Category Archives: Reproductive Health

‘Iran 9th country with lowest maternity death worldwide’

‘Iran 9th country with lowest maternity death worldwide’

2018-11-12

It’s a big achievement because to end the death during childbirth is a goal that UNFPA has set for the whole world – or, as we say, zero maternal deaths. There are just a handful of countries who have achieved this milestone, Dr. Natalia Kanem said.

“We have to trust women to make choices in planning their families,” a key message from the Executive Director of UNFPA.

“The woman should be the one to decide, and of course it’s natural for the woman to confer. This is the whole point: We have to trust women to make these decisions because the woman is one half of a couple and is the one who bears a child; the woman also understands how many children she already has and she also understands her responsibilities for looking after the next generation,” Dr. Kanem explained.

Dr. Kanem travelled to Iran to attend the HelpAge Asia-Pacific Regional Conference on Population Ageing which was held in Tehran from October 23 to 25, with the main theme of “Family, Community and State in Ageing Societies.”

UNFPA is the United Nations sexual and reproductive health agency. Its mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled.

Here is the full text of the interview:

1) Based on the latest census figures in 2016, older persons currently constitute almost 9 percent of the total population in Iran and demography experts predict that by 2050 some 20 to 30 percent of the population will be 60 years or older. How can this inevitable demographic transition be addressed with regard to the Sustainable Development Goals?

Everywhere in the world have demographic challenges that are different from each other, of course. UNFPA is quite convinced that the demographic challenges that the world is facing are really closely linked to the issue of choice. The choices that we are making today are going to influence older people as they age, but they are also linked to the cycle of life. So those same choices have to do with how we deal with young people today. Demographic transition typically refers to the phenomenon that we see in populations. In earlier times, a high birth rate was accompanied by a high death rate. Many countries had the high birth rates, women often had 8, 10, even 15 children. Even in Iran, less than 50 years ago, birth and death rates were much higher than today.

People were dying at the age of 50 or 55 and this was considered normal – something we certainly wouldn’t consider normal today. But with development we see that as choices expand typically people would choose to have smaller families so that you can invest more in each child. And as advances in medical care, nutrition and quality of life occur then the death rate also comes down. So this is the demographic transition: you have high birth rate and high death rate and then slowly over time fewer and fewer children, but also people are living much longer. So all of these change the structure of the population.

In less developed countries where UNFPA is working – for example, in parts of Asia and Africa — the “many children paradigm” is still there. The death rate is still relatively high and so the structure of the population in those countries presents a different challenge.

Iran is a very good example of a country where you’ve had these advances in development and medical care. People are now living much longer- on average 20 years longer than a few decades ago- and it’s a big achievement for Iran and for similar countries. And of course [people are having] fewer children but more children are surviving and you are not having a lot of early deaths. Then when you’ve got to the stage where Iran is now and as you look to the year 2050, for the first time you are going to have a high proportion of older people.

At the meeting I attended here we joined other partners, including the government, to develop ideas, regionally, as to how we will address some of these challenges. The Sustainable Development Goals have that word “sustainable.” It means that it should be something that is going to endure over time. Sometimes you can fix things quickly but it’s not going to last. It’s a short-term Band-Aid [solution]. What the Sustainable Development Goals are talking about is prosperity that is going to be long-lasting into the future. So in thinking about the Sustainable Development Goals, there are 17 of them. Of course there are many noble goals of the United Nations embedded in them. Every country wants peace, wants to have productive partnerships, things like health, the end to poverty, the end to hunger, etc. This everyone can agree on. It is not an issue.

But there are some other interesting SDGs which are less known like the SDG 10 which is about an end to inequality; or the SDG 5 which talks about men and women and making sure that the services of the country, of a community and of a family cover both men and women. And as we think about the ideals of climate and the environment there are sustainable goals for water and life in the sea, and there are sustainable goals for agriculture and life on Earth.

For UNFPA the relevance of all of these goals to an ageing population is that you have to strengthen not just the body and mind but the attitude of everybody to understand the cycle of life. If the baby is healthy in the mother’s womb this is a stronger child who is going to be a stronger adult and who is going to avoid some of the health problems when they become 60-70 or 80 years old. But if you have no good nutrition, lots of diseases may occur and if there’s not an understanding about the relationship of men, women, older people and younger people in the family then as you get older you are not going to be well integrated into the society. You will suffer great loneliness which is a problem, which can be even a health problem, and you are also not going to be able to be productive. The big point that we make about the demographic transition is that older people can and should continue to contribute to society.

They contribute to their family, of course, because of love. But they can also contribute to their community economically by their wisdom that they have acquired over so much life experience and also to be able to give guidance to the next generation that’s coming up.

So in a nutshell we also want to stress that these Sustainable Development Goals stand for having a world that is just, and in that just world women are half the population and therefore women are half the solution. The solution to the economic problems, because prosperity comes with more women contributing and more women in the workforce. More women being supported by childcare and other things that are going to allow them to make their contributions all the better. The relationship between healthy old age and providing and planning and protecting women all along a chain makes a difference because women tend to outlive men, so when you look at the population over 60 typically there are more women than men as opposed to half and half. But normally women do not have the chance to have pensions, for example, so poverty among older people tends to have more women represented. These are the type of questions that the Sustainable Development Goals ask us to address and these were some of the things that were discussed in the conference.

2) How does UNFPA evaluate Iran’s effort to address population ageing including increased inclusion of the older persons in the community, making cities more accessible for them, and financial support for health services?

UNFPA has worked very closely with some of the ministries that are in the lead on thinking about the family. We were much honored to have with us the Vice President who has taken leadership on some of the issues on family dialogues that you are having in this country. It’s a very enlightened way of looking at problems that every society has by trying to encourage dialogue among the generations and also to think about family life and family relationships. Iran is doing well when it comes to concentrating on better health for all, including the challenges that you face because of the migrant population and other factors.

