Jane Safari sits pensively outside the Coast General Reproductive Health section queue waiting for her turn to see a gynecologist.
Jane is here for a tubal ligation process. It’s an exercise where the fallopian tubes are cut or blocked to disrupt the path normally taken by eggs from the ovaries in order to prevent a woman from getting pregnant.
She says that she has settled for tubal sterilization, a permanent type of birth control after conceiving two babies while using Depo –Provera, a contraceptive injection.
“I got pregnant while I was using the three months injection as a way of family planning. This time, I do not want to get it wrong with the type of family planning that I will be using since I am done having children,” she stated.
Men and family planning
The mother of five narrated that she had settled for the process after pleas to have her husband Bernard Safari to undergo vasectomy were futile.
“I wanted my husband to undergo vasectomy, but he has been hesitant about it and I’m afraid of getting pregnant yet again as we continue to negotiate on who should use family planning,” she noted.
Jane’s husband has accompanied his wife for the procedure. A shy man sitting at a corner of the hospital bench. He says he’s here to witness the exercise and hear for himself the side effects of permanent sterilization.
“I’m still apprehensive but since she has insisted,I’m here to support her,” Benard says.
"I’m here to listen to what the doctor who is conducting the process will say though I’m afraid of the unknown and I’m kinda against the procedure," he adds.
His wife interrupts him and informs him that he should reserve his comments since they have discussed the issue for the past four months.
"He has insisted that he cannot undergo the procedure and he still doesn't want me to undergo the process. He is still adamant and wants me to change my mind. I’m ready for the process and I’m now waiting for my turn,” Jane insists.
Bernard listens to his wife keenly before interrupting her; "it's a taboo for men to undergo vasectomy,"
According to Kenya Demographic and Health Survey (KDHS) 2022, the use of modern family planning methods among married women has increased over time to 57 per cent.
"The modern use of family planning by married women has increased from 18 per cent in 1989 to 32 per cent in 2003, and 57 per cent in 2022," the report reads.
The report further revealed that the use of implants commonly known as (coil) had increased from 1% to 19% over the same period.
The report has further revealed that women aged between 15 and 49 years reported having used the emergency contraceptive pills.
“The uptake of the emergency contraceptives is the highest among women aged between 20 and 24 years,” the report reads in parts.
Over the same period, use of injectables increased from 3% in 1989 to 26 % in 2014 before declining to 20 per cent in 2022.
According to the survey, five per cent of women aged between 15 and 49 years reported using emergency contraception in the last 12 months
The uptake of emergency contraceptives is reported to be the highest among women aged between 20 and 24 years.
Doctor Swabra Swaleh, a gynocologist at the Coast General Referral Hospital attributes the increased uptake of modern family planning to dissemination of family planning information and the fact that women have now taken responsibility of their reproductive health.
"Unlike in the past when decisions on family planning were made by a couple, the modern woman is now more informed about her own reproductive health and will seek contraceptive services without even involving their partners," she explained.
Swaleh added that women from the ages of 15 to 49 years were not bowing down to societal expectations that expect a woman to bear children at a certain age.
"Socitial expectations are no longer considered by women of child bearing ages. Women are now more focused on making better choices and this comes with bearing a number of children one is comfortable with,” Swahel added.
"The change can also be attributed to readily available information about reproductive health," she added.
Collaboration of Women in Development(CWID), a non-governmental organization that champions for women’s health reproductive rights through its Executive Director Betty Sharon has said the rise of modern family planning is due to increased awareness and sensitization programs on the importance of career development among young people.
"The government's move to introduce community health workers who can easily reach out to women of child bearing age and administer the modern family planning methods on the ground has made it easier for women to easily access whatever type of family planning they are comfortable with ,” Sharon says.
Family planning and myths
In the same breath, Sharon has said that men are still shying away from using modern use of contraceptive methods due to lack of awareness and men friendly health facilities where such processes can be conducted.
"Matters sterilization on men still remains a grey area filled with myths. For instance, some people believe that a man cannot ejaculate if he undergoes vasectomy,” she explained.
KDHS has revealed that the number of men who have undergone sterilization still remains as low as 0.5%
However, with all these, Swahel says there’s a rise in Vasectomy in Mombasa county, a factor she attributes to the fact that Mombasa is a tourists hub.
"We have seen an increase in the number of men seeking vasectomy services in Mombasa even if the reported numbers are from the white men who live within,"she said.
She further noted that there was likelihood of more men embracing vasectomy.
Countrywide, data indicates that Embu County is leading in the number of women using any method of family planning at 7 percent while Bomet County recorded the least number of women using any type of contraception at 5 percent.
