Wednesday, 23 January 2008

Contraception as a prelude to quality MNCH

Many women are familiar with the better-known barrier contraceptive methods namely: condoms, diaphragms and the cervical cap. With perfect use, combined with spermicide, the pregnancy rates are minimal, but with typical use, the pregnancy rates are much higher. One reason for the high failure rate of barrier methods is their inconvenience and sometimes messiness; these usually make people not to use them regularly. For example, the diaphragm and condom have been said to interfere with spontaneity, is messy and a little uncomfortable.

Different methods of contraception have their individual advantages and disadvantages. There’s no single ‘best’ method of contraception, so a woman has to decide which is most suitable for her. Whatever the situation, there should be a contraception option that works for every woman. For many people, barrier methods of contraception are best, because they not only prevent pregnancy, but also prevent HIV and other sexually transmitted diseases from being passed on during sex.

The hormonal methods are among the most effective contraceptive choices for women. There are two main types of hormonal contraceptive :the contraceptive pill, and the injectable hormonal contraceptive. If used properly, both are extremely effective in providing protection against pregnancy – but they provide no protection at all against sexually transmitted diseases.

The contraceptive pills, also known as the birth control pill is very effective if the pill is taken exactly according to the instructions. The chance of pregnancy occurring is practically nil as long as the pill is taken reularly and at practically the same period each day. A disadvantage of the pill is that it does not provide any protection against STDs. The combination of the birth pill and male condom is a good protection against both pregnancy and STDs.

The contribution of contraception to reductions in obstetric mortality and morbidity is universally acknowledged. One major pathway is by reducing the number of unwanted births. Each pregnancy and childbirth carry a health risk for the woman, and where obstetric services are poor, maternal mortality is still very high.

Contraception contributes to better maternal health beyond its potential to reduce the proportion of births that are unwanted. This depends on the extent to which births averted by contraception would otherwise pose as greater risk to the mother than wanted or intended births. The risks of childbirth are known to vary with the mother’s age and may also be linked to her parity (number of children she has had already) and to the interval since the previous birth. Contraception is likely to change the age pattern of childbearing, particularly by reducing fertility at older ages, and will certainly affect parity-specific fertility.

No particular contraceptive method is right for every woman. Personal beliefs, willingness to risk pregnancy and comfort levels with the various methods vary from woman to woman. But all women have a choice in planning their families according to what's right for them thereby assuring a better quality maternal, newborn and child health (MNCH).

Reported by: Adanma Ike

1 comment:

Emmanuel Otolorin said...

It is interesting to examine how the differences in contraceptive usage in Northern and Southern Nigeria correlate with maternal, newborn and infant mortality rates. While Southern Nigeria geopolitical zones have contraceptive prevalence rates ranging from 13-23%, the Northern geopolitical zones have CPRs of 3-10%. The consequence is that women in the Northern States are likely to have more children, have higher maternal mortality ratios (>1000 per 100,000 live births) and under-5 mortality rates. These women are also less likely to use antenatal care services or deliver with skilled birth attendants.

To compound the problem, we continue to see teenage pregnancies in communities least equipped to provide emergency obstetric and newborn care services. For every woman who dies as a result of pregnancy and childbirth complications, many suffer long-term disabilities such as obstetric fistula.

As we struggle in Nigeria to reduce maternal and newborn mortality, we must recognize that contraceptive usage is a key and effective intervention to embrace. To get this message across, we need healthy timing and spacing of pregnancy (HTSP) champions in Northern Nigeria. If you can, join the struggle and be a champion.