UNFPA’s role is to assist governments as we think of what are some of the measures that we can put in place. For example, if something like an earthquake or another type of natural disaster happens, usually women are more affected than men in any country, so UNFPA works with women and girls so that together with government, we can position lifesaving supplies and how we can assure that we are ready to assist the population if, God forbid, something happens in terms of a humanitarian crisis.

We also help government to analyze some of the trends that are happening in the population, not just ageing and but also on the other side of what’s happening with the younger people in the country. Iran has a highly educated population, including women who go to school. This is something that is a model for other countries in the region and UNFPA is helping to share the experience that you have had with other countries in the region. We’ve been very gratified and happy to see that when it comes to women’s health issues Iran takes them very seriously. Your midwifery programs have been very successful, so you have fewer deaths during childbirth than other areas which had started from the same indicators where Iran did.

Iran achieved MDG 5 [United Nations Millennium Development Goals] by being the 9th country with lowest maternity death worldwide. It’s a big achievement because to end the death during childbirth is a goal that UNFPA has set for the whole world – or, as we say, zero maternal deaths. But you are already there. There are just a handful of countries who have achieved this milestone and now we are working feverishly to try to share that example, in particular, the benefits of midwives and safe delivery and antenatal care. All of these are factors that helped Iran to have women survive. No woman should die while giving birth.

Of course there is always more to do and among these is trying to strengthen key policies; we are working with government and together we are encouraging policies that seek to address and end violence against women, for example, and there are other areas that we have been working on very closely with Iran.

3) In the UNFPA State of World Population 2018 report you mention that “choice can change the world”, could you please elaborate on that?

The State of World Population report was published just a few days ago [October 17]. In this report UNFPA analyses choices – including why choices are in short supply everywhere. We looked at every country and we were looking at fertility levels and number of children per woman and we noticed that in the countries that are still very poor and are trying to raise their economic prospects they still have very high fertility. Like I was describing before, women in such countries are having more children that they actually desire. When you have a big family you have big challenges especially in a poor country, so UNFPA is working together with governments to provide contraception and also information. So that women would be aware of the things that they could do safely in order to plan their family.

Now this type of guidance is not ‘one-size-fits-all.’ It has to be done sensitively; you have to work with the culture and religion and social norms of the country and you have to understand what it is that women prefer because it should be their choice. A simple example is if a women wants to use contraception to plan her family size it should not be just one type of contraception. You should have 5 or 6 or 7 modern methods of contraception for family planning, and she will pick the one that works for her and her husband.

Now on the side of countries where fertility is on average two or three children we’ve done an analysis to see choices there and choice is relevant because very often a woman does not have a choice to work; she would like to but there is not enough social support. If there is no grandmother to look after the children, for example, what is she going to do? If there is no consideration for all of the different options, she may have the education and she may have the preparation to achieve her potential, but she may not be able to ultimately participate in the economy of her country. And this is going to make sustainable development much more difficult.

And then we also talk about developed countries where the options of not only future income but things like the policy for maternity and paternity leave are discussed. If you have a job and now you have a child will you lose your job because you now have taken leave while you were pregnant and while the child is young? And we are also very bold about saying that fathers should also have adequate paternity leave, so they can bond with the new baby and be a family together when the baby is very young. This is very helpful for the baby as they are growing to have a few weeks or a month, for example, with their father and not just the mother.

So these are some of the things the report is bringing out. And then lastly in some places – many of them in Asia-Pacific, the average fertility rate is very, very low. In Taiwan, for example, it’s an average of one child per woman – It’s the lowest in the world. In other parts of Asia like Korea and Japan where families are very small, or a country like Finland which also has low fertility, the concern is why women are not choosing to have more children. So we did an analysis to look at choices. Sometimes a woman would like to have two children but she is not able to afford. So this is a type of choice which is limited for her. There are other women whose choices are limited because of, I would say, ignorance about transmitted infections that can lead to problems of reproductive health. This is what UNFPA has to work with not just in Iran but in every country where UNFPA works. We attend to these issues of women’s health.

The current fertility rate in Iran is 2.01. From our perspective what’s normal is what the woman wants, so we don’t have targets labelled good or bad. We look at the spectrum and we provide advice based on what it is that any woman in Iran would want. I would observe that many countries see two as the ideal because you have a stable population. It’s not growing too fast and it’s not shrinking too fast. But again a lot depends on what women themselves want. If a woman wants a bigger family, we should help her to have the support to have the ability to be able to afford more children. If a woman wants a smaller family and that is her choice then we should support that choice. But for Iran your fertility rate of 2 is in balance because that’s considered “replacement rate” of the population.

4) Would you please explain why reproductive health and rights remain in the 2030 Sustainable Development Agenda?

There is no country on earth that can claim that they have made reproductive health and rights a reality for everyone. Even when a country is doing well we see that there are shortfalls, maybe a farmer who is trying to have her farm in a rural area, maybe it’s a migrant or refugee etc. We always know that choices can be limited and the goal of UNFPA is to make sure that these millions and millions of people have more choices, not fewer. This is what I said earlier. It’s not good to try to tell a woman you must have two-and-a-half children

so that the statistics look good. We have to analyze what is happening with your family. Can you afford four or five children if you want that many? Well, this may be a blessing for you. But maybe you cannot afford five children, so maybe you would like contraception because you are afraid everybody will stay in poverty and you won’t be able to invest in each child well, so you should receive the help to exercise your choice accordingly.

Ultimately the point about the Sustainable Development Goals is to make sure that women are able to speak and that women are able to understand what is the future for them and for their daughter or for their son for that matter. Because of course the girl is going to marry the boy and we want to make sure the boy knows about the respect for women, we want to make sure that the boy is in good health, and also in every country we face the challenge of domestic violence and this means that raising awareness among men and boys is very important. They are the ones that are also going to share that understanding.

