Haira Kaitesi has been using birth control since she gave birth one year ago. But recently she was shocked when a routine visit to a Doctor revealed that she is two months pregnant. She uses Hormone shots, a type birth control where a shot of progestin is injected in the arm every three months to prevent pregnancy. 

"I have been getting the routine injection every three months after I gave birth, but a few weeks ago, I started feeling sickly and when I went for a checkup, the doctor told me I was pregnant. This came as a shock to me since I was on family planning and I am not ready for another child,” Kaitesi says.

Like Kaitesi, some women wake up to such news, yet they are religiously using different types of birth control to prevent pregnancy.

So what exactly goes wrong? Why would a woman sexually active woman using contraceptives end up pregnant?

Medical experts say if used well, contraceptives are effective in preventing pregnancies but they may not be 100 percent safe.

"Birth control methods can provide certain advantages. But they can’t be relied on completely since they are not a hundred percent effective,” warns Dr Teckle G.Egiziabher, a gynecologist at Rwanda Military Hospital.

According to Dr. Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, there are several reasons why a woman on family planning can get pregnant.

She says forgetting to take even one contraceptive pill increases the risk of getting pregnant. Use of poor quality condoms which can rip and use of cervical caps incorrectly can all increase risk of pregnancy.

Dr. Pande explains that a woman may not use contraceptives because she thinks she is in her "safe period” but there is no absolute safe period. There is inconsistency in the conventional safe period and in addition to that, all the contraceptive methods have a failure rate, but however small the percentage of the method’s failure is, it may still lead to unwanted pregnancy.

"Sometimes regardless of the birth control method a woman is using, there can be failure if the woman does not follow the right directions for use. For those who take pills, one can forget to take the pills at the right time. Once you fail to take the proper dose at the right time, you are bound to get pregnant,” Dr Egiziabher says.

He adds that it’s not always about the inexperience of the doctor who gives the prescription; sometimes the device can shift from its position in the case of a woman using an intra-uterine device (IUD) or an implant.

Dr John Muganda, a gynecologist at King Faisal, also shares the same view. He says that getting pregnant while using family planning can be caused by failure to follow the right instructions.

He says that there are cases when women vomit or get diarrhoea when they use particular birth control methods, and in that case, one has to be careful because the dose can’t be enough in the blood to prevent pregnancy. A woman has to protect herself or even decide to use other methods in that case.

"When a woman is using a coil she is advised to not use anti- inflammatory drugs because that can cause a condition of inflammation in the uterine cavity and that doesn’t work well with the coil. Therefore, before a woman decides on which method to use, they have to first weigh the disadvantages of the other methods, know the side effects of the method they use and be careful on how to follow the prescription given by the medical worker,” Dr. Muganda explains.

Some women who use methods like implants or intra-uterine devices say that sometimes, the device switches location and moves to another part of the body where as others even pop out.Ange Uwimana went to University Central Hospital of Kigali (CHUK) to schedule an appointment with a doctor; she was to be operated on because the IUD had moved from its original position and penetrated her body through her uterine cavity.

These, and many other complicated situations, have left women at the risk of unwanted pregnancies and also, exposed them to health risks. However,health specialists say that the devices can move from place to place but are not harmful to one’s health.

"An IUD can move from its position but it doesn’t go far. But if it goes to the abdomen it has to be removed. It is not fatal but since it’s a foreign material in the body, it would be safer to remove it. When the implant moves, one should go to the hospital for it to be put back in its position,” Dr Muganda says.

Dr Egiziabher explains that a situation where the IUD moves from its original position is called displacement, and when it does, a woman can get pregnant.

"When the IUD is not in the right place, a woman can get pregnant, and if she does, we allow the pregnancy to progress and remove the device later. The device’s movement in the body can be harmful but not that much as it depends on which organ it penetrates. If it’s lost in the body, first of all we do an x-ray, find it and remove it,” Dr Egiziabher adds.

Nathan Mugume, the head of communications at Rwanda Biomedical Centre, says that it’s hard to determine the number of women who have poor experiences with family planning since a few report such cases.

"Women do experience such but they don’t report it, instead they go to doctors and change to a more appropriate method with effective results. The use of family planning, or use of modern contraception methods, has over the past years steadily increased but the number is still low,” Mugume says.

He adds that educating the general population on the advantages of child spacing is ongoing.

editorial@newtimes.co.rw

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I SAY: How can women avoid contraception mishaps?

Charlotte Mukanyandwi

We have received enough information regarding contraceptives and their correct use. Whenever we go to health centres, the nurses often sensitise us on the use of contraceptives and also inform us on the side effects if not used properly. We need to pay attention.

Charity Mutuyimana

Regardless of the fact that contraceptives are available and there is massive sensitisation on using them, awareness on how to use them correctly is still low, which results into several consequences like unwanted pregnancies. Women need to really understand how to use them.

Josepher Bamusabire

The Ministry Of Health, through health centers and tutors, has played a good role in the awareness on several contraceptives available and their proper use. Eventually, this has saved not only us as mothers but our children as well. We need to follow such programmes.

Claudine Namubonye

I believe health workers have done their best regarding educating the public about the use and various forms of contraceptives. So the remaining effort is in our hands; to seek further information on what particular contraceptive is safe for us.

Clementine Mutuyimana

I can’t blame everything that has gone wrong so far on poor awareness programmes but still, more effort is needed. The Ministry should introduce more campaigns to promote adequate public knowledge on the various forms of contraceptives and their correct use.

Josepher Manirora

I have heard of several women who use family planning methods but still get pregnant.This implies that awareness concerning their proper use is still low. Women need to be guided on the use of contraceptives and which ones are healthy and safe for them.

Compiled by Dennis Agaba