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. 

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;

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

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

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.