With the ever-growing population around the world, it is imperative to control birth for many reasons, including that failure to space well between births poses many risks, including stunting among children, especially in vulnerable families.

Grace Nyiransengiyumva, a mother of four, experienced many misfortunes emanating from delivering her first and second born children within a span of two years. 

Nyiransengiyumva and her husband reside in Ruhango District in the Southern Province. They gave birth to their first child in 2000 and the second in 2001. She recalls the burden they had to bear to raise their children who were inadequately spaced.

The children suffered from malnutrition, and she also had post-pregnancy complications, among other problems.

Nyiransengiyumva says as toddlers, the children struggled as barely a month went by without them falling sick. As a result, she could no longer participate in income generating activities, like attending to the farm, as she had to allocate more time to taking care of them.

"No one should have children that close in age. Having two children that were like twins kept me so busy, I barely had time to take care of myself. And the saddening truth is that I had inadequate financial means to handle them. That is when I decided to change, realising how tough it was to raise children born in such a short interval,” she narrates.

Nyiransengiyumva, 40, opted for birth control pills in order to avoid future distress.

Following her decision to go on the pill, Nyiransengiyumva is now at peace as the decision, she says, had a positive impact on her family. She has since had two more children albeit spaced well.

The family says it is grateful to the government that sensitised couples to embrace family planning by encouraging both men and women to opt for methods of their preference.

Effects of poor spacing

Pregnancy spacing can affect more than how close your children are in age. And, research suggests that a woman should wait at least 24 months after birth to get pregnant again.

According to Mayo Clinic, research suggests that beginning a pregnancy within six months of a live birth is associated with an increased risk of:

• Premature birth • The placenta partially or completely peeling away from the inner wall of the uterus before delivery (placental abruption) • Low birth weight • Congenital disorders • Schizophrenia • Maternal anaemia

In addition, recent research suggests that closely spaced pregnancies might be associated with an increased risk of autism in second-born children. The risk is highest for pregnancies spaced less than 12 months apart, Mayo Clinic states.

Sensitisation

The Vice Mayor in charge of social affairs, Alphonsine Mukangenzi, commends the current uptake of acquiring modern contraceptives in Ruhango District which stands at over 70 per cent.

She explains that mobilisation is ongoing to sensitise people on the role of family planning to the development of the family as well as the country at large.

"People are understanding family planning more. This has helped the district to reduce stunting as well as malnutrition. Currently, we mostly have issues related to teen pregnancy,” she says.

Elie Dusengimana, the head of Kigoma Health Center, emphasises that contraceptive services are highly adopted at a satisfactory level in Ruhango Sector.

The five main methods of contraception include long-acting reversible contraception (the implant or intra uterine device/IUD), hormonal contraception (the pill or the Depo Provera injection), barrier methods (condoms), emergency contraception, fertility awareness and permanent contraception (vasectomy for men and tubal ligation for women).

According to the Ministry of Health, Rwanda has experienced a 10.5 per cent increase in contraceptive use over the last five years.

The use of modern contraceptive methods increased from 47.5 per cent to 58 per cent between 2015 and 2020.

Well-being

Nyiransengiyumva says the decision to use pills as a contraceptive method was a game-changer in their home, and saved her children, and herself, from risks of poor spacing.

"Those pills were very useful to me and my family, I will use them until menopause. My children got all the care and attention we owe them to the best of our ability as parents. We struggled at first but we managed to make it through because we made the right choice,” she says.

In addition to that, Nyiransengiyumva says, their home saw many positive transformations, including significant economic growth.

Planned pregnancies spaced two or more years apart result in healthier babies and fewer medical problems for the woman. Planning for a child will help you avoid the social, health, and financial problems you face if an unplanned pregnancy happens.