Tuesday, June 18, 2024

Man or woman: Who should carry the burden of family planning?

Although family planning methods nowadays cater for both men and women, it is still assumed that the burden of contraception lies with the woman. In many relationships, women will be comfortable with their man throwing caution to the wind, only to later run up and down searching for emergency pills.

Many women also have no problem popping pills. This is despite the risk of contraception misuse and the availability of risk free contraception solutions.

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Adoption of contraceptives in relationships

According to Dr. Petra Boynton, a psychologist and author of The Research Companion, some partners fear that initiating conversations about contraception in a relationship will be misinterpreted as a disguise for chasing after other partners without fear of pregnancy.

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“Others fear that talking frankly might seem too overbearing or be perceived as a passion killer. Also, many partners think that the talk on contraception is similar to putting a question on the level of trust in the relationship,” she says.

According to a research study that was conducted by the Guttmacher Institute on the use of contraception at different stages of relationships, the timing and choice of method will strongly depend on the type and strength of relationship.

For instance, during first sex in a relationship or during sex in the early stages of a relationship, many women will show an urgency to negotiate for condom use while men will show motivation to practice contraception.

“As the relationship progresses, many couples tend to abandon condoms and adopt traditional methods out of mythical fear such as infertility. After the first birth, couples will prefer modern contraceptives to space children, but side effects often lead women to switch methods or discontinue with contraception,” the study found out.

Contraception usage

In Kenya, implants are ranked as the second most used contraception method after injectables. According to a 2018 review report title Lift Off: the Blossoming of Contraceptives Use in Africa, out of every 100 married women who use contraception, 30 use implants.

In 2019, Kenya surpassed its FP2020 commitment to increase use of modern methods of family planning among married women to 58 per cent. According to the report, FP2020: Women at the Centre, Kenya has a modern contraceptive usage rate of 60 per cent.

Also, according to figures from the Ministry of Health, the contraceptive prevalence rate has been rising steadily over the past one decade in Kenya. This growth has been widely noticeable among women in marriage.

For example, between 2009 and 2019, the rate of contraception use among married women in Kenya increased from 46 per cent to 58 per cent. “There is a positive ripple effect from this rise as more contraception use means fewer unwanted pregnancies and maternal deaths,” says Dr. Thuthwa.

According to the Economic Survey 2020 report, as at the year 2020, Family Planning (FP) Injections was the most popular method of contraception with 2.3 million women taking it, followed by Pills Combined Oral Contraceptive, which had 681.6 thousand women.

With permanent family planning methods, the number of females undergoing Sterilization Tubal Ligation was 4,435 while male Sterilization Vasectomy had 334 men only. The report showed a general decline in the uptake of modern contraceptive methods, except for pills which continued to increase.

Hormonal problems

According to Dr. Janet Thuthwa, an Obstetrician-Gynecologist, decreased sexual desire is among the side effects that women using hormonal contraceptives attract.

“The link between mental health and reduced libido is not so farfetched. Sexual activity among women is to the largest extent mentally induced,” she says. Dr. Thuthwa adds that other side effects associated with hormonal contraception are inter-menstrual spotting and breakthrough bleeding, missing periods, heavy periods, weight gain, headaches and migraine, and breast tenderness.

Vasectomy vs tube ligation

With the possibility of side effects, vasectomy can be the best alternative. However, myths have kept the majority of men away. The procedure for vasectomy usually takes 15 to 30 minutes and is about 99.8 per cent effective.

It does not affect sexual functioning or sexual pressure. Where men have refused to undergo vasectomy, women have had to adopt riskier methods such as tube ligation (surgical sealing of fallopian tubes).

Is your spouse, sibling, friend, neighbour having depression and you’re unaware?

According to Dr. Ramon Suarez, the managing director of No-Scalpel Vasectomy International, the failure of vasectomy could only mean that a child might be sired accidentally, whereas the failure of tube ligation could end up claiming the life of the woman undertaking it.

Condoms and myths

Apart from being a protective sheath against sexual infections, condoms are also a form of contraception. However, in relationships, condoms tend to face a mountain of myths.

For instance, a study on how men in Mombasa rationalized sex without contraception found out that many men feel that taking condoms for contraception ends up denying women sexual pressure. They also feared that condoms as contraceptives caused pain rather than pressure to their women due to friction.

Making the choice

Ultimately, you will need to make a decision on which method of contraception suits you, be it condoms, implants, pills or even vasectomy. Be aware of all the available options – both hormonal and non-hormonal and their risks and benefits.

Subsequently, according to Dr. Boynton, you should raise the red flag if your partner refuses to use condoms when you want to, or belittles other contraception choices you may have made.

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