Knowledge and Utilization Of Modern Contraceptives Among ChildBearing Women in Itu Local Government Area Of Akwa Ibom State
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Contraception is defined as the intentional prevention of conception or pregnancy during sexual activity. Modern contraceptive utilization is a human right issued under the international human rights law. The use of modern contraception helps couples and individuals realize their basic right to decide freely and responsibly on their family. Contraceptive methods help individuals control the number, interval, and timing of pregnancies and births. Traditional and modern methods are the two common types of contraceptive methods. Modern contraceptive methods are more effective than traditional methods that include pills, the intrauterine device (IUD), injectable, implants, and condoms.
In Akwa Ibom State, Itu Local Government Area has the highest average fertility. Contraceptive use prevented a good number of unintended pregnancies in the study area since 2012, averting 5000 unplanned births, 18,000 abortions (of which 40% are unsafe), and 7,000 maternal deaths. The contraceptive prevalence rate among married women in the study area increased from 14.7% in 2000 to 27.9% in 2019 and 29.6% in 2021. In the past decades, studies have shown that contraceptive use is influenced by various factors; these factors include demographic characteristics, religious beliefs, knowledge of contraception, education of couples, gender preference among children, the quality of the contraception among women, limited choice of methods, and fear or experience of side-effects.
Essien (2014) posit that the unmet need for modern contraception is high in Akwa Ibom State. The 2019 Nigeria Demographic and Health Survey (LDHS) reported that 33% of women have an unmet need for family planning (21% for spacing and 13% for limiting). Subsequently, the total fertility rate (TFR) in Nigeria was estimated to be approximately 4.2 children per woman. About 24% of married women are currently using a modern method of contraception. Injectable, implants, and pills are the most commonly used methods Agharuwhe (2013). Condoms reduce the risk of transmission of many Sexually Transmitted Infections (STIs), including Human Immunodeficiency Virus/Acquired immune Deficiency Syndrome (HIV/AIDS) when used consistently and correctly. Achieving this plan is estimated to avert more than 6,000 unintended pregnancies and nearly 2,000 abortions and will prevent more than 3000 maternal deaths.
According to Tait (2015)modern contraceptive is an important and cost-effective public health intervention to reduce maternal mortality and avert unintended pregnancies, especially in developing countries. Bakare (2016) intimated that to increase the level of contraceptive use, it is necessary to understand factors that significantly influence contraceptive use. Therefore, assessment of the various socio-demographic and reproductive variables that contribute to contraceptive use is essential to the development of effective family planning programs.
According to Tinto (2015) modern contraceptive methods were invented so couples could act on natural impulses and desires with diminished risks of pregnancy. Modern contraceptive methods are technological advances designed to overcome biology. In this regard, modern methods must enable couples to have sexual intercourse at any mutually-desired time. The term modern contraceptive is rarely defined. Instead, organizations and individuals who use the term simply name contraceptives and approaches that fit into their perception of that label. Thus, researchers who measure levels of modern contraceptive prevalence often differ in how they categorize particular methods Adebanjo (2016).Contraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimum spacing between births, reducing maternal and child mortality, and improving the lives of women and children in general. This study aimed to examine the factors affecting modern contraceptives utilization among child bearing women aged 15–49 years in Itu Local Government Area.
According to Association of Reproductive Health Professionals (2014), intrauterine contraception (IUC), also referred to as an intrauterine device (IUD) or intrauterine system (IUS), is a long-acting reversible contraceptive method that involves the placement of a small T-shaped device inside the uterus. IUCs use either non-hormonal ingredients or progestin to prevent fertilization; they are a good contraceptive choice for women who cannot use estrogen, intrauterine device IUDs have one of the highest satisfaction and continuation rates among patients. According to Faculty of Sexual and Reproductive Healthcare (2017), a hormone-releasing intrauterine device called an intrauterine system (IUS) is a plastic device that contains a progestogen hormone. NHS Choices (2014), reported that an intrauterine device (IUD or coil) is a small contraceptive device, often ‘T’-shaped, often containing either copper or levonorgestrel, which is inserted into the uterus.
They are one form of long-acting reversible contraception which are the most effective types of reversible birth control IUCD is a contraceptive method in which a flexible device is inserted into the virginal into the uterine cavity by a trained service provider, it is a safe highly effective and long lasting type of contraceptive method. There are two broad categories of intrauterine contraceptive devices (iucds): Copper-based iucds and Hormone-releasing devices. Iucds is a plastic and copper device which is put into the womb (uterus), it lasts five or more years and it works mainly by stopping the egg and sperm from meeting, it may also prevent the fertilized egg from attaching to the lining of the uterus.
