Perceptions on contraception

Perceptions on contraception

Children are by and large, a blessing. Realistically speaking, they are also a huge investment of our time and resources - physical, emotional, mental, social and economic.

And some children can be a burden to parents who are ill-prepared to raise them and/or provide for them.

As children are a direct consequence of sexual intercourse between a man and a woman, abstinence is obviously the best way to prevent getting pregnant.

However, the urge to have sex is one that is inherent in human beings, programmed into us by hormones and species survival instinct, and not to mention exposure to modern sexualised popular culture.

As such, it is hardly surprising that methods to prevent pregnancy, also known as birth control, have been around at least as far back as the days of ancient Egypt and Mesopotamia.

Among some of these early approaches were the ingestion of various plants that had contraceptive and/or abortifacient properties, vaginal suppositories made from various natural products, and the withdrawal method, or coitus interruptus.

These concepts and techniques still remain in practice today, although the materials may have changed according to advances in knowledge and technology.

Where women once ate plants, they now take hormones in the form of pills, injections, implantable devices and skin patches, while suppositories have been replaced by items like the intra-uterine device (IUD) and latex condoms.

Even natural methods that do not involve the use of any contraceptive devices or ingestibles have been refined over the centuries based on our increasing knowledge of the human body.

The 'natural' way

Frequent, uncontrolled childbirth has detrimental consequences on both maternal and child health, as well as the family's emotional, mental and economic resources.

That is why even religions that are against the use of contraceptive devices provide an avenue for family planning.

The Catholic Church is well-known for its stand that sexual intercourse between husband and wife must be both an expression of their unity, as well as openness towards procreation. As such, no devices or techniques that are meant to prevent conception during the sexual act are permitted.

The only form of birth control allowed to married Catholic couples is that of abstinence, which is practised during the woman's fertile period if they are not planning on having a child at that time. (Premarital sex is, of course, a complete no-no in the Church's eyes, so the question of contraception does not even arise.)

Previously, Catholic couples practised the rhythm method, which tracks the woman's fertile and infertile periods based on her monthly cycle. However, according to Kuala Lumpur Archdiocese Catholic Marriage Preparation Course coordinators Major Andrew (R) and Andrene Teoh, the current practice is to use the Billings Ovulation Method (B.O.M.), which indicates a women's fertility (or lack of) through daily observations of her vaginal discharge.

This method is taught by an accredited teacher during the eight-week compulsory course for all Catholics - as well as any non-Catholic partners - who intend to get married within the Church.

Sharing their personal experience of using the method, the Teohs explain that their third child, Audrey, was planned using the B.O.M. Their elder two children, Alvin and Amelia, were planned using the Pill.

Andrene, 69, admits: "Many years ago, when our faith was not so strong, we used the Pill.

"At that time, Andrew was in the army and was posted everywhere, so for convenience's sake, we used it. Then when we came back to the Church and understood the actual meaning of church teachings and the reasons why, we went back to the natural way (of family planning)."

They used the method to successfully practise periodic abstinence and prevent unplanned pregnancies, until, as Andrene says, they got caught out with their youngest child Aaron.

He was accidentally conceived when Andrene was 46. But both Andrew and Andrene are quick to emphasise that it was their own carelessness that resulted in the pregnancy, not the weakness of the method.

Explains Andrew, 69: "Andrene's ovulation was irregular already, and you need to be disciplined to follow the Billings Ovulation Method, so we got a bit careless."

In the end, he says: "The Church is not asking you to have 28 children; the Church is saying, have as many children as you want, but plan them according to the natural method, not by using artificial contraceptives."

Benefits

According to the National Population and Family Development Board (better known by its Malay acronym, LPPKN) Human Reproductive Division director Dr Norliza Ahmad, the benefits of planned parenthood, or family planning, are many.

"Firstly, it's for the health of the mother, so that she has enough time to recover after giving birth. Family planning reduces maternal death and morbidity, and decreases induced abortion, sexually transmitted diseases and certain gynaecological cancer types.

"Secondly, it is for the health of the baby, so that his or her chances of survival are better. Pregnancy spacing of less than two years might increase the risk of premature delivery and low birth weight, leading to neonatal death."

The best spacing between children should be at least two years, and not more than five, says Dr Norliza.

"Thirdly, it's for the wellness of the family, and harmony of husband and wife." She explains that bringing up children is a challenge to couples financially and emotionally. Husband and wife also need private time together to strengthen their relationship.

"And fourthly, it is for the benefit of all the family's children, so that the parents have enough time to take care of all of the them well," she says.

She adds that if the spacing of children is very short - one every year - parents would not have the time to look after all of them well, affecting their development physically, psychologically and emotionally.

Selangor Islamic Religious Department (better known by its Malay acronym, Jais) Family Law Division senior assistant director Abdul Rahim Salleh agrees with many of her points, saying:

"Family planning is not wrong if it is firstly, to take care of the mother's health. Too many pregnancies can affect the mother negatively, mentally and emotionally, as they can be too much of a burden."

He explains that family planning is not meant to be used to limit the number of children a family has, or to not have any children at all, but to space out the interval between pregnancies, in order to promote maternal and child health.

"Secondly, it is to arrange for the cost of living. If a family is too big, the parents might not be able to afford to give their children all that they need," he says.

Abdul Rahim adds that a father who is not able to provide everything for his children might resort to bad activities like bribery, stealing and cheating, especially if his faith and morality is not strong enough.

"With our high cost of living, family planning will lessen the stress on the head of the family, as it will be easier for them to adjust their cost of living," he says.

Family planning is also for the benefit of the children, so that their learning and development needs can be properly taken care of, in order for them to become "quality ummah (members of the Muslim community)", he says.

Also, Abdul Rahim says that family planning can be used to prevent dangerous pregnancies as "Islam won't tolerate it if it is dangerous to the mother to become pregnant".

Other methods

In Islam, both natural and artificial contraceptive methods are allowed to be used for family planning. However, according to Abdul Rahim, two important conditions are attached to their usage.

"Those contraception methods that are allowable are those which are reversible. For example, the Pill is temporary (contraception) because once you stop eating it, your fertility returns," he says.

Other methods like IUDs, hormonal implants, condoms and the withdrawal technique, among others, are also allowed as they are reversible.

The other condition is that both husband and wife must agree on the method of contraception.

Abdul Rahim shares: "These methods can only be used under the condition that the wife agrees. For example, if the husband wants to use the withdrawal method, the wife must agree; if he wants to use condoms, she must agree."

He adds: "Even to get pregnant, the wife must agree because she is the one carrying the child. The husband is only watching.

"Family planning must also be a discussion between husband and wife."

Meanwhile, according to Abdul Rahim, irreversible methods of contraception like removal of the uterus (hysterectomy) are strictly prohibited, unless the procedure is medically necessary.

LPPKN also promotes the use of modern contraception methods for family planning, as their effectiveness has been scientifically proven.

Aside from their permanent clinics around the country, the board has programmes like training for healthcare providers, health camps and mobile clinics targeted at disadvantaged families as these families are the least likely to be well aware of, and have easy access to, contraceptives.

According to Dr Norliza, the board also conducts family planning talks for new mothers in government maternity wards.

"We introduce to new mothers what their options are for contraception, and why it is important to practise family planning. We also give out free samples of some of the contraceptive material," she says.

For the board, the guiding principle for the provision of contraception is that couples have the right to choose the number and timing of their births, and the method of family planning.

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