ECONOMIC CRISIS FORCES WOMEN TO EMBRACE FAMILY PLANNING AS HEALTHCARE COSTS SOAR


Posted on: Tue 11-06-2024

Family planning professionals have noted that economic hardship plaguing the country is pushing many partners into adopting compulsory birth control measures to avoid further financial strains on their already overburdened pockets.

They also said the rising cost of living has resulted in multiple abortions among married couples, as they seek to limit the size of their families to lessen expenditures and strains.

Experts and couples told our correspondent that the persistent economic hardship had brought with it substantial stress, tension, and crisis, with many marriages breaking down irretrievably.

To counteract this trend, couples, PUNCH Healthwise learnt, are striving to maintain a manageable family size and alleviate financial strain through the use of family planning methods, with some women even being forced to abort their pregnancies.

Family planning, according to the World Health Organisation, allows people to attain their desired number of children, and to determine the spacing of pregnancies through the use of contraceptives.

According to the Society for Family Health, there has been a notable increase in the abortion rate among married women, stating that many of them decide to terminate pregnancies without informing their husbands.

This trend, it noted, is attributed to a combination of factors, including a deep concern for their families and the relentless inflationary pressures affecting household and their cash flow.

The Country Social and Behaviour Change Coordinator for Delivering Innovation in Self-Care, SFH, Michael Titus, said married women often opt for abortion to mitigate the negative economic consequences of expanding their families, revealing that abortion among married women is undeniably on the rise.

The British Pregnancy Advisory Service describes abortion as when a pregnancy is ended so that it does not result in the birth of a child, which can also be referred to as ‘termination of pregnancy’.

Titus added, “It’s apparent that many men are avoiding the conversation about the importance and benefits of family planning. Our country faces numerous challenges, such as inflation, which erodes the purchasing power of families.”

“This puts pressure on household budgets, particularly with the escalating costs of essentials like diapers, food, and school fees.”

He further noted that women deeply care for their families and husbands and are motivated to prevent a decline in the family’s financial stability.

“Consequently, some resort to abortion to avoid the perceived burden of additional children on the family unit. This dynamic explains the increasing prevalence of abortion among married women,” he added.

Some married couples who spoke with PUNCH Healthwise in different interviews affirmed that the rising cost of food, school fees, clothing, shelter, goods, and services among others have pushed them into desperation to reduce the number of children they desired.

33-year-old Rosemary Ibeh is among the mothers in desperate need of immediate and effective family planning options after her marriage was threatened by an unplanned pregnancy.

The Lagos-based civil servant had a seven-month battle with her husband, Martins, over an unplanned pregnancy due to his declining income.

Ibeh said her husband had consistently lamented the ever-increasing prices of baby foods, beverages, medications, and school fees, among others.

She noted that Martins was worried over the financial strain the family’s expenses were exerting on him and had consistently mentioned that he would be unable to support another child, especially after already raising a girl and two boys.

According to her, Martins, who is currently struggling to care for his three children, demanded an abortion when he learnt of the pregnancy but she was defiant.

She told our correspondent that her husband bought an abortion pill and encouraged her to take it, claiming that the pregnancy was a mere clot of blood, but she found it difficult to heed his demand.

Her fears, she confessed, were based on the likelihood of having life-threatening complications.

However, based on the advice of a friend, she brought her mother-in-law to mediate between her and Martins, believing that it would make a difference, but he insisted on having no more children.

When all means of achieving a meaningful dialogue failed and she insisted on keeping the pregnancy, Martins, she said, decided to keep his distance from her.

“It was when I was seven months gone that he decided to forgive me. He neither talked to me nor ate my food for the seven months and it was hell for me,” the housewife recalled.

Ibeh, who is currently seeking the best and most effective family planning option to prevent a repeat of the experience, said, “I don’t know the best contraceptive implant to fix to avoid what I went through.

“Again, I am wondering how to forgive my husband and pretend nothing happened because of the pain and agony he put me through.

“I cried and went into depression but my husband showed me no mercy over what we did and enjoyed together.”

Contraceptive implants threatened my life

“I once had an implant but my husband blamed me for removing to conceiving despite expressing his desire to not have any more children.

“I had the implant removed after I went to work one day and suddenly started bleeding profusely. I lost consciousness and was rushed to the hospital, where the bleeding was finally stopped.

“It was then revealed that my implant was responsible. I immediately requested its removal for my own safety. Upon returning home, I informed my husband, but he insisted that I should have it replaced. However, when we adopted the withdrawal method, I became pregnant.

“I have approached a family planning coordinator in my vicinity to seek for a better birth control option.”

According to an online medical portal, Mayo Clinic, a contraceptive implant is a flexible plastic rod about the size of a matchstick that is placed under the skin of the upper arm.

“The implant releases a low, steady dose of the hormone progestin. Progestin prevents pregnancy by pausing ovulation. And it thickens the mucus of the cervix.