Risks of using an intrauterine device (IUD) include: Menstrual problems, the copper IUD may increase menstrual bleeding or cramps, women may also experience spotting between periods, the hormonal IUD may reduce menstrual cramps and bleeding. About 2 to 10 out of 100 IUDs are pushed out (expelled) from the uterus into the vagina during the first year, this usually happens in the first few months of use (Dean, 2014). Expulsion is more likely when the IUD is inserted right after childbirth or in a woman who has not carried a pregnancy. When an IUD has been expelled, women are no longer protected against pregnancy, complications caused by an intrauterine system IUS are rare and usually happen in the first six months after it has been fitted. These include: Damage to the womb: In rare cases (less than one in 1,000 insertions) an intrauterine system IUS can perforate (make a hole in) the womb or neck of the womb (cervix) when it is put in. This can cause pain in the lower abdomen, but doesn’t usually cause any other symptoms. If the doctor or nurse fitting your IUS is experienced, the risk of perforation is extremely low. If perforation occurs, women may need surgery to remove the IUS. Contact your GP straight away if you feel a lot of pain after having an IUS fitted, Perforations should be treated immediately, Pelvic infections may occur in the first 20 days after the IUS has been inserted.
National Institutes of Health, (2014) reported that barrier method of contraceptive is designed to prevent sperm from entering the uterus, barrier methods are removable and may be an option for women who cannot use hormonal methods of contraception. Male condoms is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman’s body, male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin (made from the intestinal membrane of lambs). Latex or polyurethane condoms reduce the risk of spreading sexually transmitted diseases (STDs). Lambskin condoms do not prevent STDs, male condoms are disposable after a single use. Female condoms are thin, flexible plastic pouches and a portion of the condom is inserted into a woman’s vagina before intercourse to prevent sperm from entering the uterus, the female condom also reduces the risk of STDs and female condoms are disposed of after a single use.
The introduction of the first hormonal contraceptive was one of the most important events of the twentieth century for women. The availability of Oral Contraceptives (OCs) provided women with greater control over their reproductive lives. As of oral contraceptives usage steadily increased, so did concern over health risks associated with their use. In the four decades since the first of oral contraceptives, women seeking contraception have benefited from the development of non-oral hormonal delivery systems, including injectable, intrauterine devices, implants, a vaginal ring, and a contraceptive patch. Women and men have long tried many methods to prevent pregnancy prior to modern method of birth control; women relied on withdrawer or periodic abstinence (Kirsten, 2013). It is hoped that this expanding menu of choices affords women opportunities to find methods better suited to their individual needs, clinicians should continually evaluate their patients’ hormonal contraceptive needs, and provide adequate counseling so that every woman is afforded the opportunity to achieve contraceptive success reported by (Department of Obstetrics and Gynecology, USA, 2015).
Statement of the Problem
Many studies have reported low use of modern contraception in Itu Loccal Government Area. Low levels of awareness, women’s and partners’ disapproval of modern family planning methods, religious beliefs, fear of side effects of modern contraception, women’s misconceptions of contraceptive side effects, use of unproven methods or concoctions and infrequent sex are common among child bearing women.It has been observed by the researcher that many child bearing women are not aware of the importance of the use of modern contraceptive which often result in unintended pregnancies that expose women to obstetric risks arising from undesired fertility, unsafe abortions, inadequate birth spacing, and pregnancies in high risk group. Family planning (FP) using modern contraceptives reduced the number of maternal deaths. In 2013, 360 women were estimated to still have an unmet need for FP in Itu Local Government Area. If all women who wanted to avoid pregnancy were able to access effective FP, unintended pregnancies, unplanned births, unsafe abortions, infant deaths and maternal deaths would have been preventedAjayi and Dore (2015). Though studies on this subject have been conducted in other study areas, none was conducted in Itu Local Government Area.It is on this premise that the researcher intended to close the gap by investigating the effect of modern contraceptives among child bearing women in Itu Local Government Area.
The risk factors associated with avoidance of modern contraceptives include unwanted pregnancy among child bearing women, inadequate family planning services, low socioeconomic status, and lack of or improper use of family planning methods and unawareness of it. Unplanned pregnancy is associated with an increased risk of problems for the mother and fetus. If a pregnancy is not planned before conception, a woman may not be in optimal health for childbearing. Women with an unplanned pregnancy could delay prenatal care that may affect the health of the baby.
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