Rwandan women who use barrier (such as condoms) and traditional (such as periodic abstinence or withdrawal) birth control methods are more likely to get pregnant again within a year, in contrast to those utilising longer-term methods like contraceptive implants or injections, a new study published in the RBC journal has found.
Titled "Return to Fertility after Discontinuation of Modern Contraceptive Methods in Rwanda”, the study revealed that, after one year, 94 per cent of women utilising barrier and traditional methods experienced pregnancy. Rates were slightly lower for other methods, with a 92 per cent pregnancy rate for intrauterine devices (birth control that’s inserted into the uterus), 87 per cent for pills, 83 per cent for implants, and 81 per cent for injections.
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The research conducted by Sylvain Hirwa Muzungu, a medical doctor and data scientist, and Valens Rwema, a data scientist and a statistician, from June to September 2023, utilised data from Rwanda Demographic and Health Survey (RDHS) 2020, which involved around 10,000 women.
According to Muzungu, the research sought to provide evidence regarding the time it takes for women in Rwanda to conceive after utilising modern birth control methods. The goal is to contribute valuable insights for policymakers and relevant organisations, aiding in formulating informed policies and practices.
"Our research also aims to help women make informed decisions about family planning methods based on their fertility goals,” he added.
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According to the study, the factors influencing delayed pregnancy after contraceptive use in Rwanda included a woman’s age (older women experienced longer delays), the number of children (more children led to quicker fertility return), and the duration of contraceptive use (long-term use did not significantly impact fertility return).
"Older women tend to have delayed pregnancy after contraceptive use,” said Muzungu. "As the age of a woman increases, their chance of early return of fertility after contraceptive methods decreases. So, you would understand that if someone is 40, for example, and another one is 20, and both have used injectables, the younger woman is going to become pregnant faster than the older woman.”
According to Muzungu, reassuring women about the possibility of getting pregnant after using birth control proves challenging for doctors and women’s health experts given that fertility is influenced by various factors, including a woman’s age, existing medical conditions, and lifestyle choices such as weight, smoking habits, and frequency of sexual activity.
Additionally, different countries have their distinct factors impacting fertility.
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He said the research findings will provide practitioners with essential local data, enabling them to make informed decisions based on factual information.
"As a medical doctor, having local evidence now allows me to advise women more effectively when they seek guidance on family planning and pregnancy after stopping contraceptive methods,” he explained.
Muzungu noted that the research team intends to partner with RBC and the Rwanda Association of Midwives to conduct outreach and disseminate knowledge related to the research.
Henriette Fabiola Ukunduwe, a Rwandan midwife, highlighted the challenge of providing specific information on birth control methods due to the absence of local data on the rapidity with which women in Rwanda could conceive after discontinuing a particular birth control method.
"We would share general information about birth control, but unfortunately, precise percentages for barrier or hormonal methods were not available. What we had were a few words about the success of certain methods in other women we had worked with,” she said.
"Assuring a woman without concrete data can be challenging, as choices made without factual information may lead in unpredictable directions. However, when there are concrete facts, it becomes easier for a mother to make an informed choice.”
Bisanukuri, a mother who opted for the injection birth control method, said that when she initiated its usage, a midwife provided her with information about its significance and assured her that she could conceive again when she decided to discontinue the method.
She emphasised, however, that her choice was influenced more by the trust she placed in the midwife rather than factual knowledge
About the research, she stated, "The findings could empower mothers to make informed choices regarding family planning depending on their needs. For instance, if you have facts about the impact different methods had on other Rwandan mothers, it can help you identify which one best fits your needs.”
Bisanukuri urges researchers to disseminate the findings, emphasising the potential benefits not only for mothers but also for midwives who play a crucial role in guiding individuals through family planning choices.