Cancer. Deformed babies. Damaged wombs. These are just some of the fears that many Kenyan women associate with family planning.
Fifty countries, Kenya included, look like they might miss the health-related Millennium Development Goals (MDGs) 2015 deadline, especially those on cutting the mortality rates of young children and mothers.
Reproductive health experts say that the achievement of all eight goals is closely linked to family planning policies and their effective implementation.
A recent reproductive health study showed that myths and misconceptions about family planning are widespread, with close to 80 per cent of the women surveyed believing that family planning leads to health problems.
The World Health Organisation defines family planning as the practice that helps individuals or couples to attain certain objectives such as avoiding unwanted pregnancies, regulating the interval between pregnancies, controlling the time at which birth occurs in relation to the ages of the parents and determining the number of children in the family.
Two reports, 2010 Urban Reproductive Health Household Report and the 2010 Kenya Urban Household Service Delivery Report, launched earlier this year, captured some of the concerns of urbanisation, including overstretched health service provision, poor access to reproductive health services and a high incidence of early sexual activity amongst the urban poor.
However, top on the list were findings on how fast rumours on family planning spread.
Of concern, the health report cited, is that every four out of five women surveyed believe that users of family planning end up with health problems like cancer, deformed babies, womb problems and even infertility.
“For example, in Kakamega 57 per cent of women surveyed believed that use of a contraceptive injection could make a woman permanently infertile,” reads part of the report.
Other fears are that family planning harms a woman’s womb.
Some 38 per cent of the women also believed that contraceptives increase promiscuity.
The late 1990s saw a decline in birth rates in Kenya, with an estimated 4.7 children per woman as compared to 8.1 in the late 1970s. The decline was attributed to the acceptance of family planning and increased availability of contraceptives.
However, the total fertility rate stagnated at an estimated 4.6 children per woman in 2008.
Reproductive health experts fear that Africa will soon experience dramatic population growth and thereby impose enormous pressure on the already strained resources.
In many African countries, child-bearing begins much earlier than in Western countries, with girls as young as 14 having babies.
In some communities, terms such as “contraception”, “condom” and “child spacing” are considered bizarre intrusions on cultural integrity and therefore no-go areas. Some African men consider family planning a sign of weakness and a sure way of losing respect.
But experts warn that myths and misconceptions related to health are a prescription that will result in poor and hungry nations.
Reproductive health experts say that contraception is to maternal health what immunisation is to child health.
So, do contraceptives cause cancer and deformed babies?
Dr Gathari Ndirangu, a reproductive health specialist, says family planning methods do not cause cancer and that, in fact, some methods may be protective against certain cancers.
“For example, the combined hormonal contraceptive methods may protect against ovarian cancer and the intrauterine contraceptive device or IUCD may be protective against cervical cancer,” Dr Ndirangu says.
However, he emphasises the need for cancer screening among all women of reproductive age. The doctor says that whilst most methods do not hinder the return of fertility upon discontinuation, the three-month injectable contraception may cause a delay because it is designed to be effective for a long period of time.
“The female and male condoms also prevent the transmission of sexually transmitted infections (STIs), including HIV,” he says.
Some STIs can cause infertility by damaging the fallopian tubes (through which the ova travel to the womb) or vas deferens (the duct through which sperm is carried to the ejaculatory duct).
“Contraceptives are safe to use by most people. However, in some people, they may cause severe side effects or worsen pre-existing diseases,” Dr Ndirangu says.
For instance, epilepsy, high blood pressure, heart disease and circulation problems could be made worse by oral contraceptives. It is therefore important to consult a health professional before deciding on a family planning method.
On promiscuity, the gynaecologist points out that many young people use contraceptives because they are not ready to have children, but this does not mean that family planning drives people to be promiscuous.
“One of the advantages of contraception is that it prevents up to 32 per cent of maternal deaths and 10 per cent of neonatal deaths,” the doctor says. “Frequent birth poses great danger to the survival of children.”
Since contraception allows families to have the number of children that they can take care of, its use allows a country’s population to grow at a more manageable rate, thereby increasing the likelihood of achieving Vision 2030.
By reducing the burden of unplanned pregnancy, contraception allows women to complete their education and develop careers that will allow them to contribute to the development of the country.
According to the Kenya Demographic and Health Survey, only an estimated 39 per cent of people living in towns are using contraceptives, largely because they are unaware of family planning options, lack access or are influenced by myths on family planning.
According to Dr Lukoye Atwoli, a consultant psychiatrist and lecturer at Moi University’s School of Medicine, myths are dangerous when it comes to health because they are the reason health objectives and goals are not optimally achieved.
“The structure of human society is very favourable for the propagation of myths. Historically, people have propagated knowledge by word of mouth, and the word of certain people is trusted more than that of others,” says Dr Atwoli.
“Sadly, our society still trusts authority more than evidence; we are stuck with myths until such a time that we shall become more critical of information provided without adequate backing. Ignorance and uncritical acceptance of authority are the main drivers of myths.”
Myths attain the “power of truth” through transmission from authority figures like parents, teachers, older friends and acquaintances.
“Questioning widely accepted ideas is not easy, and requires a degree of intellectual curiosity that is simply lacking in most people,” Dr Atwoli adds. “The longer an idea is held as true, the more difficult it is to debunk and replace with the actual explanation.”
This would therefore explain, for instance, why some women will shun certain types of contraceptives on the grounds that they will harm the womb, perhaps based on an anecdotal report that is repeated so many times that it appears the event has occurred countless times, Dr Atwoli notes.
“For instance, even in developed countries, there was a myth that the measles vaccine causes autism. The myth spread so widely that some parents started refusing to vaccinate their children, exposing them to the dangerous virus. Despite numerous scientists arguing that there was not demonstrable link between the vaccine and autism, the myth continues in certain settings.”
He recommends that myths be debunked and accurate information provided through opinion leaders who play a central role in the propagation process.
The consultant psychiatrist fears that if this is not done, the uptake of new interventions, however useful, will be delayed and lower than expected.
“Often, the impeccable science behind an intervention is less powerful than the negative myth propagated by mothers, religious leaders, elders and even politicians.”
Religion has also been found to play a role in contraception, with many religious groups upholding natural family planning methods.
Christian acceptance of contraception is relatively new; churches disapproved of artificial contraception until the start of the 20th century.
Liberal protestant churches often teach that it is acceptable to use birth control, as long as it is not used to encourage or permit promiscuous behaviour.
The Roman Catholic Church only allows natural birth control, by which it means only having sex during the infertile period of a woman’s monthly cycle. Artificial methods of contraception are banned.
Anglicans were the first church to issue a statement in favour of contraception, which they did at the Lambeth Conference in 1930 by a majority of 193 to 67. A group of American protestants followed in 1931.
Pope John Paul VI believed that contraception encourages “disrespect for the body”. “Using artificial contraception,” he preached, “could mislead human beings into thinking they were entitled to unlimited power over their own bodies.”