Family Planning: Finding the right method of contraception for you

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The 2022 Uganda Demographic and Health Survey reveals a significant disparity in contraceptive usage between refugee women and Ugandan nationals. While 43% of Ugandan women and 27% of women in host communities use contraceptives, the rates are substantially low among refugee women. This gap is primarily attributed to limited access to accurate information or misinformation regarding contraceptive methods, commonly referred to as family planning, within Uganda. This article explains family planning; its benefits, the different methods of family planning, and where to access family planning services.

What is family planning?

Family planning is an aspect of reproductive health that allows individuals and couples to make informed decisions about the number and spacing of their children. Family planning allows people to attain their desired number of children, if any, and to determine the spacing of their pregnancies. It is achieved using contraceptive methods and the treatment of infertility.

Benefits of family planning

According to the World Health Organisation, the prevention of unintended pregnancies helps to lower maternal ill-health and the number of pregnancy-related deaths.

Delaying pregnancies in young girls who are at increased risk of health problems from early childbearing and preventing pregnancies among older women who also face increased risks, are important health benefits of family planning.

By reducing rates of unintended pregnancies, contraception also reduces the need for unsafe abortion and reduces HIV transmissions from mothers to newborns. This can also benefit the education of girls and create opportunities for women to participate more fully in society, including paid employment.

Other benefits of family planning include:

1. Empowerment: Family planning gives individuals the power to plan their future, pursue education, and participate in the workforce.
2. Health: Access to family planning services reduces maternal and infant mortality rates by allowing women to space pregnancies and plan for safe deliveries.
3. Economic stability: By enabling families to plan their finances and investments, family planning contributes to poverty reduction and economic stability.
4. Gender equality: Family planning empowers women to make decisions about their bodies and reproductive health, promoting gender equality and independence.
5. Environmental sustainability: By controlling population growth, family planning contributes to environmental sustainability and effective resource utilization.

What are the different methods of family planning?

Oral contraceptive pills

Also known as birth control pills, these are taken by women daily to prevent pregnancy. The pill needs to be taken at the same time every day to effectively prevent pregnancy.

Its ability to prevent pregnancy depends on a person using it correctly. They should be taken with instructions from a qualified health worker.

There are two types of oral contraceptive pills - the progesterone-only pill and the combined pill. These two types have different advantages and disadvantages. During a consultation with a health worker, you will be guided on what is right for you.

Note: If you get the contraceptive pill, it can take between five to seven days for the pill to start working. You can use a condom or abstain from sex during this time. Your normal fertility will return immediately after you stop taking the pill.

Condoms

This is a barrier method that not only prevents pregnancy but also protects against sexually transmitted infections. When used correctly, condoms are highly effective. Condoms are also the only contraceptive method that protects against both pregnancy and sexually transmitted infections (STIs), including HIV and syphilis. Condoms must be used correctly every single time you have sex to be effective.

How to use a condom

• Use a new condom each time you have sex.
• Check the expiry date on the packet.
• Be careful how you take the condom out of the packet – sharp fingernails and jewellery can tear the condom.
• Find the teat or closed end and squeeze it to get rid of the air. This will also help you roll the condom on the right way around the penis.
• Put the condom on when the penis is fully erect and before it touches the vagina or genital area.

NOTE: If your condom breaks or slips off, you may need to use emergency contraception to prevent pregnancy.

Intrauterine Devices (IUDs)

IUDs are small, T-shaped devices inserted into the uterus to prevent pregnancy. They can be hormonal or non-hormonal. It should only be inserted by a qualified health worker. The IUD can live in the womb for up to 10 years and can be removed whenever you want. Your previous fertility will return immediately after the IUD is removed.

The IUD can be inserted right after childbirth and starts working immediately. Only a qualified health worker should perform the insertion and removal procedures.

The most common side effects include heavier or prolonged periods, along with light spotting between periods, especially in the first few months after insertion. These side effects usually subside within two to three months.

