Savitri on family planning

Twice now I’ve gone to Tafelsig High School with nurses from the child health department of the clinic to talk to young girls about family planning (birth control) and address the growing problem of teenage pregnancy. Their talks go along the lines of this, with the pronoun “you” referring to the female students that the nurses address:

• There have already been three pregnancies among the grade 9 female students and the principal has expressed concern over these increasing rates of pregnancy.
• We have come to offer family planning options (two month injection, three month injection, daily oral contraceptive) that will allow you to take control over your life and pursue your dreams without putting yourself on hold because of misinformation, embarrassment, or violence. We acknowledge that there are many ways a woman can get pregnant – do not assume that every girl staying behind to take family planning is doing so because of consensual sex; she could be victim to rape or incest at home. Respect one another because you never know when you will be in a similar situation (in need of contraception) in the future and you don’t want people to talk poorly about you.
• The benefits of the injections are that they only have to be taken every two or three months, and if you are afraid that your parents or someone else might see you taking tablets then this may alleviate that worry. However, many women using injections also experience very light or absent periods so if your mother buys your pads and you don’t want her to question your lack of period the pill may be a better option. That option goes with the responsibility that the pill is taken every single day at approximately the same time.
• Myths debunked – going on family planning does not take away your ability to have children later on in life. If you do experience difficulties that is due to existing problems and not because of the nature of the pill or injection. And neither of these methods causes weight gain; what they do increase is appetite but because you are all young and active, so as long as you eat healthy you will be fine.
• Because these methods are only contraceptives they do not protect against sexually transmitted infections. HIV is still a serious problem, so always condomize with your partner. Female condoms are inserted by twisting the ring into a figure 8 shape, inserting it into the vagina up to several hours prior to sex, and pinching the outer ring when withdrawing the penis to avoid spillage of semen.
• Be respectful of one another; don’t make judgments because we don’t know what other people’s private lives are like; we are not encouraging you to have sex because you are young and have plenty of time to explore; abstinence is the only 100% way of preventing pregnancy and STIs; virgins can get pregnant on pre-cum or if the semen is ejaculated near the vagina. We are just giving you the tools and opportunity to make responsible, adult decisions and take control of your life and be uninhibited who you want to be.

First of all, I really appreciate that the nurses address rape and incest because those are still very taboo subjects and female participation in consensual sex as it is already carries such a stigma. It is a very practical and realistic way of broaching the topic of respect – how to get other women to respect each other and break the cycle of victimization that perpetuates gender inequality. Of course, men also contribute to gender inequality but in a different way. The traditional social construction of masculinity trains many men to reinforce negative gender stereotypes and perpetuate types of violence through patronizing acts of domination (ex: chivalry), unwanted attention (ex: cat-calling), and assumptions about romantic intention (believing that all women fit neatly into the virgin/whore dichotomy). Meanwhile, many women are conditioned to upgrade their status to the respectable and dignified metaphorical “virgin” by shaming, blaming, and otherwise distancing themselves from other women. If gender-based violence is to be reduced both men and women must be equally addressed, and if rape prevention is to occur men must be at the forefront of such education since only potential perpetrators can prevent crimes.

Secondly, it is apparent that a lot of pressure is being put on the health care system to address social issues as well as physical needs of the community. While it is certainly a good and necessary thing to combine multiple aspects of social need into one address, it is unfair on the nurses to make them accountable for so many responsibilities. It is not as if they are just lounging back at the clinic – on the contrary, they have a lot of duties to fulfill and taking them out of the clinic each week to address these young girls is distracting and disruptive to their primary work. In addition, there is pressure put on them to get fulfill high quotas of students going on family planning. This goal is unrealistic and unhelpful because a high quota does not necessarily translate to the same number of women actually staying on and following through with their contraceptive plan. In addition, if the girl was not planning on having sex anyway what good does going on family planning do? Contraception, while important, is only part of a very complex issue surrounding young adult female health.