So as we think about the SDGs and the goal of ending poverty, women have to be an integral part of that equation. As we think about the second SDG to end hunger, for example, you know that many times women are active as farmers, women are the ones who are purchasing the food and cooking the food, so understanding about health and nutrition is good for them personally but it’s also good for the family and it’s good for the community.

And as we go through all of the SDGs, on education for example, I think we want to celebrate examples like Iran where woman have achieved and they can finish their education. This is not true in a lot of the world. In a lot of the world girls are discriminated against, they don’t get to go to school or they finish half way and then they would never go to the university. It’s not just girls that are in school; for many reasons there are girls that are also out of school, and today I saw a wonderful example in Iran of a community center [called Ofogh for adolescents where they can go and to learn to communicate and acquire life skills] where young girls are being taught through workshops and taught through interacting with each other about good health and how to avoid social problems in the future.

And we were accompanied by Dr. [Mohammad Mehdi] Gouya, Director of the Health Ministry’s Communicable Diseases Control Department, who is a brilliant scientist but who is also helping the people in Iran to understand life skills which is so important for their future.

And the last observation I made about Sustainable Development Goals in reproductive health is that it was in Tehran 50 years ago that the first International Conference on Human Rights took place and during this very famous conference that was the first time when the United Nations and all the countries agreed that it is the right of couples to freely and responsibly plan their family. So for UNFPA this was kind of our beginning and we will be 50 years old next year because we were born from this conference so this is why we are very happy to be in Iran and we know it’s a historic location for choice, for women and for couples to be able to plan their families.

5) Why has UNFPA put greater emphasis on women’s role in planning their families regarding the number of children, spacing, etc.?

The woman should be the one to decide and of course it’s natural for the woman to confer. This is the whole point: we have to trust women to make these decisions because the woman is one half of the couple and is the one who bears a child; the woman also understands how many children she already has and she also understands her responsibilities for looking after the next generation, so it’s her body and the right of the woman over her body has been established. So the woman always has the good sense to confer with everyone who is involved. Now when you say the couple it becomes a little ambiguous – you cannot dictate to a woman to either have or not have a child. The world at times had got into troubles by trying to force women against their will either to have a child or not to have a child and this is why we say that reproductive health should be women-centered and when we are talking about fertility the woman that carries the child should be the one to decide.

This is getting very interesting in a time of technology, for example with the new technology we have to be very sure to respect the right of the woman, as you know there are possibilities to either carry the baby or to be a surrogate mother. There are many things that are coming on the horizon where we feel that for the community and for the woman, herself, she should be knowing that’s her choice if she likes to have contraception it should be available; if she would like to have a baby we should support her with all the good care and support and the aftercare in the aftermath as well.

It’s interesting that as we think about the configuration of the family and as we think about the demographic transition- as I have described- the danger when you get into a low fertility environment is that there is a temptation to insist that, “Well, you should have three children – the country needs you.”

Ultimately, if you have a healthy productive ageing population that’s contributing, a smaller population can be better than a bigger one. There are many countries that have a big population but they are very poor – they have too much of a population to be able to care for them, so these are the kinds of issues that UNFPA helps to discuss with governments – and in any case I think governments would want to take good decisions based on what’s good for women in their country.

https://www.tehrantimes.com/news/429414/Iran-9th-country-with-lowest-maternity-death-worldwide

What Reasons Establish our Contraceptive Choices?

What Reasons Establish our Contraceptive Choices?

2018-06-26

Every one is unique in their own way. Our bodies may function in a similar fashion but everyone is different. When it comes to our physical health people have physical differences amongst each other such as allergies, immunity, weight, temperament and environmental sensitivity.

 

When we think about contraception we need to take into consideration a person’s individuality and choice. For some people a condom suffices, however, some women are more comfortable with taking pills while others just prefer to take injections.

 

Contraceptive choice matters when it comes to age, relationship of the couple, mental health, comfort level with the contraceptive in use (allergies, sensitivity and irritation), hormonal levels, availability and price.

 

A woman’s age is a huge and important factor when it comes what kind of contraception she uses. Usually woman aged of 40 and above (apart from women who have reached menopause) desire to use more long term contraceptive methods. Women over 40 usually use IUD and depot Provera acetate injections. Some women who are and above 40 also choose sterilization because they already have children and do not want more. Women below 40 usually use short term methods such as condoms, pills, IUD, insertion and withdrawal. The reason for this is that they want to get pregnant in the immediate future.

 

A woman’s relationship with her partner may show what kind of method is being practiced. A person’s relationship status depicts what kind (if any) of family planning method is put into action. Research suggests that couples who are in a short term relationship such as “causal dating” are prone to use contraceptives like condoms and pills. It has been proven by many researchers that the longer the relationship duration is, the decision amongst couples to use a condom decreases. Long term couples usually go for hormonal therapy such as injections as a form of family planning.

 

According to many studies there is a correlation between a person’s mental health and a person’s reproductive health. In accordance to this a person’s mental health does affect their choice of contraceptives or weather or not they use contraception at all. A woman menstrual cycle affects her mental health as well and child birth and menopause. Mental health issues such as post partum depression cause women to take contraceptive measures, however, the use of condoms prevail in this scenario because for women who are lactating hormonal contraception could cause harm to the breast feeding child.

 

There is a high possibility that a couple’s choice to not choose a particular contraceptive is the physical side effects, allergies and reactions they have to it. For example, women who take hormonal contraception might get prone to:

 

  • vomiting
  • bloating
  • vaginal discomfort
  • nipple discharge

 

Due to these discomforts women may abandon this contraceptive method. Also a lot of men and women are allergic to latex (the material of which condoms are manufactured) which causes couples to use other means to prevent unwanted pregnancies.

