“I am 17 years old and a mother of two. I was impregnated by my then ‘boyfriend’ who was my schoolmate and older than me from a wealthy family. He showered me with gifts some of which my single mum who worked as a casual laborer and had 6 children could not provide. When I learned I was pregnant, I didn’t know what to do. The man who was responsible denied being the father and asked me to have an abortion because he was too young to be called a father. I was too scared to tell my Mother and abortion was not an option for me either. I was too stressed and young to think straight.
I met an old man who had a wife but was willing to take me with my baby. I eloped with him and started a life together. After I delivered my baby life changed drastically. It was difficult to take care of my baby and my husband could not provide for us. He claimed he gave me shelter and that I should feed myself and my infant. I started washing people’s clothes with my baby on my back to raise money for my upkeep. I went to my local clinic to be guided on what method of family planning I would use as I was not ready to have another baby but was turned away that I was too young. I went back the second time again to be told that there was no one to attend to me. I did not give up and went back five times with no success.
I got pregnant again! Not because I wanted but because I was denied my rights. I was mad, upset, angry and cursed the day I was born. I did not have gainful employment as a young mother and providing basic needs to my child was a nightmare. I was depressed and it’s during this tough season that I met a social worker who introduced me to a charity organization that was empowering teenage mothers. We were taught life skills including reproductive health and also using contraceptives to limit the number of children. I could finally access contraceptives and started using injections. I am now back to school and continue giving advice to other young women with hopes that they will follow and learn my lesson. Our governments and health institutions need to understand that reproductive health including family planning is our constitutional right and that they need to increase financial allocation towards women and children’s health.”
– Magda – Kenya (I met Magda in one of the slums of Nairobi during a field visit)
World Contraception Day (WCD), celebrated on 26 September, is a worldwide campaign with a vision for a world where every pregnancy is wanted. Launched in 2007, its mission is to improve awareness of contraception to enable young people to make informed decisions on sexual and reproductive health. Observation of this day raises public awareness of the means of contraception. Sex education programs are targeted at young people, including minors. Awareness of contraception and reproductive health will help avoid unplanned pregnancies, abortions and spread of sexually transmitted diseases. Investing in family planning as a component of good reproductive health has benefits that go beyond the obvious prevention of pregnancy and reduction of disease burden, the social and economic benefits for global development goals should not be overlooked.
While contraceptive use has risen to relatively high levels in many areas of Asia, Latin America and the Caribbean, it remains low in much of sub-Saharan Africa. Only about 1 in 4 women of reproductive age in Africa use a modern method of family planning and this proportion is substantially lower in many countries of the region. These numbers, however, do not indicate a lack of interest in family planning among women in the region. Young women in the region lack access to or are not using an effective method of contraception. Reasons for this vary from each country but most are related to lack of supplies, poor quality of services and cultural and political barriers. The most affected group is young women living in poverty, those living with HIV/AIDS and those of post abortion care. In Uganda, 41% of women who want access to contraception fail to get it. The unmet need in Rwanda is 38% of women; Kenya’s is 25%.
Giving women in sub Saharan Africa the opportunity to time their pregnancies and space out their children through effective, low-cost contraception is key to turning around these heartbreaking numbers. Not only does access to family planning information and contraception improve the health of mothers and children, it also improves the economies of their households. When a woman has fewer children and more time to work, harvesting crops or growing her business, she brings more resources into the home so her children can be fed and go to school. Young women in sub Saharan Africa especially face multiple barriers to accessing contraceptives including lack of information, social stigma, provider bias, lack of confidentiality and policy restrictions. What they need is information and skills to make informed choices. In some societies young women have limited control over their contraceptive choice. They lack the power to negotiate contraceptive use with their partners and decisions are made for them mostly by their parents, spouses or partners. Teenage mothers particularly face barriers that include societal pressure to have children, fear of spouses and lack to transport to health service providers.
In most cases conversations about contraception tend to be religiously and politically charged. Some people believe that giving women access to contraception is encouraging promiscuity, even though most of the women who use oral contraception are married. Civil society organizations should continue to actively advocate for and invest in increasing access to family planning information and contraceptives as this will result in fewer women and girls dying in pregnancy and childbirth, fewer unintended pregnancies, fewer abortions, and fewer infant deaths.
I am a woman and I have a right to access information and services that will enable me to know when it is time to grow a family and when it is time to wait and also how long I should nurse my baby.
Featured image: Lindsay Mgbor/Department for International Development