MDG 5: Give Access to Long-Acting, Permanent Contraception
05/28/2010
Dr. Roy Jacobstein of EngenderHealth on Family Planning Methods
When Brenda Mensah, a petty trader in Accra, Ghana, was pregnant with her fifth child, she learned about family planning one day during a talk at her local health clinic. It was a talk Brenda wished she had heard years earlier.
Before her current pregnancy, Brenda had been pregnant numerous other times, but she and her husband, Daniel, could barely afford to feed the four children they already had, so they terminated the pregnancies. Abortions were costly and the couple struggled to pay for them. Once they had to wait until the fourth month of a pregnancy until they were able to come up with the money for one, and Brenda felt the physical toll on her body.
"I was afraid I might even die of it," she said.
Brenda was right to be afraid. Throughout the developing world, in the absence of long-acting and permanent methods of family planning (LAPMs), women are using abortion as a form of birth control. And every year, unsafe abortions kill some 70,000 women worldwide. Unsafe abortion is one of the leading causes of maternal death, along with hemorrhaging, infection, eclampsia and obstructed labor, which combined kill some 340,000 women annually, according to the latest estimates.
In order to achieve the first part of UN Millennium Development Goal 5 (MGD 5), and reduce the maternal mortality rate by 75 percent by 2015, we need to concentrate on the second part of this goal: universal access to reproductive health. The World Health Organization estimates that half of all maternal deaths could be prevented through family planning. The most effective methods are those that are long-acting or permanent: hormonal implants, IUDs, female sterilization, and vasectomy. When available, these methods are changing women like Brenda's lives.
In Brenda's case, although she and Daniel were finally ready for a fifth child, she knew she didn't want to face the other unwanted pregnancies that would inevitably come after she gave birth and became fertile again. Six weeks after the arrival of their fifth child, Brenda and Daniel returned to the health clinic where they received in-depth family planning counseling. Brenda chose to have an IUD inserted for the convenience purposes. "I am very forgetful and I didn't want to choose a family planning method that would require me to remember," Brenda said. She wore the IUD for ten years, and in 2005 had a second one reinserted.
Despite not being able to control the unwanted pregnancies earlier in her life, with her IUD, Brenda is now one of the lucky ones. More than 25 million women in Africa have an unmet demand for family planning. The main reasons for the unmet need are high up-front costs, lack of trained providers, lack of supplies and a lack of accurate knowledge about how the methods work. In coming years, however the need and demand for family planning is only expected to grow as more people than ever enter their reproductive years in Africa and urbanization, which helps drive the desire for family planning, continues its rise across the continent.
For Brenda, family planning has enabled her to improve her life and that of her family. Money is now spent on food and school supplies instead of terminating unwanted pregnancies. Brenda no longer has to worry that an unwanted pregnancy might lead to her death, and she has spread the word. Since she first attended that fateful talk that day, Brenda has brought at least 10 of her friends to the clinic for family planning counseling and care.
This article is part of a series that support the issues highlighted in Women Deliver.
Dr. Roy Jacobstein is the medical director of The RESPOND Project at EngenderHealth.
Marriage at the age 20, first child at 23, last child (2nd child) at 26 and 1st IUD at 27, 2nd IUD AT 37 will prevent maternal death. This timeline of a mother will maintain her lifeline.
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deputy RH coordinator national MOH in Somaliland so the maternal and new borm baby death rate increase due to lack of transportation and the poor facility in health facility or the delivery conducted poor or lack or qualified midwives and community midwives that controbuting the rate of maternal and new borm baby in somaliland so we need to improve the world maternal and new baby access their right
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