 

Hormonal contraception has the ability to create mood disorders such as PPD (Premenstrual Dysphoric Disorder). Therefore, couples reside to condom use. Also Polycystic Ovary Syndrome (PCOS) is a hormonal issue known to cause issues like mood swings, anxiety and depression. Many women struggle with fertility when diagnosed with PCOS hence they avoid hormonal contraceptive methods and opt for condoms as well.

 

In many rural areas in Pakistan, India, Afghanistan and Africa contraceptives are difficult to attain or unaffordable. Social and religious taboos prevent couples from obtaining contraception as well. This causes couples to indulge in the withdrawal method. This method is not the best way to prevent pregnancies but unfortunately for some it is the only way.

 

There are many reasons which dictate contraceptive choice. It is always better for couples be open and comfortable to discuss their choices. Gaining advise and information from a doctor is also a good way for couples to identify their options.

 

For more detailed information, click on the link below!

https://www.nhs.uk/conditions/contraception/

 

 

 

What We Want When It Comes To Our Periods

What We Want When It Comes To Our Periods

2018-04-16

As a woman who’s been getting my period for a couple decades now, I thought I knew everything there was to know about menstruation. That is, until my team started developing Spot On, a period and birth control tracking app. In the two years since launch, we’ve gotten feedback from thousands of real users. The lessons they had to offer serve as the North Star as we continue to develop the app, and can also be useful for anyone trying to build products that serve people around their periods.

 

Help me out. Yes, for many people, periods suck. Cramps hurt, remembering tampons is annoying, and the whole thing is inconvenient more often than not. But women have had enough of products that perpetuate period myths and stereotypes equating periods with weakness. They aren’t looking for a pep talk or a promise of chocolate; they just want to be told something useful, like when to expect their period or how to manage their symptoms, and broader advice about their sexual and reproductive health. They want actionable information that’s easy to understand — and specific to their own situation.

Keep it to yourself. According to a recent survey, 68% of U.S. consumers worry about how brands use their personal data — and people are even more sensitive about health data, with 70% distrusting health technology. Whether looking for protection from their information being shared with strangers, or needing an app style and icon that is discreet enough to prevent people looking over their shoulder, people want a worry-free way to understand what’s up with their own bodies.

Period pride. Menstruation can be as empowering as it is annoying. In fact, many of the people we spoke to described their periods as a time to get back in touch with their bodies and take better care of themselves. In early user research, one young woman described her period as “My free rein for a few days,” while another said, “It’s cleansing. We should embrace it. It’s not a burden to have a vagina.”

Please stop with the pink. Regardless of their gender identity or sexual orientation, the vast majority of the users we’ve spoken to are fed up with seeing heavily gendered design in anything and everything period-related — a lesson that most of the products out there, from apps to tampons, seem to have missed. As Mashable writer Rachel Kraus says, “Please stop marketing my vagina to me in a color that reeks of stale marketing meetings, approachability, and tranquility. I’m not afraid of my period, and your app can’t tame it.”

Don’t make assumptions. With all of the sexual health products I’ve worked on, there is one resounding theme in the feedback we hear, especially from those potential users young enough to have grown up with smartphones: they expect their products to treat them like individuals, not like demographics or categories. Regardless of how our users identify, they are wary of anything that makes assumptions about their gender, lifestyle, and sexual activities — including the countless period trackers that default to treating them as cisgender women with male sexual partners.

Don’t be the usertalk to them. It can be tempting to build products that solve the problems that are most familiar — especially when you’re building a period tracker as woman who’s experienced your fair share of periods. But it’s crucial to remember that, as someone working on a product, your own experience is only the tip of the iceberg, and your best guesses about what other people want often say more about you than they do about your potential user. Getting ongoing user feedback, especially if you’re supporting experiences that people often keep private, is invaluable. Whether you’re building something on your own or as part of a big company, find as many opportunities as you can for your team to get some perspective from the people your product will serve. It doesn’t have to be expensive and it doesn’t have to be perfect, but it will get you out of your own head and broaden your point of view.

It’s not one-size-fits-all. Periods are the most normal thing in the world (at least, for those of us who have had one — some dudes seem a little scared?), but that doesn’t mean there’s any “normal” period experience. We talked to some people whose flow came like clockwork and never bothered them. Others got debilitating cramps, and were using birth control to manage their symptoms even if they weren’t worried about preventing pregnancy. Some identified as men, and struggled through gender dysphoria with each cycle. And others still had mostly stopped having their periods thanks to birth control like the implant or hormonal IUD, which can reduce or eliminate periods for many users, and suddenly found themselves feeling a little nostalgic for that monthly marker.

The most important lesson? Whether it’s a cherished marker or one to be avoided, there is no single way to get a period — and our technology has to make room for the full spectrum of experiences.

Inadequate health services make women vulnerable: Report

Inadequate health services make women vulnerable: Report

2017-10-18

Islamabad – One out of 98 women in Pakistan die because of insufficient health facilities in maternal mortality control while the country lags behind other regional countries in the provision of reproductive health facilities, an official said on Tuesday.

United Nations Population Fund (UNFPA) launched The State of World Population Report 2017.

UNFPA official Hassan Mohtashami said at the launch of the report under the theme of ‘Sexual and Reproductive Health Inequality’ this year, that women in the developing countries die of maternal mortality because of inequality of rights given to them.

He said that in Ireland the ratio is 1 out of 12000 while in Pakistan it is 1 out of 98.

“Nearly 2.2million women in Pakistan go for abortions because of lack of awareness and facilities in reproductive health,” he added.

Indonesia, Bangladesh, India, Nepal, Saudia Arabia, Bhutan and Sri Lanka are above the graph in providing reproductive health facilities to women in the country.

He said it will be difficult for the country to achieve first Sustainable Development Goal (SDG) if women are not given the social rights in reproductive health.

