The very first episode of The Spread Podcast aired on 29th August, 2016 and it was ALLLLLL ABOUT CONTRACEPTION. Sexual health has remained a key theme throughout the years and almost 5 years later, this topic is still so very relevant.
There are about 9 different types of contraception and these can be categorized as;
· barrier methods which includes both the external "male" and internal "female" condom
· hormonal methods such as the pill, injection, patch, diaphragm and the mirena IUD
· the only non-hormonal method which is the copper IUD
· sterilization – this is tubal litigation for women and vasectomies for men
· emergency pills/plan B – the terms & conditions for these should be clearly read.
· natural and herbal methods – please bear in mind that though these have been effective for some, they aren’t scientifically proven. They include fertility awareness methods, withdrawal method, use of herbs such as Queen Anne’s Lace, Neem etc
Despite this information being more readily available, there are still quite a number of challenges women struggle with when it comes to selecting and accessing the contraception of their choice.
The stigma around getting contraception is still very strong because of the culture around Christianity, lack of positive and inclusive sex education as well as the shame surrounding women taking ownership of their sex lives and lives in general.
This stigma is the base of the challenge but that is not where it stops.
Medical research and funding has for years neglected women’s issues because they simply do not care for women’s health. So many women have complaints around the different forms of contraception varying from hormonal imbalances, fluctuating weight, acne, interruption to their menstrual cycles, painful cramps, ectopic pregnancies among others.
When it comes to the selection of contraceptives, many women therefore have to rely on information from friends, podcasts and articles such as these and even then all bodies are different so what worked for your friend may not work for you. We also have different personalities, preferences and needs when it comes to contraceptives; someone may have no issue setting a reminder to take a pill each morning while someone else (like me) would be pregnant by the next month as I am so forgetful.
Another problem women face is getting a gynecologist who is unbiased in their craft and affordable.
If you are looking for a list of gynecologists, we are in the process of creating a database on the same (along with many other queer & queer-friendly service providers) so be on the look-out for that but for now, you can head over to our Instagram highlights and look through the one titled, gynecologists.
Going back to April's article we defined being sexually healthy as, "having the information and support you need to explore sexuality and relationships in a healthy, respectful and safe way."
What then does it mean when people who can get pregnant have to jump loops to get unbiased reproductive health information? When medical personnel advise against certain contraceptives because “it is better suited for people who already have kids” or my personal favourite, “that you might change your mind?”
Mariestopes is the leading center when it comes to reproductive health. They have clinics all over the world and around 20 centers in Kenya. Their slogan is “children by choice and not chance” and they have been the recipients of heavy backlash over the years from anti-abortion movements such as The Church.
Last month, the Mariestopes Kenya account posted a tweet encouraging men to book vasectomies.
While the move was great (we are always preaching that the burden of reproductive health should be shared with a push to have men leading the way), a lot of women noted with concern that the leading clinic has never posted about tubal litigation despite both of these procedures being classified as sterilizations/surgeries.
A lot of the discourse pointed at the clear misogyny that the Medical world is not free of.
Why is it that a person with a penis can walk into a clinic and pay approximately Ksh 20,000 and get a vasectomy with no further requirements while those with uteruses are required to
· Seek consent from their male partners if they are married
· Be asked questions about unborn children or their decision to not have children when unmarried
· Be advised against it (regardless of whether they have children or not) if they are still in their 30s
The discourse on twitter made me decide to do some digging and find out if there was any written law forbidding medics from carrying out tubal litigations on consenting adults.
I came across the Population Policy Guideline that states that the legal status of sterilization was allowed for contraceptive purposes in Kenya in 1986.
1-9-8-6 that is 35 years ago. Why then is it still so difficult for women to access this service?
This is why reproductive justice is still so important. When we say access to information, we are not fighting for crumbs of information but comprehensive and unbiased information. When say we want access to contraceptives, we aren’t saying “provide me with 3 poor choices to pick from”
When we say we want equality, we are saying that we want to be able to access tubal litigation as easily as those who access vasectomies; without the need for consent from partners and without being asked rude, insensitive and intrusive questions.
It is also worth noting that I found the 6th edition National Family Planning Guidelines for Service Providers by the Ministry of Health.
It reads as follows;
Men who should not have vasectomy
Vasectomies are not the appropriate choice for every man. Men who should not have vasectomy include the following:
· Clients who are uncertain of their desire for future fertility
· Clients who cannot withstand surgery e.g. bleeding disorders
The same document says this about tubal litigation
Women Who Should Not use BTL (Bilateral tubal Ligation)
Providers should not perform BTL on certain women:
· Young women and women with no children – who are uncertain of their desire for future fertility
· Women or girls who do not give voluntary informed consent; in situations where the client is mentally challenged, consent may be given by the parent or guardian.
Why the disparity Ministry of Health?????
Next week we will be looking at part 2 of this but from the angle of ableism, eugenics and once again women being treated as property to be owned, controlled and regulated by the state and their male relatives.
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