Florida Uzoaru: Men, Don’t Be Shy About the Family Planning Discussion

One of my favourite songs of all times has got to be the oldie Wait For Me by Onyeka Onwenu and King Sunny Ade. The lines that ‘sweet’ me most are:

“Having babies, no be joke oh
You go feed them
You go give them cloth
Give them love too
If you never ready to carry the load oh
Why put am for another person head”

They go a little further to mention the sometimes unreasonable pressure from family:

“Papa say make we marry
Mama say make we born oh
Plenty children dey
But no food to eat, my friend
This kain life
Na so so wahala”

Sadly, a number of us women find ourselves in this position, pressured to have children we do not want or are not ready for.

I remember at my wedding, I’m pretty most women will attest, I was told the clock has now started ticking. You know how friends and family will joke that they are waiting to be called again for celebration in 9 months time. Yes, you do. Fortunately for me, I was just as eager as my family to get pregnant. One pregnancy down, and I was cured of every kind of baby fever. But my family wasn’t. Year after year, they ask, “What is keeping you? Your son needs a sibling? Is something wrong?”

Sometimes, the questions come one at a time; other times, they call a meeting so all of them can descend on me at once. Distance is not a deterrent, mind you. Like the time my grandmother called from the US to speak to me because she felt my mother’s words were not getting through to me. When that was not working, she insisted I hand the phone to my husband, so she could talk sense into him.

I am lucky in the sense that I had my husband in my corner. Him and I were in sync. It was the two of us against the world. But this is not so for many women. It is a solitary journey for them. Their men are in cahoots with the “other side”, so to say. The man is just as anxious, looking for signs that ‘it has happened’ with the rest of her family and possibly his.

Perhaps he’d begrudgingly agreed to practice pullout, knowing the chances of pregnancy is pretty high. Or maybe she did not press him when he protested that she couldn’t possibly expect him to wear a condom with his own wife. He had retorted with a “If a child comes, then it comes; if it doesn’t, then it doesn’t” when he tried to make love during her unsafe days.

Meanwhile, madam knows in her heart of heart it was not something she was willing to risk – she is not ready for (more) children. She takes matters into her own hands. She secretly gets contraceptives.

The problem with doing this quietly is that, her options is immediately limited. There are a number of things to consider.

One, she needs a contraceptive option that she can take without her husband knowing. This means she needs to experience little or no reactions to it, i.e. such side effects like breast tenderness, nausea, and yes the dreaded weight gain. If her reaction is severe and prolonged, he just may notice, ask a lot of questions and if he doesn’t get satisfactory answer, become suspicious.

Unlike what is popularly believed, not every women reacts this way to contraceptives. Those who do will likely do so to hormonal contraceptives like the daily pills or injectables. But one cannot tell if you’d react or not, until you actually use them. Seeing that most women don’t begin contemplating the use of birth control until after marriage, despite being sexually active, she may not have much of an experience to fall back on. She cannot tell how her body will handle the extra hormones from the contraceptives.

What can she do? Wait until her husband is away from home to give it a go. Or more likely, she may decide not to bother at all. The problem with that is, the longer she delays, the higher the possibility of her getting pregnant.

The second thing to consider is, how often will she be required to take the contraceptive. Now, with daily pills, as the name goes, they need to be taken at the same time every day. I think even the most clueless husband will one day wonder what is this thing his wife keeps swallowing like clockwork.

Injectables are easier to hide – you only need to get the injection every three months. And with Sayana Press which can be self-administered, (you can get one from Slide Safe; just shoot me an email), you don’t even need to make regular visits to the pharmacist or clinic to get it. However, both daily pills and injectables (including Sayana Press) require prescription before use for the first time. You need to be assessed by a doctor to know if you are suitable to use them. Your age, personal or family history of cancer, past and existing medical conditions, and even your weight all factor in deciding which birth control method is is safe for you to use. This is why self-medication can be very dangerous.

Sadly, not every woman is mobile or free enough to make the unexplained and unaccompanied visits to a clinic without arousing suspicion or accusations. Even if she were, finding the clinic or medical professional that will attend to her without demanding for her husband’s consent is another matter altogether. She may not know how to begin this search, or who she could ask without fear of her questions making it back to the husband’s ears. Making it the third thing to consider.

This shouldn’t be; but some doctors, fueled by their personal bias or the fear of a irate husband coming to the clinic to make trouble, are not willing to offer family planning services to a lone woman.

Doctor-patient confidentiality is also not guaranteed if one goes to the family doctor, as some people may be obligated to save a marriage by not being an accomplice to ‘deception’.

Where the doctor is a man, disclosing to the man what his wife is up to may be his way to avoid getting roped into the fiasco that will follow should he discover what’s up – perhaps told by a busybody.

The woman could wind up being accused of infidelity (“you’re trying not to get pregnant for your lover, abi?”) and he accused of being the said lover.

So far, I’ve focused on daily pills and injectables. This is because these are two of easiest contraceptive to access in Nigeria, with the exception of condoms. Daily pills and injectables are sold in pharmacies and “chemist” stores. The latter may not even ask to see the doctor’s prescription beforehand. Implants and intrauterine devices (IUD) do have the advantage of not requiring frequent replacement, since they often protection from pregnancy for 3-5 years (up to 10 years if using copper IUD).

They are also less likely to have accompanying side effects. However, you cannot just walk into a pharmacy and get them inserted. A visit to the doctor’s is definitely required. Moreover, they are not so discrete – especially days, weeks or even months after inserting them. For a woman doing a clandestine operation, that may to too long for her to hide away from her husband.

In other words, it is not a walk in the park for the woman trying to go this journey by herself and on the downlow. There is the ever-present fear of being caught, which brings loads of complication.

There is also the disappointed husband who feels hoodwinked and left out of a crucial decision he rightly should be a part of.

Of course, there is the trust that is potentially being destroyed.

Some women consider all these hurdles, and decide against birth control ‘for the sake of peace.’

Nigeria has a national average of less than 20% usage of modern contraceptives among married women, with husbands’ disapproval high on the lists of reason for this. It is therefore no wonder that of the 600,000 plus abortions performed annually in Nigeria, a lot are by married women.

All this English I am speaking is simply to implore our men to be more open to conversations about family planning. To learn alongside their women the different options there are, and be supportive when family pressures mount on her to “have all the children God gave you”.

For best results, family planning decision must therefore be jointly made. I understand that some husbands really love children, and will be hands-on fathers. But the pregnancy and infancy stages weigh more heavily on women – they bear the brunt of it. Therefore, if she is not ready, she is not ready. Do not put your woman in the position to lie to you. It erodes communication, and introduces friction where they shouldn’t be.

Photo Credit: Dreamstime | shock