On World Contraception Day, Reflections on the Importance of Choice

On World Contraception Day, Reflections on the Importance of Choice

{Malagasy CHV from Anjeva presenting family planning options to a young woman. (Photo Credit: Samy Rakotoniaina/MSH)}Malagasy CHV from Anjeva presenting family planning options to a young woman. (Photo Credit: Samy Rakotoniaina/MSH)

When it comes to contraceptives, having choices is key.

More than 220 million women around the world want to avoid pregnancy but are not using modern methods of contraception.

Reasons for this vary, from family disapproval, to fear of side effects, to infrequent sex. Increasing access to multiple contraceptive options can allay some of these barriers.

Without multiple options, a woman who is dissatisfied with her current method may stop using contraception completely. With more choices, she can switch to another method and have the support she needs to avoid an unwanted pregnancy.

Family planning is important not only for women’s health and empowerment, but it also helps reduce pervasive poverty and environmental degradation, and contributes to our goal of an AIDS-free generation. According to the World Health Organization, family planning has the potential to reduce maternal deaths by one-third and reduce newborn, infant, and child deaths by 10 percent.  

And more contraception methods exist then ever before. MSH has been helping to make more of these methods available around the world, so that more women can make the decisions that are right for them.

In Cameroon, through the Evidence to Action Project, MSH is operationalizing the updated Medical Eligibility Guidelines from the World Health Organization, which expands contraception options available to breastfeeding women who have recently given birth. Previously, women who had given birth in the previous six weeks were limited to barrier methods of contraception — such as condoms or exclusive breastfeeding, which suppresses a woman’s fertility in the weeks after she has given birth. The guidelines that MSH is implementing will expand access to more methods, including progestin-only implants and the copper IUD.

 In the Democratic Republic of Congo, the MSH-led, USAID-funded IHPplus project implements family planning activities in more than 1,400 facilities. This year, the project has expanded its range of methods and now offers the injectable contraceptive Sayana Press and the contraceptive implant Implanon NxT.

Sayana Press, which provides protection for three months, uses a specially designed, prefilled, single-use device to inject a lower dose of the popular contraceptive method Depo-Provera. Sayana Press causes fewer side effects and is easier to use than a traditional needle and syringe, and because it is delivered under the skin and not deep in the arm muscle, it does not cause arm pain.

Implanon NXT prevents pregnancy for up to three years and comes preloaded in an applicator, ensuring ease of insertion in the upper arm. It is also radiopaque, meaning that it is visible under X-ray—allaying concerns that some women have about the implant becoming “lost” in the body and making it easier to remove.    

The Mikolo project in Madagascar is also scaling up Sayana Press through its network of community health volunteers. Mikolo has trained and supported more than 600 community health volunteers to introduce this new method throughout the country.

And yet another option is now on the table — a new type of emergency contraception. Emergency contraception is still the only method that is effective after sexual intercourse, though awareness and availability is still extremely low. Last week, the International Consortium for Emergency Contraception, hosted by MSH, held its annual EC Jamboree, which convened researchers, program managers, pharmacists, regulatory bodies, suppliers, and distributors to discuss emergency contraception. Attendees discussed Ella, a relatively new and more effective emergency contraceptive.

With each new method comes another choice, and an increased chance that a woman somewhere will be able to plan her future, space her pregnancies, and have a healthy family.