At 20, Tabia Saidi has two children. It is not uncommon for girls in Mangochi, a tourism hotspot along Lake Malawi shores, to become mothers by their 13th birthday.
The main cultural shock in her rural setting is that she gave birth in quick succession—with her firstborn aged seven and the second six.
“I was still breastfeeding when I got pregnant again,” she explains. “The firstborn did not receive adequate care as my attention switched to the baby in the womb. I became a laughing stock. The whole village was ridiculing me, wondering why I could not control my fertility.”
Kutumbiza, conceiving while nursing a lactating baby, is considered a disgrace in many cultures.
Saidi rues having babies by chance at this terrific speed.
But the hostile treatment marked her turnaround.
It persuaded her to start using contraception to ensure every child is born by choice, grows health and receives maximum care.
“After kutumbiza, some good Samaritans approached me to discuss the importance of modern family planning methods to delay childbearing. I was convinced that I could not continue having babies so quickly,” she says.
In 2013, Saidi walked to Maldeco Clinic where she opted for an injection because she did not want anyone to know she was using contraceptives.
Three years ago, she switched to microganon implants, which prevents pregnancy for three years, due to on-off supply of injectables.
She counts herself to have migrated to the long-acting reversible method because she no longer frequents the clinic for family planning purposes.
Studies show long-term methods have a low failure rate, estimated at just one percent.
“My husband and I agreed to have five children, but we learned the hard way that it is not good to have a baby a year like goats. Thanks to family planning, we have not had another baby since the birth of the second born six years ago,” she narrates.
There is contentment and determination in her eyes as she narrates her story, saying she now has enough time to sell fish to sustain her family.
Girls, who drop out of school early, face the likelihood of having many children and low incomes in their lifetime.
Studies show that those who remain in school tend to have smaller families, with the first baby often coming later in their lives and subsequent children either delayed or spaced.
But Saidi, who was forced to marry in 2012, says contraception has offered her a second chance.
“My friends have six or more children, but I only have two. The implant in my upper arm empowers me to delay pregnancy and space children as I want,” she explains, patting her biceps where the family planning chip is tucked.
Every day, 10 to 15 women seek family planning at Maldeco Clinic in a densely populated fishing community where the nearest facility, Koche Catholic Health Centre, does not offer contraceptive services.
In 2015, United Nations Population Fund (UNFPA), with support from Britain’s Department for International Development (DfID), spent about $7.1 million for the procurement of family planning commodities, midwifery kits and maternal health antibiotics and drugs.
According to UNFPA family planning manager Milika Mdala, it is estimated that the intervention averted more than 1 640 maternal deaths and couple years of protection estimated at 1 188 500.
At Mangochi District Hospital, family planning coordinator Joyce Chalusa is excited that more and more women are reaping the benefits of family planning methods of their choice.
“In the 2015-16 financial year, 72 percent of women in the district were on contraception-up from 64 percent previously. This means more women are realising the importance of having fewer children and child spacing,” says the nurse.
She reckons increased use of contraceptives would help reduce the country’s high mortality rate estimated at 574 death in every 100 000 live births.
“Child spacing reduces the risk of birth complications which kills many mothers, especially adolescent girls whose bodies are not ready for childbearing,” says Chalusa.
She says the majority of women using contraception were on long-term methods, with almost 70 percent using injections.
The major challenge is that most men do not want to be associated with anything to do with family planning issues. To them, having many children confirms that they are real men. That’s why we have myths that purport that when a woman has an implant, her husband will become infertile and weaker in bed. The truth is that population is growing but land and fish catches aren’t,” she says. n