APPOLONIA ADEYEMI 
Family planning contributes significantly to the prevention of maternal and child mortality as well as boosting the health of the mother. However, many women still do not use modern contraception due to several factors. In this report, experts highlight strategies of managing side-effects of contraceptives, reports APPOLONIA ADEYEMI
Family planning, a life-saving procedure provides many benefits to mother, children, father, and the family. It enables the mother to regain her health after delivery and gives her enough time and opportunity to love and provide attention to her husband and children. These are just a few of the numerous advantages that come with using family planning products and services.
Family planning is the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods. Based on this background, a good number of the Nigerian population in their reproductive age, between 15 to 49 years, are expected to have adopted family planning services to boost their wellness.
Data from the National Demographic Health Survey (NDHS) 2018 shows that 17 per cent of married women aged 15-49 in Nigeria use any method of family planning. While 12 per cent use a modern contraceptive, sexually active, unmarried women age 15-49, 28 per cent use a modern method and nine per cent use a traditional method.
Irrespective of the low accessibility of family planning in the country, it has also been shown that some women would like to delay child birth but are not using needed family planning services. In Nigeria, 19 per cent of married women have an unmet need for family planning: 12 per cent want to delay childbearing, while seven per cent want to stop childbearing.
Unmet need for family planning is defined as the proportion of married women who want to delay or stop childbearing but are not using family planning. Although, there are several reasons why some women who need family planning services chose to keep them at arm’s length, one of the major factors hindering the rapid uptake of services is the fear and ordeals of side effects. It is not an overstatement to say that was what happened in the case of Funmi Bello who before getting married had planned to have two children only.
Sadly, the fear of rumours and misconceptions of side effects from family planning kept her away from taking advantage of family planning services; the stories were indeed scary. Relating her experience, Funmi said she was particularly concerned about narratives that family planning products on administration on clients resulted in protruding stomach, heavy and endless menstruation flows and infertility even when such products have been removed. It was so serious that more than seven years after her marriage she failed to ditch the fear and take advantage of family planning despite her husband’s opposition to her position. Her major challenge was her persistent refusal to visit the family planning clinic in her neighborhood in Ketu, Lagos where officials would have educated her better.
To date, she still struggles to provide for the four children she has within seven years. Relating her experience about how she ignored stories of side effects from family planning, Olubukola Oluseye, a school teacher in Isheri Secondary Grammar School,Magos Phase 1, Lagos State, said although she had heard that family planning could trigger infertility on users, she went ahead to adopt the estrogen injection. She said, “The two month injection that prevents conception initially made me sleepless most nights and resulted in high blood pressure.
The contraceptive injection is a shot that contains hormones, either a progestin alone, or a progestin and an estrogen together, that stop your body from releasing eggs and thickens the mucus at the cervix. A client needs one shot either once every month or once every three months from a healthcare provider.”
Sharing her experience with the contraceptive injection, Oluseye said, “Within a few weeks my blood pressure had returned to normal reading while I overcame the sleep disorder.” In another, 32-year old Adewunmi Omodunmiju, an entrepreneur who resides at Pipeline area of Egbeda in Lagos State, said despite the negative tales about side effects from family planning, after successful delivery of three children within 18 years marriage, my spouse and I decided we didn’t want more children.
“With counselling from family planning providers, we decided to adopt the intrauterine device (IUD) contraceptive.” She said, “Consequently, my menstrual flow reduced from normal four days to two to three days. Also, during sexual intercourse I used to feel that something was in me, but over time, I stopped feeling like that again.” Thereafter, she said after using the IUD for two years, she removed it and got pregnant. Consequently, I got the IUD administered on me for another five years. After I removed it in June last year, I became preg-nant again.”
Explaining why some birth control causes side effects, an Obstetrics and Gynaecologist, Kelly Morales said most hormonal birth control, like the combined birth control pill, works by raising hormone levels in the blood. This ‘tricks’ your body into thinking you’re pregnant so you stop ovulating. “But since your body thinks you’re pregnant, you may experience symptoms some women experience in early pregnancy. Some of the most common side effects of hormonal birth control include: spotting, breast tenderness, nausea, acne, changes in hair, headaches, emotional changes, weight gain, bloating, among others.
Morales said some women never have any side effects. For most women however, these symptoms resolve after two to three months of consistent birth control use, but for others, they never leave. She said, “If you continue to experience side effects after three months, talk to your doctor.
There are many birth control options available, and sometimes eradicating symptoms is a matter of finding the pill with the right balance of hormones for your body.” Similarly, reacting to the attitude of some women to side effects, a Consultant Obstetrician and Gynaecologist at the University College Hospital (UCH), Ibadan, Prof. Christopher O. Aimakhu said, “All family planning methods have some side effects on certain people; that is why taking a history and counseling clients is important before administering a family planning method for them.” According to him, not everyone is the same, adding because someone reacted or had a side effect to a method does not mean it will happen to another client. However, Aimakhu advised that if a woman has a side effect she can go back to where she got the family planning method.
He added that it can be removed and another method administered if the side effect is severe. According to him, “all methods of family planning have a failure rate; it’s however very low or negligible in some methods.” Also, corroborating the views of Prof. Aimakhu on side effects arising from family planning, the Social Behaviour Change Communication (SBCC) Officer of the Disc Project, Society For Family Health (SFH), Amarachi Tikal said the right step to take when there are issues with using any family planning product, was to return to the provider for professional intervention. According to Tikal, family planning is not rocket science. Speaking further on how to prevent side effects from birth control pills, Morales said it was to select the right birth control for you. It’s helpful to remember that whenever you start a new hormonal birth control, your body needs some time to adjust.
