'Don't tell my husband I am on contraceptives'

When I read the findings from the recently released Kenya Demographic Health Survey, it took me back to the time I spent at a family planning clinic during my student days in medical school.

The findings showed that the country's population growth rate has declined from the 3.4 per cent recorded in 2014 to 2.2 per cent in 2022. The fertility rate, on the other hand, stands at 3.4 children, a drop from 3.9, in 2014 with the desired fertility rate being estimated at 2 children per woman.

Thinking back to my days at the family planning clinic, I remembered noting a phenomenon that I thought was very strange at the time - most women would walk in without their husbands or partners. Often, the patient would pause if the pill was prescribed.

In the initial days, I assumed that women would hesitate as they feared that they would one day forget to take the contraceptive pills. While that might have a been factor, I realised that the real reason was far more sinister as one patient once put it, "Mzee asijuwe (I don't want my husband to know)."

Later, a nurse explained it to me - most women who frequented the clinic, preferred discreet family planning methods to avoid having conversations with their husbands on family planning.

It didn't matter if the recommendation, based on the patient's medical history was an alternative form of contraceptive, most women would still insist on injectables. In fact, some women would even reject implants, even though they were discretely placed, "beneath the skin" on the inner arm. They wouldn't want to risk it. I was baffled.

To make matters worse, some of these women feared that there would be "consequences", even hinting at physical violence. The repercussions included being mislabelled as an "adulteress" as, in a misogynist's world, why else would a married woman want to be on a contraceptive?

Why would she, after having three or even six children, want to stop, yet the goal was to bring forth a football team? Why interfere with her purpose in life of procreating and filling the earth? Apparently, the family's resources, when it came to being able to provide or feed the children, weren't a factor.

Not forgetting the majestic African male species who threatened his wife that he would take a second wife if she dared to go on a contraceptive, even though she had five children -- two of whom had nearly cost her life and having had one stillbirth.

Forgive me, I got carried away. But outrageous as some of these consequences were, as I read the findings of the Kenya Demographic Health Survey, I couldn't help but wonder, "How many women had to hide that they were on a contraceptive?"

In fact, I thought of how all that was needed was education. An educated woman's interests and perception of self would naturally lead to the conclusion that two children are OK; a contraceptive is a personal choice, and whoever has a problem with that - it's their problem, not yours.