ASK DR LUVUYO BAYENI | Both partners are responsible for contraception

Literature defines contraceptives as a collective name given to medicines and other devices that are used to prevent unwanted pregnancies.

Over and above the role of preventing unwanted pregnancies, contraception should be appreciated and embraced as a tool to empower couples towards family planning.

The national department of health encourages women to “decide their own family planning method, in consultation with their health care professional, taking into consideration safety, efficacy, acceptability and access”.

The reality, though, is that the choice of family planning method is influenced by various factors such as knowledge, acceptability and attitudes towards each method.

However, education and awareness regarding contraception cannot be limited only to the woman in the partnership, as her decision is likely to be influenced by the sentiments of those close to her, including her partner.

Several studies reported that awareness and education have achieved improved and positive attitudes towards family planning. We all deserve supportive partners in our lives, and family planning support is no exception.

Family planning benefits include decision and control on when to have babies, including spacing the pregnancies. Of course, from a medical point of view, planning also prevents pregnancy-related illnesses and complications.

That also covers unwanted pregnancy and potential terminations. It may seem that the main beneficiary here is the woman, but the partners are included. The same way it takes two to tango, it takes two to raise a child.

Discipline is everything

There is a natural method of contraception that involves full understanding of the menstrual cycle and its ovulation phase. Abstinence during a woman’s fertile periods definitely prevents potential pregnancies. However, this method requires a supportive partner who will respect the decision on abstinence without being judgmental or applying undue pressure.

There is another natural method, withdrawal, that requires the male pulling out before ejaculation. Control and discipline from both partners is required.

These methods clearly demonstrate the need for a supportive partner for them to be effective.

We can both bring it

Condoms are the common form of barrier methods available for both males and females, designed to prevent the sperm from reaching the egg.

Despite widely available information about condoms, including the dual benefit of preventing sexually transmitted infections (STIs), mutual understanding and knowledge about acceptability by both partners remains critical.

Other types of barrier methods for female use are cervical caps, diaphragms and sponges. If the partner is not familiar with such methods, it may create misunderstandings and misinterpretations of “things” in the vagina which may create discomfort or arguments.

Timing is everything — let’s share the alarms!

Synthetic hormones are used to prevent pregnancy as they prevent ovulation, thicken cervical mucus to prevent sperm from reaching egg and thin the uterus wall, preventing implantation of fertilised eggs.

Hormonal methods effectively work based on their availability as per the prescription. They are taken daily (pills), weekly (patches) or every two or three months (injections).

Whenever there is an interruption of hours, days, or weeks between the due doses, the effectiveness of the method becomes compromised and the risk of falling pregnant increases.

There is also a principle of drug interactions, which means there may be some medications that reduce the efficacy of the hormonal methods. This is why it is encouraged that women on hormonal methods of birth control should inform their healthcare providers of the contraception they use whenever medication is prescribed for them.

Partners need to understand how hormonal methods work to be able to accept the choice and also support their partner by, for instance, reminding them to take their dose in time or book an appointment for prescription renewal.

In case we forget

Implants and intra-uterine devices (IUDs) contain synthetic hormones (progesterone) which work over time through thickening the cervical mucus and preventing ovulation (implants) or thinning the lining of the uterus (IUDs). They work for between three years (implants) and five years (IUDs).

Factory is closed

There are permanent contraceptive methods or sterilisation available in the form of vasectomy for males and tubal ligation for females, commonly called “getting your tubes tied”. These are regarded as highly effective for individuals who are certain they no longer want to have children.

Notwithstanding that this is an individual choice, family planning involves a couple, and it is important for the partner to be made aware of this choice, especially if the procedure is already done. Non-disclosure may have a negative social impact on couples with either the female being impregnated by another male (if her partner has already had a vasectomy) or the male questioning his fertility when failing to impregnate his partner (if she has had tubal ligation).

Ooops moment

Emergency contraception (the morning-after pill) is used after unprotected sex or failed contraception. The pills are effective if used within 72 to 120 hours of unprotected sex, depending on the type of pill offered.

Take-home message

Contraception is part of family planning and the involvement of both partners is important. Knowledge of the different types of contraception by both partners helps with acceptance of the chosen methods, as it is easier to support each other.

Of course, any medical intervention has side effects and when both partners are involved, handling them becomes a lighter burden. Despite the risk of side effects, benefits of contraception being an effective way of preventing unwanted or unintended pregnancy outweighs the potential drawbacks. Emergency contraception should not be used as a primary form of birth control.

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• Dr Bayeni is a medical doctor and host of DR B Talks, a weekly health conversation platform focused on empowering communities through accessible health education.