Source: The New Vision
When I set out to unearth why some women shun contraceptives, I thought it would be a story I could do without running after many women.
For me the reasons seemed like they would point to the same thing I have heard time and again, "the fear of side effects".
Yes, most women I talked to highlighted the fear of getting complications from taking certain contraceptives as reason for shunning contraceptive use, but what other women shared made me realise the effort to encourage use of contraceptives is going to take more than significant financial pledges and other promises.
"I am not married," one of the ladies in the group I ambushed on a ladies night out, said. Prompting, I asked if she was saving sex for marriage, giggles and murmurs are what followed.
"I am as good as one abstaining. Sex is a once in a while thing," she said before lady two interrupted to explain that sex once or twice a week meant it was rare hence she saw no need of using contraceptives. "It is unlikely that one will get pregnant with such inconsistency," the other added.
One of the ladies revealed that although she may negotiate condom use, she is likely to have sex when the condoms run out. Baffled by the idea of young, working, seemingly informed women not planning to have a child yet shunning contraceptives basing on those ideas, I knew it was no longer the obvious.
Withdrawal, is what Hasfa the next woman I talked to said she was depending on to stay away from modern contraceptives.
She is a working mother of two, married for five years and she does not want to have another child for at least three years!
"I have no reason to doubt it works because I have not been pregnant for a year now. Many
of my other friends, married and unmarried are using it," she said.
Asking a few more women, I realised this is a method that has gripped many women who are branding it the safe and effective birth control method keeping them away from modern contraceptives.
But Hilda, a mother of one shares a different story dismissing the withdraw method as effective.
"After I had my first child, my fiancé and I did not want to have another child until we both had stable jobs. I had a bad experience with the contraceptive I was having, we decided to use the withdraw method. Months later I was pregnant and had to terminate the pregnancy because we were in no position to have another child," she confesses.
For Rose, a young, sexually active, never married woman says it is because of the stigma attached to sexual activity before marriage.
While women like Hasfa have the money and information to access contraceptives, Nusula, a food vendor and mother of five cites low income as her reason. "The money I get out of my work has to cater for my children's needs and my needs.
My husband offers little support. I do not have the money to start thinking about contraceptives," Nusula says. When I ask if she ever thinks of contraceptives as a solution to help her manage the needs of her family better, she hesitates before confessing:
"My husband would not accept and if I did it without talking to him, I fear something might go wrong, how would I explain?" she questions.
Nusula lacks the money to think about contraception but Nalwoga shuns it because she feels she lacks ample explanation. "I have a friend who decided to opt for contraception, and all the provider asked her was, short term or long term? Next thing she took longer than she wanted to get her next child.
They do not take time to ably explain and assess someone's needs," a skeptical Nalwoga criticises. "Ugandans should be empowered to sustain healthy behaviour," she rightly concluded.
Such criticisms sound familiar for Dr. Rodgers Ampwera, the reproductive health program manager for Program for Accessible Health, Communication and Education, an organization encouraging healthy behaviour among Ugandans.
He says most women have a tendency to depend on someone else's story and keep telling it like it is their own.
"In most cases what women say about modern family planning methods are all misconceptions.
All drugs have side effects but they are manageable unless they turn into complications,"Amperwa says adding that some women visit incompetent or non-professionals to adopt a family planning method and blame it on the method when something goes wrong.
The new UDHS 2011 indicates an increase of contraceptive prevalence rate from 24% to 31% . Even with such an increase, we cannot totally celebrate yet because women like Hasfa, Nalwoga, and the anonymous voices in this story are some of the real faces bound to fall in the high unintended pregnancies in Uganda that will result in the 350,000 induced abortions every year.
However, not all is lost. A few women are picking up on the benefits of using contraceptives.
Esther Kakaire a newly married 25-yearold sales assistant wants to take a course to advance her career. "I really do not want to get pregnant until that happens," Kakaire says.
Most women said their desire to give their children a better life, good health, education prompts them to opt for a family planning method.
Ampwera says the level of satisfaction with a woman's chosen method influences her contraceptive use.
Linda Ahaisibwe, a mother of three agrees: "So many women are unhappy with their contraceptive options, if one fails they may not want to try another and those who find one that works will not see reason to shun family planning methods."
Young unmarried women said they stick to contraceptives when they are not sure about the man they are dating or when they discover he has been unfaithful, "the first time I took an emergency pill was after I discovered after spending a night with my fiancée that he had made a woman pregnant," says Joylyn Namaleya who is still engaged to the same man but ardent about contraceptive use.