Category Archives: Reproductive Health

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.

The Sexual and Reproductive Health Needs of Very Young Adolescents Aged 10–14 in Developing Countries: What Does the Evidence Show?

The Sexual and Reproductive Health Needs of Very Young Adolescents Aged 10–14 in Developing Countries: What Does the Evidence Show?

KEY POINTS

  • This report draws on analyses of national survey data and literature review results to provide an overview of the evidence on key aspects of sexual and reproductive health among very young adolescents aged 10–14 living in developing regions.
  • Early adolescence is a period of rapid physical, social, emotional and cognitive changes. As such, it is a critical time to lay the foundation for positive sexual and reproductive health outcomes.
  • Many developing countries have national policies and curricula that support comprehensive sex education (CSE) in primary schools; however, available data tell us little about the extent to which 10–14-year-olds are actually receiving CSE, or about the quality of such education.
  • While most very young adolescents report that they have never experienced sexual intercourse, some have begun to explore intimate relationships and to engage in noncoital sexual activities, such as kissing, hugging, fondling, and oral and anal sex.
  • For many, first sexual intercourse happens as a result of coercion or violence. Between 3% and 23% of adolescent females aged 13–17 report experience of sexual violence in the past year; it is 0–13% among adolescent males.
  • The proportion of adolescent females married before age 15 varies by country—from less than 1% to 24%—as well as by region, residence and wealth.
  • Very young adolescent females had an estimated 777,000 births in 2016; 58% of these births took place in Africa, 28% in Asia and 14% in Latin America and the Caribbean. Slightly more than one-third of births to mothers younger than 15 in developing countries were unplanned.
  • Delivering CSE, continuing to reduce levels of child marriage and sexual violence, emphasizing equitable gender norms, and providing financial incentives in education are some examples of strategies to support sexual and reproductive health among this age-group.

https://www.guttmacher.org/report/srh-needs-very-young-adolescents-in-developing-countries

Sending the wrong message on sex and reproductive health

Sending the wrong message on sex and reproductive health

2017-05-09

By FIONA MACGREGOR | FRONTIER

DON’T DO that! No, I mean it. Really. A video called “Don’t do that”, which has been circulating recently on Myanmar social media attempts to shame and frighten young women with misinformation about unplanned pregnancies and abortions, is extremely damaging.

The short film, sponsored by a popular domestic soft drinks company and produced by Myanmar Media 7 news, follows the story of a young woman. It shows her dancing at a nightclub and then having dates with various men before she becomes pregnant.

If it is meant to be educational, it fails miserably.

The cause of her unplanned pregnancy is merely hinted at. Did it happen when she was seductively sipping juice in the swimming pool? Was it the moment she travelled through Yangon at night with her head protruding from a car’s sunroof? Or was it – as is strongly implied – simply the consequence of being a young woman failing to follow restrictive societal conventions.

But if the “slut-shaming” message of the video is abhorrent in itself (the men in it are not subject to the same judgements), its depiction of the abortion becomes a horror show. Confusing the differences between a medical termination (by taking a pill) and one involving surgery, it ends with the young woman in agony – physical and mental – after being forced to look at the aborted foetus.

Tragically, the reality for women in countries such as Myanmar where abortion is illegal is that those who terminate a pregnancy too often suffer unnecessary, and sometimes fatal, physical and mental trauma that could have been avoided had proper medical services been available to them.

If the moral debate around abortion remains divisive in many parts of the world, the right of women to receive accurate, impartial information and access to family planning and reproductive health services is something that should always be protected.

Yet, early this month the United States government announced that it was halting funding for the United Nations Population Fund (UNFPA), which has been instrumental in providing family planning and maternal health services to women throughout the world and preventing maternal mortality. In other words, UNFPA’s work directly focuses on saving the lives of women and babies.

The cut came after President Donald Trump earlier this year reinstated a ban on US funding for any international organisation that provided any kind of abortion service or advice.

The US is not the only country failing to support women’s reproductive health services at previous levels. Last year Denmark also announced a significant reduction in funding to UNFPA. As donors throughout the world increasingly focus attention on the global refugee crisis, it is feared vital women’s services will lose out – an irony being that displaced women are in particular need of such support.

Myanmar’s 2014 census found that 282 women die for every 100,000 births, or about eight deaths every day. That is double the regional average and more than ten times the mortality ratio of 20 deaths for every 100,000 births in neighbouring Thailand. The need for better family planning and reproductive health services is more than evident.

If anything positive emerged from the “Don’t do that” video, it was the number of Facebook responses from women who objected to its sexism and erroneous information.

“Instead of this story, why don’t you do a story about birth control choices for women and men. Also educate about STDs [sexually transmitted diseases]. This is not convincing me about staying against abortion at all,” wrote one woman.

Another responded, “So much misinformation here! Not all club-going, rich, social girls end up getting knocked-up. (In fact, it’s the poor, uneducated girls who mostly suffer from unwanted pregnancies.) ALSO, taking abortion pills is different from yanking a foetus out. ALSO, since it’s supposed to be ‘educational’, do inform the public about many options such as use of contraceptives, taking morning-after pills, etc, to prevent unwanted pregnancy.”

It is extremely encouraging to see young women standing up for themselves and others and, even though the issue is controversial and potentially emotive, defending their right to receive accurate information free from gender-based discrimination and prejudice.

Yet even among these strong and enlightened young women there were clear gaps in their knowledge of reproductive health options.

One respondent, who made it clear she was aware of emergency contraception and how it works, nevertheless “doubt[ed] you can also abort a baby simply with a pill”.

Another highlighted the discrimination and challenges young women face when it comes to discussing sexuality, and said she believed the reputation of the actress in the video had been ruined by playing the role.

“I am a virgin but I know everyone is using a condom for one night stands. Also, the way you presented [the video] completely destroyed the girl’s career,” she wrote.

The tendency to oppress women’s self expression and freedoms rather than deal with deeper societal problems, permeates much of society in Myanmar.

It was evident when Yangon Region Chief Minister U Phyo Min Thein announced a crackdown on alcohol consumption near Thingyan pandals this year.

“We are ending the situation whereby parents are horrified to see their daughters on the pandals,” he said.

His comments may well reflect traditional cultural values that prioritise the sensibilities of parents over those of their children, but they also exhibit an inherent sexism.

By ignoring the common reports of groping and sexual assaults by male revelers during the festival, and focusing instead on the behaviour of young women whose only “offence” is to be seen enjoying themselves in public, it promotes the idea that “saving face” is more important than defending women’s rights.

This is the kind of attitude that leads to women keeping domestic abuse secret, to sexual assaults going unreported, and to the practice in some communities of women who have been raped being forced to marry their rapist to “protect their family’s honour”.

In previous years, Yangon authorities have demanded that shops clear their shelves of condoms during Thingyan in an ill-advised attempt to control “morality” by depriving people of contraceptives.

The responses to the “Don’t do that” video show that young women want access to the information and services that will allow them to protect themselves and make their own decisions about contraception and how they live their lives.

Politics, religion and policing in this country, as in much of the world, are overwhelmingly dominated by older men, most of whom appear to show little inclination to take the concerns and demands of young women seriously.

All the more important then that funding continues for organisations, international and national, that can provide women with accurate and impartial family planning information and reproductive health services.

Those who support women’s rights everywhere must work to ensure the needs and demands of young women are met and to end the situation in which decisions about women’s health are made by roomfuls of men, whether in Washington or Nay Pyi Taw.