According to the UNFPA data, out of total 207.774 million country population, 36.38 is living in urban areas while the annual average growth rate over a period of 1998 to 2017 is 2.4 per cent.

The Gender Inequality (GINI) for Pakistan as per World Bank report of 2013 is 30.7 per cent. The contraceptive prevalence rate women aged 15 to 49 ranges between 40 to 31 per cent using modern and other methods.

Executive Director (ED) National Institute of Population Studies (NIPS) Dr Mukhtar Ahmed said the indicators on the social side of the country are ‘worst’. He said Pakistan is the 5th biggest country in the world with the 207million population.

He said that the country allocates and spends fewer resources on the social side, while the unchecked growth of population is the biggest challenge for Pakistan.

“Women must be empowered with reproductive rights while the sexual and reproductive must be the priority of government,” he said.

The report said unless inequality is urgently tackled and the poorest women empowered to make their own decisions about their lives, countries could face unrest and threats to peace and to their development goals.

The costs of inequalities, including in sexual and reproductive health and rights, could extend to the entire global community’s goals, adds the new UNFPA report, entitled, “Worlds Apart: Reproductive Health and Rights in an Age of Inequality.”

Failure to provide reproductive health services, including family planning, to the poorest women can weaken economies and sabotage progress towards the number one sustainable development goal, to eliminate poverty.

Economic inequality reinforces and is reinforced by other inequalities, including those in women’s health, where only a privileged few are able to control their fertility, and, as a result, can develop skills, enter the paid labour force and gain economic power.

In most developing countries, the poorest women have the fewest options for family planning, the least access to antenatal care and are most likely to give birth without the assistance of a doctor or midwife.

Limited access to family planning translates into 89 million unintended pregnancies and 48 million abortions in developing countries annually. This does not only harm women’s health, but also restricts their ability to join or stay in the paid labour force and move towards financial independence, the report argues.

Lack of access to related services, such as affordable child care, also stops women from seeking jobs outside the home. For women who are in the labour force, the absence of paid maternity leave and employers’ discrimination against those who become pregnant amount to a motherhood penalty, forcing many women to choose between a career and parenthood.

“Countries that want to tackle economic inequality can start by tackling other inequalities, such as in reproductive health and rights, and tearing down social, institutional and other obstacles that prevent women from realizing their full potential,” Dr Kanem said.

The UNFPA report recommends focusing on the furthest behind first, in line with the United Nations blueprint for achieving sustainable development and inclusive societies by 2030. The 2030 Agenda for Sustainable Development has “envisaged a better future, one where we collectively tear down the barriers and correct disparities,” the report states. “Reducing all inequalities needs to be the aim. Some of the most powerful contributions can come from realizing – women’s reproductive rights.”

This news was published in The Nation newspaper. 

Youth Are Helping To Change The Birth Story Around The World

Youth Are Helping To Change The Birth Story Around The World

2017-08-22

We are inundated with birth stories in our day-to-day lives. Glance at the magazine rack while in line at the grocery store and you’ll see at least one headline announcing a new celebrity baby. Or scroll your social media feed — just last month the story of Beyoncé and Jay-Z’s twins “broke the internet.”

In Bangladesh, the early and forced marriage of girls is very common especially in poverty-prone rural areas. The marriage rate of young girls in Bangladesh is eleven times higher than boys. Many young girls are made to give up their education in order to marry and raise families, when they reach puberty. But early and forced marriage puts a girl’s health and wellbeing at serious risk. It can lead to girls experiencing violence, sexual abuse, premature pregnancies, and death in childbirth.
Tohura married a 21 year old man when she was 11. They both say they were in love though and Tohura has always been treated well by her husband.

Then there are the birth stories we hear far less about.One woman dies every two minutes from causes related to pregnancy and childbirth.About 16 million girls aged 15 to 19 give birth every year — most in low- and middle-income countries.Complications from pregnancy and childbirth are the second leading cause of death for girls aged 15 to 19 across the world.

And 2.7 million newborn babies die every year.

The birth stories above are grim but they are not predestined — they can change when communities become catalysts for transformative change.In a small school in Honduras, a group of boys are gathered in a circle. A facilitator is leading the group in a trust-building exercise, creating a safe and open space where the boys can reflect on gender stereotypes and ideas of masculinity. One young man explains how he feels pressure to act aggressively. Another reflects on his younger sister being afraid to walk to school alone.

When we think about changing these stories the first thing that comes to mind is probably not a group of young men participating in trust-building exercises and discussing masculinity. Unfortunately, unequal gender relations and values are often at the root of poor health outcomes for women and girls.

In areas where Plan International and its partners work on maternal, newborn, child, and sexual and reproductive health projects, men make most of the decisions.

In Nigeria, when asked about family planning, one woman said, “the woman first has to ask for permission from the husband [to seek family planning services], if he allows her, she will go ahead and if he doesn’t allow her she cannot.”

Because of their age, adolescent girls bear the brunt of these injustices. They are financially dependent on their partners and families and have less decision-making power. They also face a higher risk of complications with pregnancy and childbirth.

regnant adolescents are often the most isolated. They are distanced from their peers and often barred from school. If they are pregnant and unmarried they can face enormous stigma, ostracized by their families and communities and unable to access health services. An adolescent girl in Senegal told us, “as soon as the doctor knows you’re not married he can have prejudices against you and change his behaviour and not receive you in the same fashion as married women.”

It is not simply a matter of distributing contraceptives, improving health services, or changing laws — though these are critical steps. Real change requires sustained work to tackle the root causes of gender discrimination and inequality in every sphere — from private relationships to public systems. Shifting entrenched and structural norms is not easy, but it is the only way to uproot the inequalities that prevent girls and women from realizing their rights.