While the IUD may increase vaginal discharge slightly, it doesn't raise infection risk if inserted correctly. If you suspect an infection, visit a health facility for a check-up. The IUD does not rust. In rare cases, the body may reject the IUD.

NOTE: Unlike condoms, the IUD does not protect against sexually transmitted infections (STIs). Therefore, avoid having multiple sexual partners while on the IUD.

Injectables

A contraceptive injectable contains a hormone that is injected into the body that stops eggs from being released. Injectables are a very effective method of contraception when used correctly. To continue being effective, you must make sure to return for an injection every 2-3 months, otherwise, you risk the chance of becoming pregnant. However, it is difficult for some women to remember to get their injections on time.

Implants

A contraceptive implant is a small, plastic rod (or sometimes 2 rods) that is inserted under the skin in the upper arm, preventing pregnancy for 3 to 5 years. The rod releases hormones to prevent pregnancy. If you want to get pregnant before that time you can simply have the implant removed at any time. Your previous fertility will return within a month after the implant is removed.

The implant doesn't affect sexual activity. However, many women may experience changes in their bleeding patterns while using it. Although the amount of bleeding usually remains the same or decreases, the timing or pattern may become more irregular. Some women may even stop having monthly periods. These changes aren't harmful and typically return to normal once the implant is removed.

If you experience bothersome bleeding during the first 3 months of use, it often improves in the following 3 months. You may experience other side effects while on the implant, such as acne, headaches, mood changes, weight gain or loss or breast tenderness. However, these symptoms usually improve over time.

Sterilization

This refers to surgical methods such as tubal ligation for women and vasectomy for men. Sterilization is a permanent contraception method and can only be performed by qualified health workers. This method is highly effective and is suitable for people who are sure they don’t want any more children.

Tubal ligation involves a short medical procedure, usually 15-20 minutes long. It is carried out under local anaesthetic and sedation, using simple techniques to seal the fallopian tubes. After this procedure has been performed, an egg cannot move from the ovary through the tubes (a woman has two fallopian tubes), and eventually to the uterus. It also does not affect a woman’s hormones, so will not affect a woman and her partner’s sex life.

Vasectomy involves closing the tubes that carry sperm from the man’s testicles. It is a good solution for men who are certain they don’t want any more children. However, a vasectomy is not effective immediately. Another contraceptive must be used for the first 3 months after a vasectomy while the remaining sperm are cleared beyond the area where the man’s tubes were blocked.

Emergency Contraception

Emergency Contraception pills prevent pregnancy if taken within five days after unprotected sex by stopping the release of eggs from the ovaries. One common type involves taking one or two hormone tablets, often known as 'the morning after pill' or 'Plan B'. 

Are there any disadvantages to using the different family planning methods?

When thinking about family planning, it's important to know that there might be some things to consider before choosing a method. These include possible side effects, costs, how the method works and how it aligns with your beliefs. Before using family planning, talk to a qualified healthcare provider who can give you the right information and help you make the best decision for your needs.

Is it a must to use family planning?

No. In Uganda, the use of family planning is a choice. Individuals and couples can decide whether to adopt family planning methods or to disregard them.

Where to get family planning services.

If you, your partner, or any member of the community requires further information on the use of family planning, visit your nearest health centre for support and guidance on the right method for you.  

In Kyaka II settlement

Refugees in Kyaka II can access free health services from Medical Teams International (MTI). MTI health services can be accessed at the following health centres;

• Bujubili Health Center IV 
• Bwiriza Health Center III
• Mukondo health center II

In Kampala

For urban refugees based in Kampala, health services can be accessed from the following places;

Mulago National Referral Hospital

Mulago Hill, P.O BOX 7051, Kampala Uganda. 

Email: [e-mail].   

Call: [phone]

Africa Humanitarian Action, 

Plot 4285 Block 244 Kansanga Opposite Bank of Baroda, 

P.O BOX 7730, Kampala Uganda

Kiruddu National Referral Hospital 

Salama Road, Kampala, Makindye division, 

Kampala Capital City Authority Health Centre IV 

Located in the 5 Divisions of Kampala

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