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Children by choice, not by chance

A child is a blessing that most people desire, but when a child is unplanned the situation tends to create all kinds of problems.

Family Planning 2020 (FP2020) outlines that in Nigeria in 2016 the use of modern contraceptives assisted in the reduction of about 1,450,000 unintended pregnancies; 464,000 abortions; and 9,000 maternal deaths.

These underline the importance of contraception to prevent unintended pregnancies.

Yet, according to statistics from FP2020, about 23% of Nigerian women of reproductive age have unmet contraceptive need.

Approximately 7.3 million women of reproductive age who do not wish to get pregnant now or even later should be given access to modern contraception and family planning methods. This will help the nation increase total national contraceptive prevalence rate (CPR)—now a lowly 15 per cent—to 27 per cent target by 2018. There is consensus among experts and stakeholders that this will also contribute immensely to the reduction of maternal and newborn mortality and morbidity in Nigeria.

One expert put it this way: “You cannot die of a pregnancy-related problem if you do not get pregnant”.

To mark this year’s World Contraceptive Day, MamaYe-E4A met a mother of three, Mrs. Elizabeth Ali, who is an ardent latter day user of family planning.

Here's what she had to say:

“I had my children in quick succession. Even though I planned to have my children that way, I didn’t know the implications.After having the first one, I knew I would be getting pregnant again at a certain time, which happened for me. But the third one – I didn’t plan at all.

“I had hemorrhage, and I went to the hospital for treatment, as I thought that I might have fibroid or something. I found out that I was pregnant! I couldn’t believe it. I told myself I couldn’t be pregnant again!

My second baby was still tender, and the first one was still too young. I am well educated, yet I have this struggle. Imagine the kind of struggle a woman who is not educated would be having – because you have to consider this economically and in terms of health: how you can take care of yourself and the baby, because education has a lot to do with raising your family. When you are educated, you would be well informed about issues that have to do with your health, your children, and how to give them the best care. However, I still have this struggle regardless of being educated.

“I almost lost my second baby, because he became very ill, underweight and malnourished. At some point while I was battling with the third pregnancy, which was constantly threatened. My doctor told me to take series of scans, and the result kept indicating ‘viable pregnancy but threatened abortion’.

“If I had planned it, I would have been able to nurture my second baby to grow up properly before getting pregnant again. With the constant threatened abortion, my doctor recommended bed rest, which was not possible. I asked myself, “How can I take care of my two tender babies, the pregnancy, and still go to work? I had to work and earn money to support my family. I was also dealing with serious psychological problems and the depression I was facing due to the stress of joggling all of these at once. There was also public pressure to cope with, and the embarrassment of people asking you things like, ‘Why are you not doing family planning?’

“For a woman, choosing to have children, being economically independent and having the right information are crucial to managing a family.

“After the third baby was born, I made up my mind to have IUD (intrauterine contraceptive device). Other situations I wouldn’t want to mention here made me take that firm decision, and IUD has been working for me. To ensure that it doesn’t fail, I do checkups regularly. I follow the instructions I was given, and I ensure that I don’t get infections or other things that might make the IUD fail. This is where women should be trained and informed about how to use contraceptives and take family planning decisions to ensure they don’t have children without planning for them.

“When you take an informed decision about when to have your baby, you will never have to think about abortion, and this will also prevent the complications that could arise and negatively affect the course of the pregnancy. It is important to have children by choice and not by chance.

“Finally, on the issue of availability of contraceptives when people need them, having information is one thing, having access to the kind of modern contraceptives people require is another. If government hospitals and other health facilities are out of stock, it means that even when you decide to use any form of contraceptive, it will become difficult for you to have access to them. This is mostly important for young people, who sometimes find it difficult to approach their parents for guidance on contraception. They need to know that these services and information are available and easily accessible.”

To achieve the national population control objectives, it is of essence that new users of modern methods of contraception should increase.

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