Plan International Canada works to ignite and support these conversations in communities in GhanaHaiti, Bangladesh, Senegal, Tanzania, Mozambique, Malawi and Nigeria, helping to change the birth story for adolescent girls and women in these communities.

Youth-led conversations, like the one in the classroom in Honduras are critical to ensuring sexual and reproductive health rights for girls. In a similar session in Tanzania, a young man shared: “I think for us who have changed, we should just continue to educate other men through our actions in such a way that our friends who have not yet changed will learn from our actions.”

his can take many forms, from simple conversations like the ones in the classrooms in Honduras and Tanzania to community theatre where youth address gender stereotypes through drama, to empowerment clubs where girls increase their ability to assert their rights and challenge norms.

You can be part of this real change. Join the movement of Canadians who pledge to stand with Canada to change the birth story — because they believe that every adolescent girl, woman and child has the right to be healthy and to live a life free of discriminationand help change the birth story today.

Saadya Hamdani is a Senior Gender Equality Advisor for Plan International Canada.

Does Sex Get Better When You’re Pregnant? You May Be Surprised

Does Sex Get Better When You’re Pregnant? You May Be Surprised

2017-08-17

I remember my first pregnancy well. Thanks to being gifted with a morning sickness that just wouldn’t quit, and a really fun type of neuropathy that made patches of my skin painful to touch, I was miserable. My second pregnancy, though? I was a changed woman, and my arousal was off the charts. I took advantage of it, especially with all that increased sensitivity, but does sex get better when you’re pregnant? Turns out, the answer is not universal.

According to Our Bodies, Ourselves, sexual desire during pregnancy runs the gamut between non-existent and a rabbit during mating season. The reasons are fairly complex for this spectrum of sexual need. First, not everyone is going to respond to the effects of hormones in the same way. For some women, myself included, pregnancy isn’t always this miraculous thing that happens, rather it’s something to endure.

Some women, however, enjoy the rush of blood flow, and the increased lubrication, and extra sensitive nipples, according to the University of California, San Francisco. These are just symptoms of pregnancy, but they can attribute to some of the best sex of your life when you’re pregnant. Does sex get better when you’re expecting? It definitely can.

The changes that happen in your body with pregnancy are such that they can swing the pendulum in either direction. Not only that, many men find pregnant women very attractive. Perspectives on Sexual and Reproductive Health suggested that this is an evolutionary imperative that assures the continuation of the species. It is a biological mechanism put in place so that men continue to play fast and loose with their reproduction.

However, if your pregnancy makes you feel crummy, and your sex drive isn’t as great as it was before you got pregnant, that’s OK, too.

My pregnancies were night and day. While the first trimester is never something I do well, when I got into my second trimester with my second pregnancy, I felt renewed. I felt strong and sexy, and most of all, ready for sex. My husband was into it, too. I mean, who wouldn’t be into their wife diving into their pants just as soon as their toddler fell asleep?

It was honestly some of the most intimate and pleasurable sex of my life — something I couldn’t have dreamed of during my first pregnancy. If you’re concerned about your level of arousal, or lack thereof, there is no shame in talking to your provider and your partner about what is going on. Pregnancy is a strange time in your life, and you’ll need all the support you can get — even if that support is holding up your hips so your belly doesn’t pull you down into the mattress.

10 contraceptive myths you should stop listening to;

10 contraceptive myths you should stop listening to;

2017-08-03

Falsehoods can get in the way of sound contraception advice

Contraception: we all use it. It’s an important part of our sexual and reproductive health – and yet it’s still one of the most misunderstood areas of our common healthcare. I’ve met several sensible adults who believe myths about how to avoid unwanted pregnancy and sexually transmitted infections. It’s time to set the record straight and separate the truth from the speculation…

1. The withdrawal method means you can’t get pregnant

This has to be one of the most common and widespread contraception myths. It’s easy to see why – in school we’re taught that the moment of ejaculation is the moment the sperm is released. That’s followed by a convenient story about the sperm meeting the egg and the magic of new life occurring. It’s a good story, but real life is a lot more messy and complicated than that. In reality, men often release small amounts of ejaculate (the fluid which contains sperm) before they climax. Withdrawing before climax will certainly reduce your chances of pregnancy, but it won’t eliminate them.

. The birth control pill makes you gain weight

There is lots of speculation out there about the way the pill impacts your metabolism and hunger levels. Like many myths, there is an element of truth here, but it’s still very misleading. Weight gain only happens if you eat too much for your needs. Hormones occasionally alter your appetite, which may mean you choose to eat more, but the pill doesn’t directly cause weight gain.

3. Being on the pill for a long time makes it harder to get pregnant

This idea has persisted for years. It is utterly false. It is in fact very likely to get pregnant as soon as you stop the pill. If it wasn’t true there wouldn’t be so many unexpected pregnancies from forgetting to start again after your seven-day break.

4. You have to take the pill at the same time every day

This is true for the older forms of the progesterone only mini-pill, but not the most common birth control pills that will be prescribed by your GP today. Although this is a myth, it’s actually quite a useful one – taking the pill at a regular time will help you remember and reduce the chances of missing a day, but the good news is, if you take the pill first thing in the morning, a couple of hours lie-in won’t stop it from working.

5. It’s a good idea to take a break in your birth control

Some people worry that taking the pill for too long could impact their reproductive health, so they take breaks whenever they can. The reality is that a pause in your use of the pill won’t really make much difference.

These days the hormones within birth control pills are at very low levels, so you can continue to take them for many years without problems. Taking a break in your birth control pills is only advisable if you are trying to get pregnant. A very common unexpected pregnancy story we hear is the one where you go off the pill because you’ve broken up; forgetting all of our propensity for making up unexpectedly with an ex.

