Factors Influencing Young Malians' Reluctance to Use Hormonal Contraceptives

Abstract

During a qualitative evaluation of three peer-education programs in urban Mali, young people stated that they were wary of using either the pill or injectable contraceptives because they believed that these methods would make them sterile. Unmarried women's contraceptive decisionmaking was not primarily driven by a current need to limit fertility, but rather by a future need to maximize it in order to gain status through childbearing in their marital households. Further interviews explored notions of conception, menstruation, and the perceived action of hormonal methods on the reproductive system. Findings revealed that menstrual disruption (in the form of amenorrhea or prolonged bleeding) appeared to have dire repercussions, including accusations of witchcraft and immoral behavior that could result in a woman's being divorced or in her husband's acquiring an additional wife. The social consequences of side effects were perceived to be more important than their biological manifestations, and together with the fear of sterility, resulted in a preference for the condom.

Method‐Specific Attributes that Influence Choice of Future Contraception Among Married Women in Nairobi's Informal Settlements

“…2013; Williamson et al. 2009; Castle 2003). Such concerns are likely to be more of a deterrent to use and selection of methods among younger women wishing to space or postpone childbearing than among those wanting to limit family size.…”

Condoms Become the Norm in the Sexual Culture of College Students in Durban, South Africa

“…12 Secondly, non-barrier contraception is unpopular because of fears of side effects and unwarranted but common fears that future childbearing might be jeopardised by use of hormonal methods. 19,20 Moreover, condom use can be justified in terms of pregnancy avoidance even in relationships where fear of HIV infection is a major consideration. It needs no research to assert that negotiation of condoms for family planning is much easier than negotiation to avoid disease because it carries no imputation of distrust.…”

Belief in Family Planning Myths at the Individual and Community Levels and Modern Contraceptive Use in Urban Africa

“…8 According to a study in Mali, many women feared that the pill and the injectable could cause permanent infertility. 9 A qualitative study in Kenya among sexually active women aged 15–25 demonstrated that many women had misconceptions about the side effects of modern contraceptives (e.g., that they cause infertility or can harm a woman's uterus), but few had experienced or knew someone who had experienced an actual side effect (e.g., weight gain). 10 In another qualitative study in Kenya among reproductive-age women, one respondent reported that the pill “can accumulate into a life-threatening mass in the stomach, can cause blood to flow out of the nose and mouth, and can cause delivery of children with two heads and no skin.” 11 Myths and misconceptions about methods can spread through informal communication via social networks and lead to continued negative perceptions.…”