to the study.
Consequently, medical experts are of the view that up taking FP services was in the overall interest of mothers and babies. It would not only benefit clients like Mrs. Fadairo, using FP could prevent unnecessary death in abortions such as the one that killed Mrs. Olubi.
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