Family planning help in reducing maternal deaths – Dr Dade-Matthews
Dr Gbenga Dade-Mathews is a Family Physician at the Lagos State University Teaching Hospital (LASUTH), Ikeja. He is also the President, Association of Resident Doctors, LASUTH chapter. In this interview with ADESHEWA AKANNI-SHELLE, he says adequate family planning methods is the number one pillar of safe motherhood initiatives.
What is family planning?
Family planning is the means of regulating the family size by preventing the three things that lead to pregnancy; either by preventing ovulation, conception or implantation. Ovulation is when the eggs are released from the ovaries which are a sign that a woman is fertile and conception is when there’s a fusion of a female’s egg and a male sperm cell. The egg which is called the oval released from the ovaries with infusion with the sperm to form the foetus or zygotes. When that is formed, it has to be fixed in the walls of the womb which is called the uterus. So, preventing any of these stages is what we call contraception, which is the means of regulating the family size, either by choice in terms of having certain number of children you want to have, or to also enable the family have reasonable equitable distribution of finances, because you don’t want to have so many children that will outstrip your financial resources. It is also a means to ensure that you have the children you can take care of, ensure that children are well spaced out, to ensure that adequate care can be given to every child, because raising children can be a challenge, particularly if you don’t have enough resources, time, and attention for the child. Very importantly is the fact that the mother’s body also needs time. There are lots of changes that happens to a woman, so the woman needs at least about 2 years for the body to recover from all the various changes and adjustment or metamorphosis that she has gone through in the process of carrying that baby and nursing the baby.
Does family planning have any side effect?
I will explain better by talking about the various methods of family planning we have. We have the natural methods and the artificial methods. The natural methods include the methods that do not involve the use of any external device, chemical, or products. They are natural to us either using natural means of knowing when a woman is ovulating. We use the basal body temperature, at certain times in a month, she will notice that there is a little rise in the body temperature, which is indicating that she is about to or she is ovulating. We can also check the thickness of her cervical mucus, that is the discharge that comes from her cervix, it becomes thicker and stringy around the time of ovulation. Another natural means of prevention is the interruption of sexual intercourse, when the man feels he wants to ejaculate, he withdraws himself from the woman and ejaculate outside. All these methods are not reliable, because we have problems with techniques, not being able to detect when the temperature rises, when the cervical mucus changes. The artificial method that is commonly used and is very effective is the barrier method. We use the physical barrier, which comes in form of hypoallergenic latex materials, coming in rubber form, specially produced as either a male condom or a female condom, that prevent the semen from meeting the egg cells or the oval of the woman and for conception to occur. We also have the chemical methods. We have the hormonal methods, some are injectable, and some are orally taken, the oral contraceptive pills, either the single peel or the combined pills which are taken every day. The injections may be monthly, 3-monthly, 6-monthly intervals to prevent ovulation, thereby preventing pregnancy. They all have side effects, and they are all effective to different degrees, but there is no perfect contraceptive.
We try to individualize it in patient care. In cancelling, everything is tailored towards that individual, the individual circumstances, individual preferences, biological makeup, and hormonal state. Some of the contraceptive method makes a woman bigger or increase in weight gain, and the woman being predisposed to some other illnesses. Some researches about it have been linked to some cancers, but all these are things you have to consider: the individual background, family history, occupation or work she engages in, what stage is the family. One has to know if it’s the family is at the beginning stage, or they already have children, but maybe want to balance their finances before having another baby, those are the factors to consider for the methods to use. Most importantly above everything the choice of the method to use, after all adequate counselling still rest with the individual. No doctor should enforce any method on anybody, our responsibility is to give adequate and accurate advice, and the final choice and decision is made by the individual or couples.
What is the essence of family planning to the family, and to our nation Nigeria?
It’s important because to the family it helps to space out your children, helps you to have a better economic balance, you don’t just keep reproducing babies at every nine months without any financial backing, you are also allowing the mother to recover. It also promotes physical wellness for the mother, makes her more fit, more healthy to be able to take care of the family, because the person that takes care of the family is the mother. So we need her to be healthy. To the nation, it helps us to put our population in check, so we don’t have a population explosion, population overgrowth that will outstrip our resources as a nation. So it is important you don’t produce or give birth to children you cannot take care of, because they become a liability to the family, to the community, to the state and to the nation at large. It is important to imbibe good family planning or child spacing method in place to help the nation.
Is family planning one of the key pillars that help in achieving safe motherhood?
Safe motherhood initiatives is something that is key to help reduce maternal mortality. It is one of the key indices for health in any part of the world. Adequate family method is the number one method of the safe motherhood initiatives. Another important thing is the presence of a skilled birth attendant, postal birth care, because these are the reasons our mothers die unnecessarily or fall ill, adequate provision of ante-natal care, the provision of adequate reproductive health knowledge for women in their reproductive age group. Family planning is actually right up there amongst the pillars when we say motherhood initiatives. It is important to know about family planning, how to take care of yourself when there is a miscarriage, to ensure you don’t hinder your chances of having another pregnancy subsequently. All these are important to the family well-being, family functioning, the society and to the nation.
