Long-Term Contraception Lagging as Sexually Active Singles Barred Access

Jakarta Globe, Dessy Sagita | September 28, 2010

Tania Widyaningsih is only 28 years old, but she already has three children and is expecting her fourth in about two months.

While condoms are available and are preferred for
 preventing sexually transmitted diseases, many
can’t access other birth control. (EPA Photo)   

She says she is aware of the contraception options available to her, including the permanent ones, but prefers the more traditional techniques of withdrawal, counting the days in her menstrual cycle, or using a condom.

She adds she once got an intrauterine contraceptive device (IUD), but stopped using it shortly after because she feared it would disrupt her menstrual cycle.

“I know a lot about contraception, but I miscarried twice before I had my first child, so having a lot of children is actually bliss for me,” Tania tells the Jakarta Globe.

Tania, who married at 20, says she frequently worries that she may not be able to provide her children with the proper care and attention, especially because she is a working mother.

“I’m not too worried for now because my children are still young, and our parents help us a lot, but I’m a little worried about their future,” she says.

Tania is not the only one, by far. Many Indonesians with a relatively high level of education don’t plan their families carefully, even though they know about contraception.

More than 90 percent of Indonesians say they fully understand the importance and benefits of contraception, yet only 64 percent use it, according to the National Family Planning Coordinating Board (BKKBN).

“That means almost 30 percent of those with knowledge about contraception don’t practice what they know, for various reasons,” says Sugiri Syarief, the BKKBN head.

Biran Affandi, country representative for the Asia-Pacific Council on Contraception (APCOC), says contraception is crucial not just for preventing unwanted pregnancies, but also protecting women from a gamut of menstruation-related ailments and dicomforts.

“Contraception, such as the pill, can shorten long periods and ease menstrual cramps,” he said at a press conference to mark World Contraception Day, which fell on Sept. 26.

“It can also reduce the risk of ovarian cancer and pelvic inflammation.”

Contraceptive pills contain hormones that prevent ovulation, thicken the cervical mucus — thus making it difficult for sperm to get through — and thin the lining of the womb, making it less receptive to eggs.

These pills are highly effective in preventing pregnancy, but must be taken daily at around the same time each day and are known for side effects that include weight gain and pimples — although this varies from person to person.

Biran, a professor of obstetrics and gynecology at the University of Indonesia, says the number of people using contraception is not as high as it should be because many sexually active couples are not married.

By law, contraception may only be prescribed for married couples, says Setya Edi, the director of service and guarantee for the BKKBN’s contraception unit.

“For teens, we only provide information through peer trainers to prevent them from engaging in premarital sex,” he says.

Despite this, an estimated 63 percent of Indonesia’s 65 million teenagers are sexually active, according to a 2008 BKKBN study, with 21 percent of the girls having experienced an abortion.

The study also showed that 24 percent of teens who were sexually active understood about contraception but did not have access to it.

Biran says he has treated many pregnant teenagers who ran into medical complications because their bodies could not take the strain of being pregnant.

“It’d be ideal if we could stop them having sex, but if they’re doing it anyway, at least they should be safe,” he says.

Setya agrees that birth control and family planning programs could be the best solution for the country’s social and welfare problems.

“If the government was committed to implementing family planning programs, at least five of eight targets under the [UN-mandated] Millennium Development Goals would be achieved,” he says.

Firman Lubis, the chairman of Indonesia Health Coalition (KUIS), says the indicator of a nation’s health is determined by its maternal and infant mortality rates.

“Bringing down either parameter is highly dependent on the success of family planning programs,” he says.

“Contraception shouldn’t be a burden, it should be a necessity.”