- FileYoungsters at the recent "Sexpo 2000", held at the Little Theatre, practice how to use a condom. The exposition aimed to educate the public about the importance of using contraceptives and practicing safe sex.
Patricia Watson, Staff Reporter
ONE OF the major medical achievements of the past century which significantly affected the future of women was the development of oral contraceptives, typically known as the pill.
The pill paved the way for a woman to safely control childbearing for the very first time.
Jamaican women of all economic backgrounds were able to make this choice in 1976 when the first oral contraceptive, Lyndiol was approved for sale by the Government. Today, oral contraceptives are the most popular methods of contraception, accounting for 21 per cent of women in some form of relationship. The pill works by suppressing ovulation i.e. the monthly release of egg from the ovaries, by the actions of the hormones estrogen and progestin.
"It (the pill) gave women freedom, they were able to say I want a child or I don't want one," Women's Centre Foundation of Jamaica Chairman Pamella McNeil said last week.
But apart from the freedom which the pill gives women, there are a number of other benefits of note, besides preventing pregnancy. Studies have shown that the incidence of ovarian and endometrial cancers, benign cysts of the ovaries and breasts and pelvic inflammatory diseases decrease with pill use. The pill is also known to prevent heavy and irregular menstrual periods.
Today, approximately 52.4 per cent of Jamaican women aged 15 to 49 years old have taken the pill, and worldwide there are 100 million users.
If a woman remembers to take the pill every day at the same time of day as directed, she has an extremely low chance of becoming pregnant. The pill's effectiveness, however, can be significantly reduced if the woman is taking some medications, such as certain antibiotics or if she forgets to take them.
Since the introduction of the pill, Jamaica's fertility rate has been significantly reduced, from 4.5 children per woman in 1975 to 2.8 today. This was made possible by successful initiatives carried out by the National Family Planning Board (NFPB), which is still striving to get the figure down to two children per family.
One cannot imagine what the fertility rate would be if the pill was not available to women in Jamaica, or the social and economic ills that would follow were women not taking the pill.
But despite this, much is left to be accomplished. Only 34 per cent of pregnancies today can be defined as planned and 34.1 per cent of women are currently not using any form of contraception.
One of the major drawbacks with the pill, the NFPB says, is that women tend to forget to take it sometimes, thus increasing the chances of becoming pregnant.
According to the NFPB publication, Consumer Attitudes and Behaviours Regarding Contra-ceptive Methods in Jamaica: "Women seemed to have real problems with the daily routine of taking the pill. They also spoke of numerous pregnancies which resulted from missed pills".
There are also myths such as, the pill was made to kill off black people, and although no deaths so far in Jamaica can be traced back to the pill, the myth continues. This is despite the fact that numerous black people around the world are taking it.
Ignorance
Some women refuse to take the pill on this basis and are many times backed by an ignorant male partner. The result is that these women end up having children they cannot support. An even more ghastly scenario involves those who, rather than take the pill, end up getting pregnant and abandoning the child along the roadside or other such places.
The NFPB publication also sets out other reasons why women refuse to take the pill. Among these is the claim of some women that they know of others who have ended up with blocked tubes and have had to be hospitalised because of the pill.
Some brands are also considered to be used mainly by lower class women, older women, casual and promiscuous women, naive women and the brand with the most side effects.
Uncertainties
Although the pill is considered a safe contraceptive method, there still exists uncertainties about whether they cause breast or cervical cancer.
According to the Food and Drug Administration in the United States, an international study published in the September 1996 journal Contraception stated that women's risk of breast cancer 10 years after going off birth control pills was no higher than that of women who had never used the pill. During pill use and for the first 10 years after stopping the pill, women's risk of breast cancer was only slightly higher in pill users than non-pill users.
Based on these factors, the NFPB is planning to launch a campaign to increase women's usage of contraceptives. It is also aiming to get women to shift to longer-term methods such as the intrauterine device (IUD), norplant and injectables.
Approximately 10.9 per cent of women in the age group 15 to 49 use the injection as a form of contraception, 1.0 use the IUD and 0.1 use norplant.
The longer-term methods, like the pill, gives the woman the right to have a child if and when she feels it is time. But unlike the hassle of taking the pill each day, they will in some cases give women even more decision-making power and the privacy they may not have had with the pill.
According to one woman, whenever her boyfriend sees her taking the pill he gets suspicious and accuses her of having other men. On the other hand, the boyfriend refuses to use a condom, putting both of them at risk of having a child they cannot afford.
With the injection or the IUD, the woman can go to her health provider and decide to get these without the knowledge or consent of her spouse.
Some women too, who are forbidden by their religion to use contraceptives, can also take these methods without fear of their husband telling the pastor. It is difficult to believe that God who gave man the knowledge to develop contraceptive methods would punish a woman for protecting herself.
Mind you, one is not preaching deception, but the fact is that a large number of persons are having children they cannot take care of. The result in this case is that the society is left to care for these children.
Cost
If the reason for not using the pill as a form of contraception is the cost over time, then the longer-term methods should pose no problem. The costs associated with the methods will in most cases work out cheaper than the monthly costs for the pills.
The longer-term methods at Government run health facilities cost between $75 and $150 and last from a minimum of three months up to six years.
Overall, though, the move by the NFPB to launch another campaign to heighten contraceptive use must be looked at in terms of the country's economic situation as well as the rising trend of sexually transmitted diseases. Men and women need to become more responsible in their sexual relations. Those men who claim it is uncomfortable using condoms should not prevent their women from using contraceptives of their choice. Men and women should also realise that with the increasing incidence of sexually transmitted disease, the condom is the safest way to avoid them.
Those who feel their only purpose on earth is to have children should understand that the country cannot take care of children they sire and cannot maintain.
It will be a difficult task to convince the 34 per cent women not on any form of contraceptive to at least try some method, but nevertheless the effort will be worth it. As it regards children and diseases, it is the woman who will have to make the first move as she cannot depend on her man to do so.