“This makes it hard for sperm to reach an egg. Progestin also thins the lining of the uterus. If sperm does reach an egg, this makes it harder for the fertilised egg to attach to the uterus,” it stated.

I take pills to prevent pregnancy after meeting with my husband

However, Ibeh is not alone in this compulsory family planning debacle brought about by economic hardship, as Jessica Ogundare, a mother of four, said she takes pills after having sexual intercourse with her husband to avoid getting pregnant.

The 36-year-old private school teacher in Oshodi, Lagos, said, “It’s been a constant challenge for my husband and my husband to pay school fees and provide for the basic needs of four children. Therefore, we simply can’t afford to have any more children.

“For our four children, we pay over N250,000 every three months for school fees alone. Food, clothing and transportation are not there, yet my husband and I don’t make that much every month.

“Even before my husband and I agreed to go for family planning, I had started taking pills to ensure that I don’t take in.

“On one occasion, I had to abort a pregnancy but my husband was not aware. I knew it was very wrong but that decision saved us a lot of stress because it has not been easy taking care of these children, especially with what is happening right now in the country. The economy is bad and there is no sign of relief.”

More women adopting birth control

According to the family planning experts at the Primary Health Centre, Baruwa Street, Old Ojo Road, Bukola Osinubi, there has been a surge in the number of people coming for family planning.

She linked the rise to the decision of some couples not to have more children than they can cater for, saying that couples now see four children as being a crowd and have moved to embrace birth control measures without being compelled to do so.

“Majority of those who now visit the centre do so to reduce the number of children they may have. They said the cost of living is not getting better in the country and there is the need for them to stop having more children.

“Over 70 per cent of the couples who visited our centre for family planning in the past nine months said that hardship and the need to space their children properly were the reasons they were coming for family. We have seen over 40 per cent rise in the number of people seeking birth control in recent times.

“They said it has come to the point where people think of the means of training their children and no longer seeing it as the fact that God gives children and therefore, they must continue to give birth to as much as possible.”

Corroborating her position, a family planning Coordinator in the Osun Ministry of Health, Ololade Abatan said more women in the state are adopting birth control methods due to the economic hardship in Nigeria.

Speaking during a three-day training on ‘Media Advocacy for Family Planning’, which was organised by Development Communication Network and supported by The Challenge Initiative, a non-profit organisation,  in Osogbo, the state capital, Abatan said serious and extensive counselling is no longer necessary as family planning facilities are now observing an increase in the number of women voluntarily accessing their services.

She noted that with the situation of the economy, more women are now flocking to their facilities to take up family planning methods convenient for them.

“We need little effort to push women to come for family planning now, unlike before that we have to mobilise, encourage, educate and counsel them before they come.

“They are now coming out of their shell to pick up family planning methods. The situation of the economy is already pushing the message of family planning to women in the state,” Abatan said.

The family planning coordinator urged men to support their wives while making family planning choices, saying “Family planning is to allow for peace, understanding, and collaboration between husband and wife. It is about effective management of the home and we are appealing to our men to support their wives.”

Also speaking, a Consultant Gynaecologist and Obstetrician at Epe General Hospital, Epe, Lagos, Dr Cynthia Okafor affirmed that there is a rise in the number of couples coming to the hospitals for family planning.

She noted that being faced with hardship, many couples have made a conscious effort to stop having children so that they will be able to feed the ones they have.

“I have seen several couples coming for family planning. Some I advised to do so because of poor spacing of their children. But women and their husbands are indeed flocking the family planning centres for birth control pills,” she asserted.

On the most effective birth control methods, she said each method is good but depends on the individual’s choice.

Okafor explains, “It is not one size fits all as some people might require one form of implant or the others. Some will require Copper T Seven, which blocks the fallopian tube to ensure that sperm does not get to the eggs.

“Copper T Seven is also known as a non-hormonal copper intrauterine device, a small plastic device with copper wire coiled around the frame. It is inserted into the uterus by a doctor, where the IUD constantly releases a small amount of copper.

“IUDs affect the way sperm move and survive in the uterus, stopping sperm from meeting and fertilising an egg. Copper IUDs can also change the lining of the uterus, making it difficult for a fertilised egg to implant to the lining to start a pregnancy.

“When the method is in the uterus, the doctors will do it but if it is under skin implant, nurses will handle that.”

She noted that the implants that lead to bleeding might not have been properly fixed, saying that copper T will last between five to 10 years before another can be fixed.

Clearing the air of misconception around implants and other family planning methods, she said, “Many people feel that after using family planning, they will find it difficult to get pregnant but that is not true.

“I did family planning after I gave birth to each of my children and when I am ready, I will remove it. And you know what, within a month after removal, I will miss my period. But today, the fear is no longer there as hardship in the country is forcing everybody to embrace family planning methods.

“I don’t support multiple abortions to downsize. I will rather encourage couples to go for family planning methods they consider effective and safe, and which will be handled by a professional,” Okafor maintained.

SOURCE: PUNCH NEWSPAPER