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Ask the Expert: Family Planning Methods
MumsVillage hosted a very informative WhatsApp chat on Family Planning Methods in Kenya with experts from Marie Stopes Kenya.
The chat was a much needed session for several of the mums who joined in as they were able to learn about the various family planning methods available in Kenya and what works for each of them. The chat also helped in dispelling famous myths about different family planning methods through expert advice and information shared by the Marie Stopes medical practitioners.
The questions were submitted by mums from the MumsVillage community based on what they needed to know about family planning. The questions and answers are as complied below.
I want to get my tubes tied once I give birth. How can I go about it? What do I need to qualify?
It is possible to have your tubes tied ones you are through with the birth process and you are certain that you have achieved your expected family size.
A trained health care provider will take you through an elaborate counselling and consenting exercise to ensure that you are ready for the procedure and to ensure that you clearly understand its permanent nature. It is not easily reversible and will be dependent on your mode of delivery.
- If through a C/Section, then you can make a request to the doctor to ligate the tubes in the process. If not possible then until healing process is complete.
- If normal vaginal delivery, then it is possible to have the tubes ligated within two weeks post-delivery, if not possible then after six weeks.
Does Marie Stopes do births and do you accept NHIF for maternity costs?
We currently conduct deliveries only at our Eastleigh Nursing Home in Nairobi and very soon we will open up Mombasa and Kisumu Nursing homes for the same.
NHIF covers all costs related to normal or C/Section deliveries save for the Laboratory investigations, Scan expenses incurred in the process of your admission and drugs prescribed upon discharge.
When an implant expires, does one have to remove it in order to get pregnant or can one still conceive while it’s still there?
When an implant expires, it no longer discharges the hormones that were responsible for preventing pregnancy and one is likely to become pregnant at that time.
It is advisable to have the implant out ones it is expired and either reinsert a new one or leave the body to recover from the hormonal influence as the body now prepares for a pregnancy.
When the implant expires, can it harm the body?
The two types of implants we currently have (3years Implanon and 5 years Jadelle) have been proven to be safe up to the periods stipulated for their use.
Therefore, no much information about their safety beyond those periods and it is advisable to have them removed.
Any dangers on pregnancy with an expired implant still in the body?
Implants work primarily by thickening cervical mucus, which blocks sperm from meeting the ovum (an egg) and by disrupting the menstrual cycle and preventing ovulation.
Implants do not interrupt pregnancy. Evidence shows that implants will not affect the pregnancy or harm the fetus if a woman is already pregnant when implants are inserted or become pregnant while using implants.
The fact that one becomes pregnant while it is expired is an evidence enough that it is not working and should be removed. On the other hand, information about their safety either to the fetus or the mother beyond their recommended period of service is very scanty and cannot be supported.
Is it true that when one is not sexually active or rarely has sex, she is not supposed to use family planning pills?
Family planning pills are most effective when taken consistently at the same time. If one is not sexually active and not intending to, then there is no need to take them.
If one occasionally engages in sexual intercourse, then it is advisable to take the pills consistently at the same time if that is the method of choice.
However, there are situations where one can benefit from taking the family planning pills to control related hormonal conditions like acne, heavy periods, cramps and some premenstrual symptoms.
How would one know that they have hormonal imbalance?
One is likely to recognize a hormonal imbalance when there are signs and symptoms that are suggestive of the same. For example;
- When one is experiencing heavy or irregular periods, missed periods (but not pregnant), a stopped period or a frequent period.
- Development of a condition known as hirsutism – excessive hair on the face, chin or other parts of the body.
- Development of acne on the face, chest or upper back
- Hair loss
Do the pills help in hormonal balance?
Yes, hormonal birth control pills may balance the hormonal fluctuations that happen throughout your cycle and hence benefit you a lot by controlling conditions brought about by the imbalance.
I am four months postpartum and my periods are not back yet, I was told I cannot get the non-hormonal coil implanted until then, kindly advise me on any other temporary option which is also non-hormonal.
Anon hormonal IUCD is a small piece of flexible plastic shaped like a T that has copper wrapped around it. It uses copper to prevent pregnancy by interfering with the way the sperm cells move so they cannot swim to meet an egg.
It is a safe and convenient method of family planning that can be inserted within 48 hours post-delivery, that is if the service provider is trained on the same.
If not possible immediately after delivery, then it can be inserted at 6 weeks when your child is receiving the 1st immunization doses.
In this case, you are eligible for the non-hormonal IUCD upon meeting the medical eligibility criteria that the service provider will take you through.
Is it true that the Copper IUD makes one susceptible to recurring UTIs?
It is predisposed to UTIs and once you get recurring UTI’s it is removed and treated. But mostly UTI is treated when IUD is in situ and it clears.
Are pills safe for family planning
Yes, they are. And there are two types: Combined oral pills and progesterone only pills. Combined oral pills if used correctly at the same time daily, can prevent pregnancy by 99%. Progesterone only pills have one hormone only, Progesterone. So if you are contraindicated against depo provera (sindano) Implants, then most likely you won’t use the progesterone only pills.
Is it true that a majority of women who have Norplant and don’t receive their menses are likely to lose weight and those who receive their menses are likely to lose weight?
Not receiving menses has nothing to do with weight gain or loss. The method itself has amenorrhea with weight gain as a side effects and receiving menses when you have that method is not a contraindication of weight gain and vice versa.
When using the implant (3 years) and it’s the first time, what are the common side effects and how long should they last? What are the alarming side effects and when should one go back to the clinic or seek medical advice?
Implant side effects present differently in different women. Some will have irregular periods, some will have amenorrhoea (no periods at all even for 2yrs but this is not harmful in anyway) and some might have heavy periods in the first few months. And some women might have very minor side effects like a few headaches
Do Mirena and Avibela do the same thing?
Technically they are both IUS or hormonal IUDs. Just different brands. It’s like Pampers and Huggies. But Avibela is way more cost effective as compared to Mirena. A wonderful product too.
How often should one have a pelvic scan to make sure the coil is still in place? What are the signs to look out for that should oblige a person to go for the scan?
You don’t need have your pelvis scanned to check for IUCD placement. There are ways of checking if it is in place vaginally by your service provider and an instruction is given to you for checks on your sanitary pad during your menstruation period. The scan can only be ordered if the service provider is not able to confirm its placement (when the threads are missing)
Is it true that pills can cause an ectopic pregnancy?
Causes of ectopic pregnancy are varied and not related to contraceptive pills. If this happens to you then your service provider can assist you manage that problem. i.e. blocked tubes
How effective is vasectomy?
This is a permanent family planning method that ligates the passage for the sperms in men. It is done under a local anaesthesia to eliminate any possible pain. very effective and safe method for men who have achieved their desired family size.
I have tried the non-hormonal coil twice but I over bleed and it keeps moving positions. What can you recommend?
You could try the hormonal IUD. We call it IUS. Intra Uterine System because the hormones are confined to the uterus. With that one, you bleed less. Other people do not have menses at all when on this. The best example is the famous Mirena. Marie Stopes has a product that works like Mirena called Avibela.
We hope you’ve learnt a lot from this article. If you’d like to learn more about MSK’s new family planning product, Avibela and to make an appointment with them, please fill in this form
MumsVillage has also partnered with Marie Stopes Kenya to provide you a comprehensive and affordable maternity package for antenatal care and delivery. If you would like to sign up for this package and to get more details, please fill in this form
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