What to consider when choosing contraception
Doctor holding a copper IUD. PHOTO | GETTYIMAGE
What you need to know:
- There are several issues to consider when deciding which method of contraception is right for you. Once you have read this information, visit your doctor or local contraceptive (or family planning) clinic to discuss your choices.
According to a recent study by Performance Monitoring and Accountability (PMA2020), there has been significant improvement in family planning use and access in Uganda.
“Modern contraceptive methods are increasingly becoming popular among married Ugandan women and the quality of care for contraceptive services at facilities has improved,” the study states.
In order to control the number of children one has and the intervals between their births, it is crucial to consider availing appropriate knowledge and receptiveness in actual use of contraceptive methods.
Methods
According to Dr Geofrey Kilama, a gynaecologist at Marie Stopes Uganda, contraceptive methods vary from long term to permanent.
Long term family planning (LTFP) methods such as intrauterine contraceptive devices (IUCDs), vasectomy, bilateral tubal ligation (BTL), and implants are current effective methods that prevent unwanted pregnancies.
These, he says, are cost effective and when compared to short term methods such as injections and pills, longterm methods result in fewer clinic visits and less unintended pregnancies.
“Injectable contraceptives cost as low as Shs5,000 at drug outlets and one is usually due for another dose after three months. The method makes it easy for users to access and administer it privately, with prescription and guidance from a health worker or pharmacist,” Dr Kilama says.
“With permanent methods, vasectomy and tubal ligation is offered to women and men respectively. This is usually a 30-45 minutes procedure which is painless as the patient’s abdominal area is numbed with anesthesia drugs,” he adds.
If pregnancy is desired after going through a permanent contraceptive plan, a successful reversal procedure in women may be considered.
However, live birth rates after such procedures is dependent on a patient’s age, type of tubal procedure, percentage of the tube that remains, amount of scarring in the pelvic area, and fertility test results in the woman and her partner, according to msdmanuals.com.
Dr Kilama recommends the Intra uterine device, which is as more convenient and not noticeable.
IUDs
Intrauterine devices (IUDs) are small contraceptive devices that are inserted into the uterus (womb) to prevent pregnancy. The two types available are the coil, which costs about Shs30,000 and the hormonal IUD at Shs40, 000.
“This hormonal method is among the most effective methods and can stay in place for about three to10 years. It is the best choice for most women since it does not interfear with one’s hormones and regular menstrual cycle,” Dr Kilama says.
Experiences
Kate Asiimwe, 32, opted for the IUD. She is happy she chose this method of contraception since she only goes for checks after a while and does not face aggressive side effects except for the frequent urinary tract infections, especially after using public toilets.
To combat the discomforts of regular infections that come with using IUDs, Dr Kilama urges women to maintain good hygiene practices in order to reduce the risk of contracting fungal infections, among others.
For Linda Nsiimenta, 38, it was not all rosy when she decided to get the IUD inserted.
“After following medical advice on choosing the IUD method, I experienced so much discomfort and even conceived while still nursing a six-month-old baby,” she says.
Dr Kilama relates with the uncertainty that comes with contraceptive methods and says the procedure might cause adverse side effects to persons with a rigid or small cervix, especially those that have never given birth.
Suitability
According to Dr Kilama, all females under the reproductive age groups are eligible for family planning and this is inclusive of adolescents below the age of 18.
However, to ensure one makes an informed choice, a consent form is issued to individuals for record keeping.
“Persons below the recommended age are required to receive consent from parents or guardians whereas adults are required to consent on behalf of their spouse or for themselves,” he clarifies.
Before a suggested family planning method is administered, one is expected to undergo screening.
“This is so we can rule out any UTIs, STIs or pregnancy,” Dr Kilama says.
Misconception
Irene Akware, 36, is worried about failure to conceive in future due to the various side effects or even untimely deaths associated with some contraceptive methods.
However, Dr Kilama rules out the possibility of short-term contraceptive methods creating infertility let alone death, among users.
“The contraceptive methods entirely evolve around hormones in one’s body which is why people react differently, depending on their level of hormones,” he explains, adding that a family planning method cannot lead to death except in cases where one had a pre-existing medical condition.
Side effects
Hadijah Naigaga, 25, had never considered using contraceptives until she gave birth to her first child. The doctors advised Naigaga to opt for a suitable contraceptive method to ensure effective child spacing.
After giving it serious thought, Naigaga chose the injection. However, this caused her to bleed for three months.
Adverse side-effects have been recorded from the use of contraceptives, especially the hormonal methods of family planning. This is largely because the body is experiencing hormonal imbalances and changes as a foreign body is administered.
“With the hormonal methods, one is vulnerable to heavy or no menstrual flow, vaginal spotting, headache, breast tenderness and weight gain, which is caused largely because it induces one’s appetite,” says Dr Kilama.
Uterine perforation, the health expert adds, is the commonly experienced complication among IUD users. This is because once the IUD is wrongly administered (past the uterus), it causes pain, vaginal bleeding and restlessness.
Similar to Uterine perforation, Dr Kilama sights discomfort arising from poorly inserted implants. This is why he cautions users to seek professional help from a well-trained physician, gynaecologist or midwife.
The gynecologist also advises users to follow up with their health workers in case of any irregularities or discomfort caused by the chosen method of contraception.
Users
The Uganda Bureau of statistics last updated their findings on the number of family planning users in 2021. It was established that there was increase in contraceptive users in 2019 compared to 2015.
However, the report recorded a spike in numbers in the year 2016, which was relatively higher than the rest of the years.
This survey is an indicator of the inconsistent usage of family planning, which identifies with the unmet need of the population in rural areas of Uganda.
