Pumulo Sianga of Kaoma District, in the Western Province of Zambia, is now a mother of six and has suffered four torturous miscarriages in her life.
She has heard about child spacing from the routine antenatal checks her local clinic offers. She understands the benefits of child spacing for the good of her health and that of her children. Unfortunately, she can’t practice it.
“The grim reality is that I don’t have power to open my mouth and suggest child spacing to my husband,” says Pumulo, “If I ask for his permission to drink family planning pills he beats me with fists and a whip.”\
“I was married at 17 and my mother’s demise left me in hunger. A year later, I had my first child. Before taking me as his wife, my husband had promised to assist me to finish school. However, he failed to keep this promise and I ended up nursing a pregnancy each year. Four pregnancies were bloody miscarriages,” Pumulo narrates.
Pumulo says she lacks a voice to confront her husband and convince him to allow her to take up family planning methods.
“My curse is I only have four children- all girls- he says he won’t stop making me pregnant each year till I give birth to a boy to compensate for the six goats he paid as dowry price.”
She says even asking her husband to escort her to the clinic for antenatal check-ups each time she is pregnant is a risk.
“It has not been easy, I have had complications during and after pregnancy but my husband is not interested in coming to the clinic with me. He only demands sex every night,” says Pumulo, “Sometimes he jokes that he wants ten babies to fill the gap of the dead ones. I don’t find that funny.”
High rates of female illiteracy, low incomes for women and a desperation to bear male children and make male partners happy causes rural women to scuttle their freedom to adopt family planning methods or ask for safer sex, explains Aaron Mwanza, a training coordinator from Ku Mwanachi Foundation in Zambia involved in women economic empowerment.
Renowned Zambian gynecologist known as Swebby Macha, states that local couples may have their own ideas and plans about the size and timing of their family. “It is critical,” he says.
Though improved by 41% between 1990 and 2012, Africa continues to bear the world’s highest maternity rate of 824 fatalities per every 100,000 births according to UNFPA data.
“Women and their partners should be educated on the importance of spacing their children to increase the chance of a positive outcome for every pregnancy- and avoid fatalities,” he explains.
Women in rural areas have lesser chances of negotiating for child spacing because of norms that demand that a woman must bear male children mainly to repay the dowry price. High illiteracy levels add to the toxic mix. Dr. Macha explains that a woman’s body is often in a different condition from one pregnancy to the next.
“By the second pregnancy, especially if it happens less than 18 months after the last birth and is coupled with breastfeeding, the body can be depleted of vital nutrients such as folic acid and iron. This is dangerous.”
“Additionally, even though most women may feel good and are physically doing well 6 weeks postpartum, it may take more time to return to a healthy weight, increase their strength, improve muscle tone (particularly abdominal and pelvic floor muscles) and increase sexual activity. That is why family planning is an important component in child spacing and also the health of the mother,” adds Dr. Macha,”The healthiest pregnancy is a planned pregnancy.”
The trouble with most rural women like Pumulo, according to Dr. Macha, is their dependence on ‘Natural Family Planning’
“Rural couples can plan when to have intercourse and when to avoid it through watching their menstrual cycle,” He explains, “But usually, clinical pills are most preferred.”
“I am willing to be schooled to understand more about what Natural Family Planning does to limit my child births since my husband bans clinical pills,” admits Pumulo.
The dilemma persists. Pumulo hopes that her husband will soon be receptive to modern contraception and finally agree to child spacing. Until then, she continues to bear his children- on his terms.
(Author note: Pumulo’s name and surname have been changed to protect her from violent retribution)