“Many of us were the unplanned children of talented, creative women whose lives had been changed by unplanned and unwanted pregnancies. We witnessed their bitterness, their rage, their disappointment with their lot in life and we were clear that there could be no genuine sexual liberation for women and men without better, safer contraceptives, without the right to safe, legal abortion.” – Gloria Jean Watkins (pen name Bell Hooks), American Author, Feminist, and Social Activist.
Worldwide, women seem to have taken the responsibility of their sexual lives into their own hands due to the increasing rate at which men have refused to use other safer contraceptives like condoms to prevent unplanned pregnancies.
One of such women is Angela Oppong, a Ghanaian living in Teshie in the La Dadekotopon District of Accra. She uses the birth control pills and says she takes them in order not to worry about any unplanned pregnancy.
“I have been taking the pills every day for years now because my partner and I do not like using the protective ones like the condom. As for Sexually Transmitted Infections (STIs), I do not have to worry about them because anytime I change partners, we visit the hospital to run tests to ensure we are both clean,” she said.
She intimated that even with the birth control pills, she occasionally experiences her menstruation twice a month but not bothered.
Akua, as I prefer to call her, on the other hand, uses the emergency contraceptive pills as and when she has sex. The 17-year-old says that can be as much as four times in a month and as little as once in a month. This practice has gone on for about a year and the only experience she had was the prolonged bleeding.
“My period usually lasts for four days but sometimes it can be as long as seven days but it is manageable so I am not worried as long as I do not get pregnant,” Akua revealed.
Godfrey has been dating his partner for three years and has ensured she used the emergency contraceptive pills until his partner got pregnant. He was disturbed but had no option than to accept the responsibility. For him, these drugs are not reliable.
Statistics from the Ghana Health Service indicate that the Greater Accra Region was rated fifth highest in the regional breakdown of teenage pregnancies in 2020 with 9,018 cases recorded as against 404 cases recorded by the Ghana Education Service in 2019.
This only depicts a considerable increase in teenage pregnancy cases, which has been attributed to the Covid-19 restrictions on movements including the closure of schools and lockdown. This is also believed to have increased unsafe abortions.
But as much as the lockdown contributed to these, young people with access to contraceptives could have prevented the over 120,000 unplanned pregnancies and unsafe abortions in the entire country. Unfortunately, this could not happen.
Emergency Contraceptive Pills
Contraceptives are made up of both clinical and non-clinical options. The WHO describes emergency contraceptive pills as a method that can be used to prevent pregnancy after sexual intercourse.
The emergency contraceptive pills and the Intrauterine device have been known to be over 95per cent effective if taken within five days of sexual intercourse, according to the World Health Organisation (WHO).
The copper-bearing IUD which prevents fertilisation by causing a chemical change in sperm and egg before the meeting has been classified as the most effective form of emergency contraceptive available yet most people do not prefer to use it. The IUD takes only about 10 minutes to be completed by a medical expert at a cost of GH₵20.
Data from Marie Stopes, Ghana, an international non-governmental organisation that provides contraceptive and family planning services, suggests millions of emergency contraceptive pills are sold each year in Ghana with about 50,000 doses of a new pill, BKI sold in 2020 alone.
In an interview with a medical officer at the University of Ghana, Legon Hospital, Dr. Gifty Odame, she noted that many young ladies were suffering from various health conditions including the change in their menstrual cycle and the resultant ectopic pregnancies due to the recurrent use of the emergency contraceptive pills which is expected to be used four times in a year.
She also raised concerns about Sexually Transmitted Infections(STIs) due to the failure of people to use condoms but using the emergency contraceptive pills which only prevents pregnancy.
This, the Head of Social Marketing at Marie Stopes, Dr Henry Bruce says is a result of the low education on the use of emergency contraceptive pills and the alternative family planning methods available.
Dr. Bruce indicated it is expected of sexually active women who are not ready for pregnancy to have a regular contraceptive method and occasionally rely on emergency contraceptive pills.
Emergency contraceptives can be taken within five days after sex to prevent pregnancy.
He said, contraceptives like condoms could break during sexual intercourse,
He, however, stated that women who are not sexually active like to keep the emergency contraceptive pills for emergency cases which are rare, reasons keeping a pill by such people cannot be wrong.
Denying women the emergency contraceptive pills , he said, could end up increasing abortion cases and eventual deaths in situations where the services of quack doctors are employed.
“Providing alternative solutions to young women is always the best option and this can be done through probing, followed by counseling to ensure optimal results,” Dr. Bruce added.
There has been no research about the repeated use of emergency contraceptive pills causing infertility as many assume but the menstrual disruption can be life-threatening.
“I have seen someone who bled clots so much due to the repeated use of emergency contraceptive pills and had to be admitted at the hospital for blood transfusion. There are serious consequences on bleeding. The danger is that this could cause anaemia and can affect the individual’s productivity,” he said.
Education must be done extensively to ensure young women know the implications of the repeated use of emergency contraceptive pills and the alternatives available.
This will also help ensure that there is universal access to sexual and reproductive healthcare services including family planning, information and education, and the integration of reproductive health into national strategies and programmes as stipulated in the Sustainable Development Goal 3.
By Adwoa Adobea-Owusu