•Tales of women who embrace family planning after horrors of unsafe abortions By Chioma Obinna Many years ago, effort to prevent or delay pregnancy was an individual business. Today, family planning is the most effective strategy to curb population explosion, according to fertility experts. And since the advent of modern contraceptives, family planning has also been adjudged as the game- changer in child -spacing and reduction in maternal and infant deaths as it prevents complications from frequent or too many pregnancies. As Nigeria recently marked this year’s World Population Day held under the theme: ‘Family Planning is a Human Right’, there are indications that more Nigerian women are truly demanding family planning as a right as enshrined in the 1968 International Conference on Human Rights’ ‘Teheran Proclamation’, which states that parents have a basic human right to determine freely and responsibly the number and spacing of their children. It also notes that women and girls have the right to prevent the hazard of too many pregnancies or too close together. The proclamation urges countries to prioritize family planning as a human rights obligation. The good news is that despite the challenges, ranging from culture to religion, more women are demanding family planning as a human right 50 years after the declaration. A field trip to some communities in Alapere, Agoyi-Ketu Local Council Development Area, LCDA, of Lagos State revealed that family planning is becoming a household name in many homes. Sunday Vanguard chronicles their challenges and success stories on the use of modern contraceptives. Incredible you would say! But it is true. Unsafe abortion was a major means of controlling births among rural women in times past. And this did not leave out married women. Elective abortion, according to a research, occurred more among married women, apparently because their need for family planning was unmet. But given the situation these rural women found themselves in and the little knowledge they had, what alternative did they have? This explains the rise in cases of unsafe abortion in the country and support findings by Guttmacher Institute study that due to low contraceptive prevalence, many Nigerian women who had unplanned pregnancies resolved the problem through abortion despite the country’s restrictive abortion law. It was revealing interacting with some of these women during a field trip organised by Pathfinder International to mark this year’s World Population Day. One particular case that pointed out the need for the Nigerian government to revisit family planning as a human right and ensure universal access to contraceptives for all women is the case of a 40-year-old mother of four. She was ignorant and under pressure. She had little education but had no information about family planning then. With tears in her eyes, Mrs. Joke Ade narrated how she ignorantly aborted three pregnancies which access to family planning would have prevented from happening. “I had serious challenges when I was not on family planning. It is not a good story to tell. I did not enjoy my marriage until last year when I was introduced to family planning,” she told Sunday Vanguard. Before Joke was introduced to family planning by a nurse in her area, little did she know that she was putting her life at risk as she indulged in all kinds of crude child-spacing methods, including unsafe abortions. She took all kinds of concoction to avoid pregnancy. Her situation was made worse by her husband who did not support her in keeping the pregnancies. According to Joke, living with her husband was hell all those years. Continuing she said: “I aborted three pregnancies. When I wanted to have another one, it became a problem. My first child is older than her sister by 15 years and since after my second born, anytime I got pregnant, my husband will say I should remove it. I could not remove the last one because the person that was supposed to do it advised me against it. So I went back home. I got pregnant again while nursing the child but because of stress I lost the pregnancy.” Asked while she continued to be pregnant even when her husband did not want the children, she said: “As long as I and my husband live together, we will definitely have sex.” Narrating how her husband almost forced her to abort their last child, she said: “All the children I was having were females. It is the last one that is a baby boy. This baby I am carrying today would have been aborted if not for the dream I had that it was going to be a baby boy. I told myself that whatever happened, I was looking for a baby boy, I will not remove it.” The decision of Joke to keep the pregnancy almost cost her, her marriage as it became a hell living with her husband. “My husband said I should go and remove it. When I refused, he maltreated me so badly. But I stuck to my decision to keep the pregnancy. At the end of it all, God took the glory as I had the child and it was a boy. That was when I met a nurse and a family planning provider. She advised me to go for family planning. Today, with the consent of my husband, I am on five years method (implants),” she said. Joke is among the 1.44 million Nigerian women who have embraced family planning. Another is Mrs. Ajewole Toyin who, despite her husband’s withholding of assent, decided to embrace family planning. According to the mother of six children, the continuous use of shortcut to prevent pregnancy became a burden to her. “My first child is 32 years because I started having children at a tender age. Having six children in the face of economic hardship was enough trouble for any couple. I decided to find alternative to keep my husband happy,” she hinted, “I never knew what family planning was until I met a retired nurse who explained to me what family planning is. Before then, I was taking an injection that will stop my menses for three months.” But it was a herculean task for Toyin to tell her husband that she had adopted a family planning method. “Because I get pregnant easily, I was afraid and had to listen to the retired nurse. She counselled me and introduced me to a long-acting method of five years (implants). I did that because something in me told me that what was at stake was my life and health, so I decided to go ahead secretly because I see it as my right to live. I was lucky, it went without complications. She explained how he lied to her husband after she had done family planning. “After the injection, my husband saw my hand and asked what was wrong with me and I said it was a boil. After a while, I asked told him that I want to go and take family planning injection but he refused. Later, I opened up to him that I had done it. One day in our bedroom, I said to him, ‘You are now enjoying sex without asking questions’. He said I should forget the past and enjoy the future”, Toyin said. “Though I was having some side effects initially, I am happy for it because my body has adjusted to it. Thanks to family planning, now I enjoy sex with my husband without fear of getting pregnant. I am ready to take up a 10-year-method, even for life. “My husband is always happy with me. Before he will be go outside for sex, now he is enjoying sex at home. No hurry up during sex. I can do any style now.” Another woman, 29-year-old Mrs Omolola Ahmed, has no regret that she embraced family planning early in her marriage. The mother of two told Sunday Vanguard that family planning had provided her double benefits of quality living for her two children and planned pregnancy. “I chose the implant to adequately space my children. After I gave birth to my first child, I became pregnant after six months. Taking care of the baby with pregnancy was stressful for me and my husband blamed me for the mistake. I am enjoying my marriage now. I don’t want to make such mistake again. No one is blaming me or judging me for any unwanted pregnancy today”, she said. Reacting to the claims of these family planning converts, a retired nurse and now family planning provider, Mrs Abiola Adekoya, who called for a budget line for family planning at all levels of government across the country, said uptake of family planning in the communities have significantly reduced deaths of women during childbirth. Stating that family planning offers many benefits to the family, individuals and society at large, she explained that the use of family planning enables mothers and their babies to be healthier, and avoid risky pregnancies. The expert said family planning also saves money and lives. Adekoya, who insisted that lack of budget line for contraceptives consumables was a major challenge affecting universal access to family planning in rural communities, said there is a need for government to invest more in family planning. Narrating how her efforts to introduce women to family planning has paid off, she disclosed that following an increasing number of women taking up family planning in Alapere, Lagos State government has cited a second primary health centre in the area. “In my community here, I have introduced many women to family planning and they are embracing it. Family planning is a tool for safe motherhood. It saves lives. It brings about healthy families “Some family planning methods available in various clinics in Lagos are implants, injectables, lactation, pills, condoms, Amenorrhea, patch, ring, bead and the irreversible ones like bilateral tubal ligation and vasectomy,”. While dismissing myths and misconceptions about family planning, Adekoya urged providers of family planning services to educate would-be users on the various methods available and the side effects for them to make informed choices. Health watchers are of the opinion that with the July report of the Monthly Economic and Financial Market Review and Outlook for 2018 estimates that Nigeria’s population may grow to 235 million in 2022 given the average rates in the population of the 36 states of the federation between 2012 and 2016, more women embracing family planning would definitely check the rising population