By Natasha Kalawe:
Strange state of affairs! 12 years in marriage. A poor couple living in the heart of the rural area has seven children it is struggling to feed and cannot afford to send them to decent schools.
12 years in marriage. A well-to do couple in the city has only two children who are well-looked after and are attending studies at an upmarket school.
We all know that every child is a gift and a joy. But when income is scarce and a family is already struggling, it is debatable on whether to have more children.
Here is a big question. Why do poor families have many children?
Obviously, there are a number of social, cultural, religious and economic reasons why poor parents especially in rural areas have large families.
Several studies show that most women and girls in rural areas are not using contraceptives.
For starters, contraception is used to plan when women, girls and couples can have children and how many children they have. This includes choosing when they want to begin having children; how far apart they want their children to be; and when they want to stop having children.
The issue of making a decision on the number of children one should have is a human right provided in the Gender Equality Act. Among others, the act states that ‘every person has a right to adequate sexual and reproductive and health including the right to choose the number of children and when to bear those children.
The Act also allows Malawians to freely choose an appropriate method of contraception they like. While the Gender Equality Act provides that people should have access to comprehensive Sexual and Reproductive Health and Rights, many people especially in rural areas are not enjoying them.
According to the World Health Organization, 214 million women of reproductive age in developing countries want to avoid pregnancy but are not using modern contraceptive methods.
The WHO report revealed reasons of the women who are not using modern contraceptive methods include limited choices, limited access to contraception, fear or experience of side effects, and cultural or religious oppositions.
There are a number of myths in rural areas that discourage people from accessing and using contraceptives. Here are some of them.
Myth: Family planning has negative effects on sexual desire and performance.
Fact: Libido depends on individuals and their circumstances. Health experts say that contraceptives generally do not diminish sexual desire or function. On the contrary, agreeing to a family planning method helps spouses have increased enjoyment during sex because they do not have to worry about unplanned pregnancies.
Myth: Family planning puts the health of my wife at risk.
Fact: When used properly, all family planning methods are safe. Women who have had more than four babies are at an increased risk of death as reported by the WHO in 2018, which means mothers will benefit greatly from family planning. Using condoms can help prevent sexually transmitted infections, like gonorrhea and syphilis, and even decrease the chances of getting infected with HIV.
Combined oral contraceptives or pills can reduce the risk of ovarian and endometrial cancers. And while there are side effects to using modern contraceptives, including headache, spotting, slight abdominal pain, and changes in weight, they are not harmful and usually do not last long.
Since family planning allows parents to space pregnancies and decide the number of children, mothers can recover better after every birth and devote time for personal growth; spouses can have better mental health and relationships due to reduced anxiety, and children can grow up healthy because their parents are able to better care for each offspring.
Myth: Long-term use of family planning methods will cause infertility.
Fact: The woman’s menstrual cycle resumes to regular schedule when she discontinues use of a contraceptive, hence mothers take back the ability to conceive once they decide to have a child.
Let’s have children by choice and not by chance.
Long-Acting Reversible Contraceptives (LARC) are 99 percent effective in preventing women from getting pregnant for three years and above, depending on the type of LARC.
For instance, a progestin subdermal implant, which is placed under the skin of the woman’s upper arm, releases progestin that stops the body from releasing ova or eggs every month and thickens mucus in the cervix that blocks sperm. Once the woman decides to have the contraceptive implant removed, her regular fertility cycle resumes immediately.
Myth: Family planning is a form of abortion.
Fact: The current law which at the moment is under review is clear on this. Abortion in Malawi is legal but restricted. Furthermore, contraceptives do not terminate pregnancy or cause abortion; rather, they prevent pregnancy and actually help couples avoid unplanned pregnancies.
Myth: Family planning is expensive.
Fact: There are family planning options that match every family’s need and situation; in public hospitals they are free while in private hospitals contraceptives are either free or reasonably-priced. Some contraceptives can be accessed over-the-counter in drugstores.
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