Thousands of women continue to face the risk of unplanned pregnancy due to the burden of family planning without the support of their partners.
Rwanda Today has learnt that this is worsened by the side effects that come with family planning, especially as concerns contraceptives that induce hormonal changes in their bodies.
While men have a choice to use non-hormonal methods such as condoms or vasectomy, many are reluctant to take the lead in planning families due to cultural and social perceptions.
For example, Grace Mukantabana, 38, is a mother of two daughters and has been married for seven years. When she had her last born five years ago, she realized she needed to focus on her job as a cashier and get the promotion she always wanted. She decided to use a five-year intra-uterine device contraceptive.
Headaches, fatigue, backaches, constant spotting, mood swings and other intense side effects made Mukantabana quit the implant for injections, which she later gave up for the same reason. Having to deal with such side effects is what challenges Mukantabana most in her family planning quest.
“These things are very accessible and are offered free of charge at health centres. But they come with too many side effects. Fortunately, my husband was understanding, otherwise, I would have another child by now,” she said. Mukantabana’s experience is shared by many women, who unfortunately have to carry the burden of family planning on their own without support of their husbands.
In Rwanda, the contraceptive prevalence rate among women reaches 70 percent depending on age and marital status while only 3,500 men have practiced non-scalpel vasectomy, according to official statistics.
This is partly because the majority of family planning programmes tend to target girls and women. As a result, the burden of family planning is disproportionately borne by women.
Yet unplanned pregnancies impact women more significantly than men. Perhaps that’s one reason why men in Rwanda and worldwide are much less likely to participate in family planning by adopting contraceptives.
Mukantabana’s husband, Yvan Rutikanga, says he would never consider having a vasectomy because of fear, beliefs and lack of information. He prefers assisting his wife and discussing what works better for her. They ultimately decided to use natural methods using cyclebeads and condoms.
“It has worked for us for years because we discussedit and decided to both be responsible. She could not keep on with other methods and I would not get an irreversible vasectomy,” Mr Rutikanga recounts.
Mr Rutikanga has heard that they have to operate on his reproductive parts, which did not sound safe to him. He shares his reasons with Abdell Hamid, a single father who is open to having sexual partners.
For Hamid, it is important for men to understand and involve themselves in family planning. “I do not plan to have any more children so I carefully avoid unintended pregnancies. I can’t do vasectomy because it is irreversible. If men were educated enough about family planning, we would make use of women’s available methods,” Hamid said.
Both Hamid and Rutinkanga admit that family planning conversations are often pinned on women's reasons being the fact that men are barely affected by unintended pregnancies.
Cyprien Iradukunda, a medical doctor and co-founder of Flavours of Family Planning (FFP), an initiative that seeks to involve men in sexual reproductive health and family planning, says unintended pregnancies would never decrease if men are not willing to be involved.
“Rwanda has always grappled with teenage pregnancies. A woman can only give birth once in a year. When educating about family planning, the focus is always on women and it’s simply wrong,” Iradukunda said.
FFP does not only sensitise men to explore vasectomy but also teach them about female menstrual cycle, and women’s family planning methods. It aims at improving access, digitising health services and promoting confidentiality in partnership with the Ministry of Health and other partners.
The available data on unintended pregnancies look at teenage pregnancies. In the last four years, 98,347 teenagers gave birth.