The only thing harder than getting access to information about birth control in Harare is trying to calm a screaming two year-old in a toy store.
Both, besides being stressful, have two things in common. Firstly, you have to get over the embarrassment of having to do it publicly. Secondly, you have to deal with the judging looks that you’re convinced everyone is throwing at you.
After three days of going from pharmacy to pharmacy, I finally found a clinic that could give me the basic information I was looking for: What are the different birth control methods available and what are the advantages and disadvantages of each? I was unpleasantly surprised that none of the pharmacies I visited had something as simple as an information brochure in store and, worse, couldn’t point me in the right direction when I asked where I could find a Family Planning Clinic in town. Nonetheless, here is what I discovered.
Is The Pill the only way?
The pill is the Kim Kardashian of birth control methods – it is the most talked about and the most popular. Depending on the type of pill that you’re taking, it can do one of two things. Pills that contain oestrogen and progesterone prevent you from ovulating. Pills that contain progesterone only thicken the cervical mucus and prevent the sperm from joining to the egg.
Research shows that women who take the pill are less likely to develop ovarian cancer, but there is also research showing an increased risk of it. Oral contraceptive also reduces acne and menstrual cramps and has been found to reduce a woman’s risk of developing ovarian cysts and anaemia.
Besides the health benefits, the pill gives you full control, which can be a good or bad thing. If you’ve got the memory of a goldfish then you might want to get the help of a daily alarm, or better still, choose a method that doesn’t require you to remember to take the pill every day at the same time.
While the pill is effective if used properly, there are alternative methods that are at least as effective and don’t require you to remember to take something every day, every week or every month. There are chemical methods, which affect the hormone levels in your body, barrier methods which block the entrance of sperm and natural methods, each of which has their own benefits and disadvantages.
This is the hormonal method for the woman who opens the fridge and five seconds later is still trying to remember what she came there for. With this method, you only have to remember to get an injection once every two months (nuristerate) or once every three months (depo provera). Along with not having to worry about taking a pill every day, depo provera can reduce the risk of uterine cancer.
- You can’t administer the injection yourself and will have to see a medical professional.
- Can decrease bone density.
- Can take anything between 3 – 18 months for ovulation to begin again so requires planning ahead when you decide you want to get pregnant.
The IUD or Loop
If you feel freaked out at the thought of having a copper device inserted into your uterus then join the club! What if it pierces my womb? What if it falls? Does it interfere with sex at all? The insertion of an IUD is a simple and relatively quick procedure that requires you to see a doctor or trained nurse at least once. It becomes effective as soon as inserted and pregnancy becomes possible as soon as it is removed. Women who use it describe it as comfortable and it can’t be felt during sex. If you are nursing, it doesn’t interfere with your milk production.
- Even if inserted properly, there is a slight risk that it can fall out of place.
- Cramping is common.
This is a more long-term form of contraception where a tiny plastic rod (about the size of a matchstick) is inserted under your skin on the upper part of your arm. Once it is done, you don’t have to worry about taking birth control for up to five years. It is invisible and can be removed at any time.
- It involves minor surgery.
- It can lead to weight gain and depression in some cases.
- It is a surgical process will be more expensive than some of the simpler methods.
Whereas the methods described above are hormonal, this is a barrier method. Think of the diaphragm as a door. It is a rubber cap that covers the entrance to the vagina to block sperm from entering the vagina. The outer layer is coated with spermicide (did you know there was such a thing?) which, as the name suggests, kills sperm.
A major advantage of this is that you can insert it yourself. You will be examined by a doctor to check what the best size is for you. She will give you proper instructions on how to insert and remove it. It must be inserted ahead of time before sex and must be left in place for at least six hours to ensure that the spermicide gets to work on all the sperm.
- Can increase the risk of a urinary tract infection if left in place for too long.
- Like all of the above methods outlined above, the diaphragm does not prevent the transmission of sexually transmitted infections (STIs) and HIV.
Condoms are the only birth control method available that can prevent pregnancy and protect against STIs. Male condoms allow your man to take an active part in the birth control process and are arguably the cheapest method. Female condoms, though not as easily available as male condoms, are also inexpensive and allow you take more control of the process because you can insert it yourself way before you sex.
- They can break.
- The female condom can cause discomfort.
- Not suitable for someone with a latex allergy.
You might opt for natural methods of birth control for medical reasons or because of your religious convictions. Natural methods involve no use of hormones or barriers to prevent pregnancy from occurring. The most common natural methods are withdrawal or the ‘rhythm’ method. Why are they beneficial? For one thing, both of them are free! Secondly, they have no side effects. Also, you’ll feel less judged by people at church.
The problem is these are probably the most risky, least effective and least reliable forms of birth control. Withdrawal requires your man to predict when he is going to ejaculate and to withdraw before it happens. The ‘rhythm’ method requires you to consistently keep track of your periods and when you’re ovulating so that you know when you are fertile. I still rely on my mom to tell me when my period is coming up! Evidently, a lot can go wrong with this and you’re very likely to end up dealing with a screaming two year-old sooner than you planned.
The methods set out above range from short-term to long-term, but if you want a permanent option, then sterilisation is for you. Both a vasectomy (for men) and a tubal ligation (for women) are drastic remedies that prevent the possibility of pregnancy FOREVER. With a vasectomy, the man’s tubes are closed to prevent the sperm from leaving his body and in a tubal ligation, the woman’s fallopian tubes are ‘tied’ so that the eggs are prevented from being fertilised.
There’s one other method I haven’t looked at and it happens to be the choice that I have made: celibacy until I’m in a monogamous marriage relationship. Having looked at all the options available, where I am in life right now and the way and the context in which I want to start a family, celibacy is the decision that I am making for myself.
What I learned
At the beginning of my fact-finding mission I struggled to get access to the information I was looking for and when I did get answers I found it intimidating. People acknowledge that the decision to make babies is huge, but very few of us acknowledge that the decision not to is too. Birth control information needs to become more accessible and less of a taboo topic.
Can birth control make me infertile? Does contraceptive cause cancer? Will this make me fat? All these are legitimate questions that we need answers to.
Now that you know that you have options, make the decision to take control of your reproductive health and get in the know about these things. For more information, visit your doctor or a Family Planning Clinic near you.
Main image from www.webmd.com