6. You can’t get pregnant if you have sex during your period

It’s unlikely, but it’s far from impossible. Sperm can live inside the body for up to seven days and most women have fairly irregular cycles, so it’s hard to know exactly when the egg will be released. If you ovulate soon after your period, you could become pregnant. It’s very hard to predict the ‘safe’ times during your cycle.

8. Two condoms make sex safer

Condoms are 98% effective, but doubling up doesn’t double your odds. In actual fact, the two condoms will rub together and are actually more likely to split than a single condom.

9. The pill or IUD is all the protection I need

These are both fantastic methods of contraception, but they do nothing to protect you from sexually transmitted infection. If you’re on the pill and you’re seeing a range of partners, you should still use a condom. If you have one, regular partner, consider going for STI tests to make sure you are both negative. After that, it’s up to you.

10. I’m breastfeeding so I can’t get pregnant

New mothers often believe this common myth. It is true that breastfeeding tends to delay ovulation, making it less likely that you will conceive – but, unless you really want to risk adding to the family much sooner than you expect, don’t rely on it.

Deciding when to start a family is one of the most important decisions we will ever make, but frustratingly, when it comes to contraception, there seem to be a lot of myths in circulation. If you have concerns or need some concrete advice, don’t be afraid to consult your doctor. They can help you to separate the truths from the falsehoods.

Dr. Seth Rankin is founder of London Doctors Clinic

This is what to do if you miss a contraceptive pill, based on which one you take

This is what to do if you miss a contraceptive pill, based on which one you take

2017-07-19

And how to prevent it spelling p-r-e-g-n-a-n-c-y

Most of us are busy women with busy lives, which means sometimes we can forget to take our contraceptive pill at the same time each day. But if you’re not planning on procreating just yet, a missed pill could be a big deal.

So what happens if you do forget? Does it mean automatic pregnancy and a foreseeable future filled with nappies and breast milk? Don’t panic just yet; we spoke to those in the contraception-know at Clue, the period tracker app, who explained exactly what steps to take dependent on your kind of pill.

They told us there are two main types of pill: the ‘combined pill’ and the ‘mini-pill’, and for those of us who aren’t doctors by profession and therefore need those terms clarifying, here’s the difference between them both:

The combined pill:

Combined oral contraceptives (COCs) include both hormones oestrogen and progestin. The most common types of combined pill in the UK include Microgynon, Cilest, Rigevidon and Yasmin.

The mini-pill:

Progestin-only pills (POCs) include only progestin. Some of the most common mini-pills given out by the NHS include Femulen, Micronor, Norgeston and Noriday.

What to do if you forget to take a combined pill

If it’s been less than 3 hours:

A pill taken within three hours of scheduled time is considered on-time. The pill is fully effective.

If it’s been 3-24 hours:

A pill taken 3-24 hours past scheduled time is considered late. Take your pill as soon as you remember, even if it means taking two pills in one day. Taking your pill late on a regular basis is not recommended. Emergency contraception is not usually needed, but may be considered if pills were missed earlier in the cycle or in pills 15-21 of the previous cycle. Talk to your healthcare provider if you’re concerned.

If it’s been 24-48 hours:

A pill taken 24-48 hours after scheduled time is considered missed. Take the missed pill as soon as possible, even if it means taking two pills in one day. As before, emergency contraception is not usually needed, but may be considered if pills were missed earlier in the cycle or in pills 15-21 of the previous cycle. Again, if you’re concerned, it’s worth talking to a nurse or a doctor.

It’s been more than 48 hours:

If you’ve missed two or more pills, take the most recent missed pill as soon as possible. Take your pill as soon as you remember, even if it means taking two pills in one day. Do not take more than two pills in one day – you can throw away extra missed pills.

If you miss a pill, it’s recommended that you should use a backup method of contraception such as condoms for the next seven days, while proceeding to take the remaining pills in your pack on time.

What to do if you forget to take the mini-pill

A mini-pill taken within three hours outside of the scheduled time is considered late (or 12 hours for desogestrel pills, such as Cerazette). If you are late taking a pill, you should take it as soon as you remember.

A mini-pill taken more than three hours after scheduled time is considered missed (or 12 hours for desogestrel pills). If you’ve missed a pill, you should take it as soon as you remember, even if that means taking two pills in one day. Do not take more than two pills in one day.

You will also need to use a backup method of contraception (eg. condoms) for the next 48 hours. You are not considered protected from pregnancy until you have taken your pills correctly for at least two days.

Emergency contraception is usually recommended if you had unprotected sex after missing your pill, and before you’ve taken your pill correctly for at least two days.

Hopefully that’s provided some useful information for you, but it’s worth remembering these guidelines from Clue do not replace the advice of a doctor – this information is based on the contraceptive recommendations of the World Health Organisation and the Centres for Disease Control and Prevention.

 

How long can you safely take the contraceptive pill for?

How long can you safely take the contraceptive pill for?

Is there such a thing as being on the pill for too long? Can it really impact your fertility or your general health? Here’s everything you need to know…

For lots of women, the pill is the easiest method of contraception. It doesn’t require unwrapping a condom every time you have sex, it doesn’t need a doctor to insert it, and you can very easily stop taking it at any time.

But along with many other myths surrounding the pill is one floating around about how long you can ‘safely’ take it for. Should you stop after five years? Ten? Twenty? Will it really impact your fertility or your general health?

To get to the bottom of these v important questions, we spoke to Sarah Hardman, researcher and Deputy Director of the Faculty of Sexual and Reproductive Healthcare’sClinical Effectiveness Unit. And here’s the long and the short of it: there’s no such thing as being on the pill for ‘too long’. It’s a safe form of long-term contraception, and you can now breathe a big sigh of relief.

When asked where she thinks the myth came from, Hardman put it down to natural changes in the menstrual cycle over time that are masked by the pill. “People go onto the pill when they’re young and they’re often on it for years and years. Meanwhile, in the background their fertility is changing, so when they come back off the pill they’re having irregular periods.”

