BFM-SHARING RESPONSIBILITY FOR FAMILY PLANNING

IMG_1434When it comes to family planning, women bear a disproportionate amount of the responsibility. There are very few male methods for family planning that are both practical and effective. Consultant obstetrician and gynaecologist Dr Helena Lim explores what’s on the horizon for safer and better family planning methods.

https://www.bfm.my/sharing-responsibility-for-family-planning

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Contraception – women’s right to choose

 

women with pills

Contraception – women’s right to choose

If anyone were to ask me which story I would like to share when it comes to stories on prescribing contraception, I would not hesitate to tell you my experience while training under the legendary Professor A.

Professor A is a famous senior professor attached to the unit where I was training to be an Obstetrician & Gynaecologist. She was one of the first female obstetricians in this country, who is highly respected and well loved for her integrity and discipline. In many ways she was my teacher and mentor. However, she was not the easiest boss to please: she expected nothing less than perfection from her trainees. I can still recall the days whereby I woke up at 5.00am every morning and arrive at the hospital at the wee hours of the day, woke patients up from their beds to obtain the latest updates and progress on their medical conditions. By 8.00am sharp, Professor A would have arrived at the ward, fresh and energetic, to start the consultant ward rounds. Professor A would expect us to know A to Z about the 20-30 patients under our care. She would get extremely upset if we flipped the notes to gather information in front of her. And honestly, it was a great challenge to remember every single detail of these patients without getting our facts mixed up. But Professor A is no fool as she could remember every single detail of these patients, and she would not hesitate to point it out directly, which sometimes could be quite embarrassing for us in front of everyone else.

It was a scary and challenging period of our lives. To survive the wrath of Prof A, we worked so hard to make sure that we meet her standard. One of the most important aspects of our presentation is our counseling on contraception. Professor A would expect us to have counseled the patients and their husbands regarding the choice of contraception and she would expect that the discussion ended with the couple making the most reasonable choice. If any single part of these steps were missed, Professor A would get extremely upset.

It was a great challenge, to wake patient up at 5.00am in the morning and bombard them with all the choices of contraception and expect them to make the decision at such wee hours of the day, and many of these patients may have just returned from the labour suite after going through long and difficult labour…..Many of them would have looked at us like a zombie as we rattled through all various choices of contraception. Some would even be irritated and ignored us. Sometimes, we even get sarcastic remarks and angry statement from the husbands. But the job needs to be done. And I must admit that sometimes when we did not get the answer from the patients, we lie through our teeth in front of Professor A……It was our survival instinct….

When I looked back at this period of my professional life, I used to wonder what kind of impression I have made upon these patients with regards to contraception. Many times I wished that this information could have been imparted to them while they were still pregnant so that they could have time to digest and discuss this information with their partners. I have also secretly wished that I have opportunity to sit down with their partners to help them to make an informed choice.

As I become more mature professionally, I began to actively discuss contraception with these patients while they attend the antenatal clinics. Professor A had taught me that contraception is such an important issue which many of us have neglected because we thought it is not important. Many patients who were not ready to be pregnant again physically or mentally came back to us pregnant at the most inconvenient period of their lives, putting themselves and their pregnancies at risk, and causing sleepless nights for the managing obstetricians. Education, like Professor A stressed, is the only solution to this vicious cycle.

Therefore, I strongly believe that education on contraception should be incorporated in our women’s health education and sex education. Education is to help individuals to make informed choices and should not be deemed as promoting casual sex or immoral conducts. Education on contraception should be viewed as part of health education rather than something that one needs to discretely find information on.

Let us make contraception a valid and conscious choice for all.

Contraception and its myth

contraceptive pills

 

Contraception and its myth

Being a modern woman in the 21st century, I faced many challenges in various aspects of education, family & career. Working as an obstetrician and gynaecologist in a busy university hospital, I have experienced numerous personal struggles in striking a balance between my ongoing educations, career pathways and raising a young family.

Pregnancy and parenthood is a beautiful journey and brings enormous joy to every couple. However, if a pregnancy occur at an un-timely period, it could potentially throws life into disarray causing unnecessary stress and challenge to a couple. Therefore, planning a pregnancy is very important especially in this modern era. The advent of contraceptive pills since 50 years ago had revolutionized the concept of family planning and empowers modern couples to take control of their fertility and pregnancy. It gives them the choice to decide on the timing of pregnancy and plan ahead to ensure that they can embark on the journey of pregnancy and parenthood at the most suitable time of their lives.

Contraceptive pill is an excellent choice of contraception as it is convenient, reliable and safe. Apart from being an effective means of contraception, contraceptive pills have many beneficial side effects which can significantly improve the quality of life of a woman. By taking contraceptive pills, women faced less undesirable body and emotional changes associated with menstruation such as premenstrual symptoms (PMS), painful menstruation (dysmenorrhoea) and heavy menses (menorrhagia). Contraceptive pills also have the benefit of regulating a woman’s menstrual cycle, improving the skin quality, reduces the risk of benign breast and ovarian cyst, and reduces the risk of ovarian and womb cancers in the long run.

However, there are still so many myths surrounding contraceptive pills amongst the society which inhibits the use of contraceptive pills as an effective means of contraception. Day and night, I have seen patients from various age groups who walked into my clinic requesting for termination of pregnancy as a mean of contraception. After lengthy counseling, most of these women, desperate and determined to get rid of their pregnancies, left my clinics and walked into the unknown darkness, seeking for termination of pregnancies elsewhere. And it crushed my heart to think of these women, vulnerable because of their circumstances, ended up at some secret places, mostly illegal and unsafe, to get rid of their own flesh and blood. I have also seen many women, who ended up at the hospital, almost losing their lives, after an unsafe abortion.

During the counseling, I always asked these women why they did not take precautions to prevent pregnancies. Many told me that their mothers or aunts or somebody they know said that contraceptive pills can cause cancers. They were also convinced that once one takes contraceptive pills, it will adversely affect their fertility in the future. Some even suggested that contraceptive pills are toxic to the body.  However, none of them realized that having a termination of pregnancy have more immediate and long term side effects which can adversely affect their health and future pregnancies. Some even lost their lives during or after a termination of pregnancy.

So, as a gynaecologist and an educator, I always ask myself: what is my role in this circumstance. How do I get to the root of the problem without ruffling too many feathers along the way? There were so many controversies surrounding the introduction of the topic of contraception into our sex education programme. Then, where do we start? How do we reach out to the women in various age groups, education background, socioeconomic status and different ethnicity and religions?

I believe that we are all responsible in playing our parts in this matter. As a gynaecologist, my role is to educate the general public on the various issues surrounding contraception and to rectify the misconceptions and myths. Therefore I jumped at the chance when I was invited to write something on this platform about contraception. Although this effort may be small in comparable to all the wonderful things that our activists from the Non-government Organizations have done to advocate the women’s right in sex education & contraception, I sincerely hope that this small contribution can make some differences. Some information about contraception can also be found on the platform written by myself and my colleagues at www.pitterpatter.com.my.

Let us make contraception a valid and conscious choice for all.