Contraceptives uptake reduced due to fertility awareness

Kenya has one of the highest fertility rates in the world with a total fertility of 4.6 children per woman.

This is according to the Kenya Population situational analysis July 2013, the first report of its kind in Africa launched on Wednesday at the Laico Regency Hotel in Nairobi.

The study presented grim statistics of the low acceptance and use of contraceptives in controlling population and thereby frustrating the realisation of the Millennium Development goals.

Prevalence rate for modern methods rose to 40 percent, way below the country’s target of 70 percent.

The report attributes population growth rates in developing countries such as Kenya as being driven by fertility. Differences in fertility levels are then determined by age at marriage initiation, contraceptive use, induced abortion and duration of breastfeeding.

The study notes that complex dynamics that involve changes in demand for children, diffusion of new attitudes about birth control and greater accessibility to contraception provided by family planning programs also play a part in determining fertility.

The report reveals Further, unwanted fertility which is fertility in excess of desired fertility declined due to contemporaneous family planning. Poor women are more likely to have unwanted fertility as they are unable to access reproductive health services.

Having more than two or three children in Kenya was once a reserve for the uneducated, low-income  earning families usually residing in the rural areas having low accessibility to health services and high poverty levels is fast changing.

FERTILITY AWARENESS

The report notes an alarming decline in the uptake of contraceptives among the rich and higher income earning groups. Recent revelations that most abortions take place in marriages and stable relationships among well off Kenyans confirm this worrying trend.

Catherine, a high school teacher is married to a banker.  She holds a graduate degree and so does her husband.

They have just had their fifth child. In a pregnancy that was concealed in shame until it could no longer be, Catherine confessed that they do not use contraceptives and they rely on natural methods.

“Contraceptives in all their forms do not work for me,” she said. The coil (IUD) I had caused heavy bleeding, the pills gave me high blood pressure and this scared me into using an injectable as I know, its effects are not immediately reversible."

What is clear is that Catherine knows all the options available and has chosen not to use contraceptives resorting natural method of contraception.

“Out of hundreds of times, I have only miscalculated twice, resulting in the birth of my last two children.” She adds with a chuckle.

Increasingly, educated women are opting out of conventional contraceptives opting to use natural methods for other reasons besides religion.

NOT A MEDICAL CONDITION

Outside religion, the use of natural methods becomes known as fertility awareness. This is a movement that has been fanned by the increasing knowledge and availability of information leading many women to accept their fertility as a part of life and not a condition that needs to be controlled using medication.

Side effects associated with conventional methods have convinced partners to support their women in embracing natural methods.

Catherine and her husband of five years use the Calendar based method. Calendar-based methods determine fertility based on a record of the length of previous menstrual cycles.

“My husband has installed numerous applications on both our phones to which he refers to. He even has one that sends him reminders on e-mail.  He said I used to cry too easily when I was on the pill. He is happy that I am now more emotionally stable. That his decision has helped keep my blood pressure low, makes him a happier husband.”

HIGH RISK BIRTHS

The study sheds light on an emerging issue in fertility. That of high risk births. Births are defined as high risk if the mother is below 18 and over 34 years of age, has had a live child within the past 3 years or more than 5 years.

Most mothers who fall in this category are in marriages.

Risper, a college-educated , stay-home mother of four acknowledges that the risks associated with contraceptives are much higher than an additional child. She has had her four children in the space of six years. 

She confesses that natural methods have sometimes worked for her and she will continue using them.

She however admits that she uses a combination of fertility awareness methods and is unsure what she would do if she fell pregnant.

“I will cross the bridge when and if I get there.” She concludes.