Considering the fact that abortion is illegal in Nigeria, one would expect that the use of the various birth control methods will be very common among Nigerian ladies. But that is not the case, as the rate of unwanted pregnancies in the country is estimated as 59 per 1000 women (between ages 15-49), and 56% resulting to abortion (1.25 million), while over 400,000 plus women have complications due to unsafe abortions . Also, there are about 34,000 deaths yearly from unsafe abortions . This only indicates that a lot of sexually active women in Nigeria do not make use of birth control, even though it is free in a lot of healthcare centers all around the country, and extremely cheap in some government hospitals, available to both single and married women. According to a research I did in a Primary healthcare center(PHC), only very few single women come to make use of the free birth control, maybe because a lot of them are not aware these services are free to them as well. Moreover, even the adverts about free birth control do not explicitly say they are available to unmarried females too, because what it always say is ‘family planning’, not ‘birth control’. Although 75% of abortions are done by married women, which probably means that married women have more cases of unwanted pregnancies.
Nevertheless, women, whether married or single should be educated about the various birth control methods, and how to find the methods that work best for them. When I did a little research, I discovered the problem a lot of sexually active females had with contraception, was that it had either failed them, affected them or they simply heard it has side effects. I spoke with a woman who told me contraception failed her once, she then decided to stop using any form of birth control whatsoever, she in fact said she prefers to have an abortion (which is clearly illegal), than to use birth control. Of course, there are other reasons surrounding the dislike for contraceptives such as, the inability of some women to have control over their reproductive health, hence they need to seek permission from their spouses, while for some other women, their cultural beliefs do not allow the use of contraceptives, or they simply do not know about contraceptives, or do not have access to them.
The most important thing ladies need to know about birth control is that it’s okay if a particular method doesn’t work for you, or gives you side effects like headaches, weight gain or weight loss, irregular or abnormally heavy menstruation etc, all you need to do is to try another method. This is why it is necessary to get contraceptives from places like hospitals or PHC, where you can easily go back to make complains if you have any, and another birth control method can be prescribed and administered to you. You cannot simply expect a particular procedure to work for you, simply because it worked for your friend, because people react to things differently, especially things that can affect hormones. Furthermore, single ladies who are sexually active should note that contraceptives are also very much available to you as long as you’re 18years old and above, just as they are available to married women, endeavor to visit hospitals or PHC to make enquiry concerning any one of your choice, these facilities are readily available to you to be used.
Here is a list of different birth control methods, their rate of effectiveness and possible side effects in case a woman’s body reacts negatively to it;
1. Safe Period: This method is simply following your menstrual cycle closely to know which time of the month you’ll be fertile and which time is safe to have unprotected sex. There are a few steps that are to be taken in order to know this;
Step 1: Firstly, you’ll have to determine how many days cycle you have. To know this, you have to count from the first day of your menstrual period, to the day before your next menstrual period, meaning of your period starts on 1st January and your next menstruation is on the 29th of January, it means your cycle is 28 days.
Step 2: Next, you have to know your ovulation day. The ovulation day is the day the egg is released from the ovary, and it is usually two weeks before your next period. This means that if your cycle is 28 days, you have to count two weeks forward from 28th of January according to the example above, then you’ll arrive at the 14th day of your cycle as your ovulation day, which means if your cycle is 28 days, the 14th day of your menstrual cycle is your ovulation day.
Step 3: This is more like the final step. Because the egg can only last up to one day after ovulation, and a sperm can live for about six days after sex, you’re only fertile for about 7 days in each menstrual cycle. Therefore, to determine your fertile days, you have to count five days before your ovulation day, and a day or two after your ovulation (to be on the safer side), every other days apart of from your fertile days are you infertile days, I.e days you cannot get pregnant.
Note: I used 28 days menstrual cycle because it is the most common, however, it your cycle is shorter or longer than that, then you have to track your cycle the same way illustrated above for a few months in order to be sure. Also, there are other means of determining your ovulation day such as (a) The temperature method – means you have to keep checking your temperature daily to know how to determine it. (b) The cerci all mucus method – here you have to keep track of your vaginal discharge. But the method illustrated above, which is the calendar method is more efficient and reliable.
2. Barrier methods: This methods included the male and female condoms, and also spermicides. The use of condoms is quite simple and reliable, it doesn’t not only prevent unwanted pregnancies, but also prevents STIs, STDs and HIV/AIDS. Spermicide on the other hand is a form of birth control that contains chemicals that destroy the sperm before it reaches the vagina. Usually, it is combined with other contraceptive barrier methods like condoms, cervical caps, sponges, but it can also be used by putting it directly inside the vagina before sex. It comes in form of creams, foams and gel. Spermicides are best used when combined with other contraceptive barrier methods.
3. Withdrawal method: This methods is one in which the penis is withdrawn from the vagina before ejaculation, during sex. This method is not reliable, neither is it efficient.
4. Hormonal contraceptives: This comes in form of oral contraceptive pills, injectable and contraceptive implants.
(a) Oral contraceptive pills: This methods involved the daily use of pills. It is highly effective if used correctly, it also can be discontinued easily by the user, and is suitable for all age groups. It also regularizes irregular periods. Although it has to be taken daily at a specific time which must not be missed, it also has temporary side effects such as headaches, weight gain, mood changes and vomiting. It has a history of raising high blood pressure in some people, stroke, heart attack, liver disease and abnormal uterine diseases.
(b) Injectables: This is a long lasting contraceptive given in intramuscular injections. It is highly effective and it decreases menstrual cramps. It involves frequent clinic visits, may cause irregular bleeding or cause menstruation to cease, may cause fertility to be delayed during reversal, weight gain, headaches, breast tenderness. It has also been recorded to have a high tendency is causing liver disease, genital and breast cancer, abnormal vagina bleeding.
(c) Contraceptive implants: It is inserted in a woman’s upper hand with a minor surgical procedure. It is long lasting, effective, reversible, does not affect fertility, effective within 24 hours of insertion, may prevent ectopic pregnancy, endometrial cancer, iron deficiency anemia. It may cause irregular vagina bleeding, Pelvic inflammatory diseases, and liver diseases.
5. Intrauterine device (IUD): It is a small plastic object inserted into the womb to prevent pregnancy. It is long lasting, effective and reversible. This method has lesser side effects compared to other methods because it is not hormonal, it does not cause any hormonal changes and is more effective, with 94-99% success rate. Although it many cause infections if user is not hygienic.
6. Voluntary surgical contraception: This is a permanent method of contraception that involves minor surgical procedure. It includes vasectomy and Tubal litigation.
(a) Vasectomy: It is a surgical procedure for sterilization for men which involves cutting, tying or sealing the male vas deferens to stop sperm from entering into the urethra.
(b) Tubal Litigation: This is a surgical procedure that involves sterilization for women by blocking or sealing Fallopian tubes. These methods are long lasting and reversals are expensive and uncertain.
Please note that to all the side effects of the various methods are not applicable to every woman, and their efficiency rate also defer, because most of the methods are hormonal. Also, according to a research I did in a Primary healthcare center, the method with the least complains is the IUDs, because it does not affect hormones.
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