Women's Health: What is the reality of common misconceptions about contraceptives in Pakistan?

 "Once a fellow lady health worker went to a house and the old mother told her, 'My son is having a headache, do something about it.' The lady health worker took out a headache pill from one of her belongings, gave it to her mother, and started walking. "You are not ashamed. What kind of family planning do you want me to do at this age? 'Said the lady health worker.' I gave you a headache pill, Aman. ' Thankfully, my son saw it and stopped me. '

"The mother's son came and attacked the lady health worker, saying, 'Shame on you, my mother, you are doing family planning.' 'Beta Bola' is a sign of the Lady Health Worker program, which is on the family planning pill. The mark is so that no one can sell this pill in the market for money. '

This story is nothing new for Bilquis Alam, who has been involved in the Lady Health Worker program for 23 years. She says she has heard a lot about her dignity and questions about her "goals". Family planning is not their only job but family planning is definitely a part of it. And the biggest challenge for them is to dispel misconceptions among people about family planning methods.

Pakistan has become the fifth largest country in the world in terms of population. The government has long launched a family planning program to control the health and population of its citizens. According to official figures for 2018-2019 in Pakistan, 34% of married women aged 15-49 in the country use some form of contraception. And 43% have used a contraceptive at least once. Educated women are more likely to use such methods. Thirty percent of illiterate women use some form of contraception, 34 percent of those educated up to first or second grade, 36 percent of those educated from third to seventh grade, and eight percent. 39% of those who have studied up to or above use some form of method.

If we look at which method is more popular, the most commonly used methods are men stopping sexual intercourse on time (27%), condoms (26%), sterilization (23%), pregnancy. Kush injections (10%), IUDs (5%) and birth control pills are 5%. But interestingly, married women between the ages of 15 and 49, whether in rural or urban areas, 99% of them know at least one contraceptive method. But despite this, there are still many misconceptions in Pakistan about contraceptives and methods.

We asked Bilquis Alam what kind of misinformation she had encountered during her many years of experience. There are many misconceptions about birth control pills. Some women believe that if they take birth control pills for a longer period of time, they will get cervical cancer, or they will not be able to breastfeed other babies, ”says Dr. Salma Kafeel, a well-known gynecologist. "Contraceptive pills are made for the hormones our body produces. The hormones that our body naturally produces are aimed at cycling a regular menstrual cycle and then cycling ovulation (the production of cells needed for pregnancy).

"When we use these hormones to prevent pregnancy, in the form of pills, estrogen and progesterone, they affect the menstrual cycle over time and help the patient," she said. Given that ovulation stops and there is no problem. He said a common misconception is that cancer has nothing to do with these pills. "When it comes to breast cancer, there aren't so many cases that we can say they're related to pills," she says. Uterine kissers are also not attached to these pills. When we advise a family to use a contraceptive method, we first check their health, meaning that no one in their family has had Kessner in the past or they do not have irregular menstrual problems. Would be To put it bluntly is not the case.

Dr. Salma says that this is not true at all because the process of producing milk is very different. It has nothing to do with the second pregnancy. There may be other reasons for the lack of milk, but it is not caused by pills. But these are not the same misconceptions about contraceptive pills. Bilqis Alam says that many women say that if I eat more of it, I will gain a lot of weight. In this regard too, Dr. Salma says that there is no such thing. I would say it has to do with lifestyle. Women who want to be lean are thinner even after taking pills. Those who want to get fat get fat even if they don't take pills. That's why I would say that there may be a slight difference, such as gaining one or two kilos, but not that the weight is too much.

Another question that Bilquis Alam often faces is that women start getting facial hair due to taking birth control pills. In this context, Dr. Salma says that the reality is quite the opposite. "Most pills are made of estrogen and progesterone. They do not cause facial hair. It is caused by an excess of testosterone in the body. In this case, women have a problem 'polycystic ovaries' in which hair grows on the face. We give pills to keep them low. It's not because of the bullets. "

Another method of preventing pregnancy in Pakistan is IUD which is commonly called 'Copper T'. In this method, a very small device is placed in the woman's ovary that prevents pregnancy. Bilqis Alam says there is a surprising misconception about this method in Pakistan.

"Women say that by keeping it, it is possible for it to go into your heart and cause you to have a heart attack. I heard that so-and-so kept it and it touched her heart! '

Bilqis Alam says that when she hears such a thing, she has to explain to the woman that look, if the baby in your womb cannot reach the heart by tearing the ovary, then where will this little thing go. Dr. Salma explains the possibilities in a little detail. The IUD can be moved out of place and into the abdomen or in the pelvic area. It can sometimes cause an infection. But it can never go to the heart. The heart is separate from the lower part of the body. But yes it can move from its place and then we check whether it is inside the body or has fallen out. But it is not uncommon for it to be shaken. In my many years of experience, I have seen five or six such cases. Another way to prevent pregnancy is to inject. Bilqis Alam says that women think that applying it will make them completely infertile and they have many examples to justify this idea.

But Dr. Salma says that's not the case. "Injections or implants are long-term contraceptives and are made from progesterone. You inject for three months or keep the implant for different periods. The problem is that some women have very low periods during this period or not at all.

"Very few women have a slight difficulty getting pregnant after that," she said. "Most people don't do it here, and very few people do have any problems with what they do." In that case, we have to follow the fertility protocols and it takes time for their fertility to be restored. ”The most popular method of contraception in Pakistan is the use of condoms. About 26% of family planners in the country use condoms.

Bilqis Alam says that even the method of condom is not free from rumors. Some women think that using a condom will make my stomach bloat and then my husband will start liking another woman. Dr. Salma understands the only reason for this idea.

"If you take a very large population and one of them has this problem, it becomes a rumor. 99%, if not 99.9% of couples who use condoms do nothing. In extremely rare cases, it may be possible for a person to be allergic to something made of condoms. In this case, it may be that some part of their body is swollen. It's so rare that I can't discourage people from using it as a doctor. "

But besides women, men also have some concerns about contraceptives. Some men think that whether it's an injection or a birth control pill, any of the hormonal methods can cause a rapid change in a woman's mood.

Dr. Salma says, "Because of the pills, women start to feel better." But very few cases, very few women say they have depression. But that number is so low that you can't say that all the other women should be shot.Dr Salma says pills are the most effective way to interrupt pregnancy. They are most effective if taken correctly. The second is injection and the third is IUD. Dr. Salma thinks that it is important to check the health of the couple before using any method. "It's not just about one couple, it's about the whole nation. If you don't control your population, your population will be badly affected, and rumors will spread, ”he said. Each incoming couple receives regular counseling and a thorough health check, after which they are presented with contraceptive options.