Jakarta, IO – During the pandemic, Indonesia is faced with no fewer than 420,000 unwanted pregnancies, spiking birth rate to 5.2 million a year. Unwanted pregnancy may occur due to failed contraceptives, inappropriate use of contraceptives, or failure to use any contraceptive at all. 2020 data from the National Population and Family Planning Board (Badan Kependudukan dan Keluarga Berencana Nasional – “BKKBN”) shows that Indonesia has 71 million women of reproductive age (15-49 years old), wherein 39 million are part of a productive age couple.
“In terms of unwanted and unplanned pregnancies, we are aware that ideally, every child being born is wanted and that the pregnancy is planned. Therefore, the man and wife are jointly responsible to take part in a Planned Parenthood (Keluarga Berencana – “KB”) program and select contraceptives together. This is not something that just one spouse can decide unilaterally. As the wife is not Mother Mary and cannot be pregnant without the husband, therefore he must be responsible to ensure his wife and baby’s safety and health. KB is a strong strategy that can reduce mother’s mortality rate, currently still at an average 305 maternal deaths per 100,000 live births,” said dr. Marcia Soumakil, MPH, Director of the Access Change towards Health Initiative (Inisiatif Perubahan Akses Menuju Sehat – “IPAS”) Foundation Indonesia, in the “The Role of Women in the Planning of Quality Families” webinar held last Saturday (19/03/2022).
The Indonesian Demographic Health Survey 2017 records that one out of 10 married women aged 15-49 years of age who want to delay pregnancy or to increase interval between births, does not use contraceptives at all. 15% of all pregnancies are unwanted, while 34% of women who do use contraceptives stopped using within 12 months, or they only use them for one interval and stop afterwards.
“It’s mostly because they are not involved in the decision concerning which type of contraceptive to use. Other reasons for not using contraceptives include respondents saying ‘We don’t have sex that frequently anyway’, ‘I’m worried about side effects’, ‘My husband doesn’t allow me to use contraceptives’, ‘I’m/my husband is/we’re already old anyway’, ‘You only need to rely on your faith and prayers to keep from getting pregnant’; the lack of competent service providers for managing the use of long-term contraceptive methods; difficulty of access to proper contraceptives; and deep-rooted outdated, patriarchal thinking like ‘the more children, the bigger the fortune’, ‘have at least one son and one daughter, keep trying until you have both’ – all of these strongly affect our people’s thinking about family planning,” dr. Marcia said.
All women have a basic human right of reproductive health, to survive pregnancy and childbirth, to avoid getting pregnant if they feel that it is not for them, to be free from pressure to get pregnant. “To ensure that women can make the decisions that are the best for themselves individually, especially as part of an effort to build a happy, quality family, they must be given truthful and accurate information concerning contraceptive options and methods, space to express their concerns and worries and fears, and access to legal, affordable, unobstructed, easy, and culturally and religiously appropriate contraceptive methods. This way, women as wives and mothers can make the best choice for themselves and their families, according to their awareness and conscience,” she added.
Permanent Contraceptive
At the same event, obstetric and gynecologist dr. Windi Nurdiawan, Sp.OG(K), M.Kes. stated that the recently popular saying “My body, my choice” is very appropriate for family planning, because the type of contraceptive that can be used strongly depends on an individual woman’s body. What suits one woman may not suit another. Contraceptive methods are non-hormonal, hormonal, and permanent. Non-hormonal or ‘natural’ contraceptives include the wearing of condoms for men and women, the calendar method, or nursing the baby consistently until it is at least six months old. Hormonal contraceptives include pills, IUD, implants, and injections.
“The target of reducing mother’s mortality to 183 deaths per 100,000 births by 2024 is only achievable if there are no pregnancies above the current rate. KB has three purposes: to postpone pregnancy, to set a longer interval between pregnancies, and to make sure that the woman can never get pregnant again, or that the man can never make anyone pregnant ever again. The latter, or permanent contraceptive, is done by performing tubectomy on women and vasectomy on men. Make sure to really think this over seriously, as the process is irreversible. Health workers will not force any man or woman to choose the type of contraceptive that they want – they will guide you so you can make the best informed decisions according to your individual bodies, hearts, and finances,” dr. Windi said. (est)