“I can not disclose my family name when talking about family planning because it is like talking sex”, she said. And talking sex among the local communities in the Southern Province is like openly discussing the oldest profession in the world, prostitution.
Marthe has however decided to use contraceptives after she gave birth to two children within a period of less than two years. She joined many other women who secretly but often visit the Association Rwandaise pour le Bien Etre de la Famille (ARBEF).
ARBEF is a provider of contraceptives and educates the community about family planning methods and reproductive health.
Marthe a 28 year old market vendor in Butare market says she can not afford to bear children every year. But she does not want to disclose how many she wants to bear either because of the myths associated with it.
Her friends Magi Régine 29 and Umwiza 25 do not believe in the myth and comfortably say they will have 3 and 4 children respectively. The family planning method used by all three is the pill although they came with a preference for the injection.
“I had back pains and headaches almost every day while using the injection”, said Marthe.
The injection was good because it gave Marthe freedom as it is administered after a period of a month plus. It also gave her the power to make this decision without her husbands’ approval and to keep it secret.
The side effects are normal and differ from woman to woman while the type of method to be used is determined by a person’s response to the method used although most of the women come with a preffered method.
“All our clients are free to use a contraceptive method of their choice but we usually advise them to change if their bodies can not easily tolerate it,” said Marie Claire Nakure, a health worker at ARBEF Butare.
Marthe was advised to change from injection to pills. Now, after two years she uses pills, she feels free, no pregnancy and no pain.
“I do not believe in the myths surrounding the pill that a woman may not bear children after using it. The side effects of pills are tolerable compared to other methods,” said Marthe.
As such many women who come to the ARBEF inquire about the pill and eventually use it with a few side effects.
Nakure says it could be psychological but their bodies seem to tolerate the pill better than the injection which is usually used because of the secretive nature of its use. Records at ARBEF health centre in Butare show that during the first semester 2008, use of the pill was 33 percent the second most popular after the injection at 39 percent.
Nakure predicted that the pill would soon take over if the three-child policy became law since other methods like Norplant and the injection can sometimes cause problems with sex, women become very dry and sore.
Marthe explained that the only problem she is facing with the pills is the routinely swallowing of the pill which she sometimes forgets and this could reverse all the prior protection. She would also like other women to try out the different contraceptives. However the Catholics can only use the natural method.
At Save Catholic health Center in Gisagara district, the moon bead and body sign observations are the only two methods taught at the centre.
Vestine Niyobugingo a health worker at Save said these methods increase love and closeness of the couple and the family at large. However, research has established that the method has only 5 percent efficacy.
Family planning is to control child bearing in Rwanda. Some government’s officials have proposed to make a policy of three children in each Rwandan family.
However, Jeanne Nyirakamana the regional director of ARBEF in Butare, suggests that there should not be a limit to the number of children birthed instead mobilisation of the population to get them aware of the population problem.
Adapted from the Rwanda Initiative