Beware: contraception is not a 100% deal
Unplanned pregnancies due to failed contraceptive methods can cause upheaval, distrust, and pain in many relationships.
These are more common than one might think and many women have to decide whether to sustain an unplanned, sometimes unwanted, pregnancy or have an abortion.
“People need to realise that contraception is not completely effective. Many women also undergo abortions because contraceptives failed, they experienced side-effects or they were not informed about all the options,” said Dr Judy Kluge, head of the Family Planning Unit at Stellenbosch University’s Faculty of Medicine and Health Sciences.
According to the Guttmacher Institute, an American research and policy organisation committed to advancing sexual and reproductive health and rights, in Africa an estimated 34 in every 1000 pregnancies are aborted.
“(Contraception efficacy)... is dependent upon a number of factors other than the way it works at preventing a pregnancy. These include ease of use, which affects compliance... the fertility of the women using it, etc,” Kluge explained.
“A good example is the pill (combined oral contraceptive pill) if you use it perfectly then the failure rate in 100 women in the first year of use is 0.3. But (with) how women typically use it, it has a nine percent failure rate... nine in 100 women using the pill will fall pregnant.”
Kluge explained that the pill is taken every day and so relies on the user in order to work correctly. Long-lasting methods such as intrauterine devices (both copper and progesterone containing) and the implant are “fit and forget” methods with very low failure rates.
According to Kluge, the implant has a failure rate of 0.05, which translates to one in 2000 women falling pregnant in the first year, compared to female sterilisation which has a 0.5% (one in 200) failure rate. So it is essentially 10 times better at preventing a pregnancy than female sterilisation.
A vasectomy has a failure rate of 0.15%.
Thando*, 34, of Cape Town and her husband experienced first hand the trauma of a failed sterilisation.
“We didn’t want more than two children. By 2010, we had a girl and were expecting a baby boy the following year. My husband underwent a vasectomy in 2011 at a local hospital in Cape Town. Four years later,we found out we were pregnant.”
A vasectomy is a permanent procedure which, according to the Royal College of Obstetricians and Gynaecologists, blocks or cuts the tubes that take the sperm. According to the college: “It takes a while to become effective and a man needs to have ejaculated about 20 times.
Thando said: “My husband took it really hard... He was studying and our children were aged six and four.”
He wanted to sue the doctor who performed the vasectomy.
After her son’s birth, Thando underwent sterilisation, but the couple lamented how no explanation was given as to how she could have fallen pregnant despite her husband’s vasectomy.
“We need to give women and men proper information about the methods that they use,” Kluge said.
In addition, she said that people should be told if their medication, taken for other illnesses, could interfere with the effectiveness of contraception.