But as we all know; a ‘period’ on the pill isn’t a real period at all. It’s a withdrawal bleed.

“It does give people a real fright when they come off it and things are not happening in a nice, regular, once a month way,” says Hardman. “But there’s absolutely no evidence that it’s the pill that’s causing that.”

Being on the pill is a balance of benefit over risk, and while the combined pill does come with some risk thanks to the oestrogen it contains – which can slightly increase a person’s chances of getting a blood clot or developing breast cancer – for most people that risk is so minimal that it doesn’t outweigh the contraceptive benefit.

That’s exactly why Hardman reminds us that doctors wouldn’t want “people to go on the pill and just stay on it indefinitely without being regularly checked up from a medical point of view,” because other factors or medical diagnoses can increase that risk.

The other cultural shift that affects people’s perception of the pill and whether it can be detrimental long-term is that lots of women are leaving it until later to start a family. Nowadays, many of us want to establish a career and a lifestyle before having children, meaning it can often be left later.

“Fertility reduces with age and from your mid-thirties your fertility really does reduce significantly,” points out the doctor. “So there will be women who have been on the pill (or any other kind of contraception) for a long time who leave it until their mid or late thirties before they come off the pill, and then they struggle to get pregnant. But that’s just because their fertility is lower at that stage than it was when they were 21, not because of the pill,” Hardman adds.

The doctor goes on to point out that “all types of hormonal contraception will change your bleeding pattern so you never really quite know what’s going on with your cycle.” For those who want a long-term contraception option but would still like an insight into what’s going on with their own natural cycle, however, she suggests you might want to try the copper IUD.

“You’ve got good contraception, you don’t have to do anything, and you would have a real period once a month if you were going to have a period once a month, so it’s your own natural cycle that you’re seeing,” she says.

Looks like it’s safe to carry on popping the contraceptive pills for a good while longer, then – unless you’re keen on reacquainting yourself with your IRL period, that is.

http://www.cosmopolitan.com/uk/body/health/a10316912/contraceptive-pill-how-safe-to-take/

Very Young Adolescents’ Sexual and Reproductive Health Needs Must Be Addressed

Very Young Adolescents’ Sexual and Reproductive Health Needs Must Be Addressed

2017-05-29

More Research Focusing on 10–14-Year-Olds in Developing Countries is Needed

As of 2016, an estimated 545 million very young adolescents aged 10–14 live in developing regions. Early adolescence is a time of physical, social, emotional and cognitive changes, including the onset of puberty and, for some, the initiation of sexual activities. It is therefore a critical time to lay the foundation for healthy and fulfilling sexual and reproductive lives.

A new report published by the Guttmacher Institute examines and contributes to the existing evidence on the sexual and reproductive health (SRH) needs of very young adolescents in developing countries. The report includes a new analysis of data on sexual debut, marriage and childbearing before age 15 from national surveys conducted in more than 100 developing countries. Drawing on these data and published literature, the report maps out ways to advance efforts to meet young adolescents’ SRH needs.

Most very young adolescents in developing countries report that they have never had sexual intercourse, though some have begun to engage in other intimate activities, such as kissing, hugging and fondling. Some adolescents in this age-group do have sexual intercourse. In 2016, very young adolescent girls in developing regions had an estimated 777,000 births. While this makes clear that very young adolescents need to be able to access SRH services, including contraception, there is no available evidence on the extent to which such access exists. However, the evidence on the structural, cultural and legal barriers to access faced by older adolescents in developing countries suggests that younger adolescents likely have a very difficult time obtaining SRH care.

“In addition to access to health services, very young adolescents need information about basic sexual and reproductive health issues so they can protect themselves and make informed, healthy decisions,” says Vanessa Woog, a researcher at the Guttmacher Institute and the report’s lead author. “Creating environments in schools and communities that are supportive of young adolescents’ education on sexual and reproductive health topics is critical.”

Primary school may be a particularly valuable setting for providing comprehensive sexuality education (CSE) to very young adolescents: In most developing countries, more than 80% of 10–14-year-olds are in school. Although many developing countries have national policies and curricula in place that support teaching CSE in schools, there is limited evidence on how or whether such curricula are used and what information actually reaches students.

Certain power imbalances and inequitable gender norms put the SRH of very young adolescents at risk. The report found that for many very young adolescents in developing countries, first sexual intercourse happens as a result of coercion or violence instead of choice. In addition, child marriage continues to occur across many cultures and religions worldwide and affects a significant proportion of very young adolescent girls. The United Nations Population Fund estimates that between 2011 and 2020, 50 million girls in developing countries are at risk of being married by age 15.

“Preventing sexual violence is critical to protecting very young adolescents’ sexual and reproductive health and their long-term well-being,” says Anna Kågesten, independent consultant and coauthor of the report. “The prevalence of sexual violence in young adolescents’ lives points to the urgent need to scale up programs that address the root causes of gender-based violence, including those that promote equitable gender norms.”

The researchers urge program planners and policymakers in developing regions to prioritize evidence-based interventions that have been shown to meet the SRH needs of very young adolescents. Suggested areas of focus include increasing the availability of youth-friendly SRH services among adolescents, keeping very young adolescents—particularly girls—in school, implementing national CSE policies and curricula, and addressing the structural and social causes of gender-based violence and child marriage. The authors also highlight the pressing need for more data specifically on 10–14-year-olds’ sexual and reproductive health. More data are also needed on the experiences and needs of young adolescent males, and those of the most vulnerable groups of very young adolescents—to inform programs and policies aiming to effectively meet the SRH needs of every very young adolescent.

This report has been made possible by UK Aid from the UK Government and a grant from The Children’s Investment Fund Foundation. The views expressed are those of the authors and do not necessarily reflect the positions and policies of the UK Government or The Children’s Investment Fund Foundation.