Uganda: ‘Withdrawal’ is Tested and Proven Method

The Observer (Kampala)

Vernon Tugumizemu

15 June 2011

Uganda last week launched a debate on population issues.

Apart from matters concerning the quality of the population, I am hoping issues of contraception and family planning, successes and failures, will also be discussed.

After all, Uganda is now rated to be the country with one of the fastest, if not the fastest, growing populations in the world. Why is this so? What happened to the family planning programmes?

One of the obvious reasons is the complacency mode that the programme went into. Mixed signals from government about the issue have not helped matters. But the other factor that I suspect is the availability of contraceptives and family planning services to the majority of women.

Be that as it may, I am left wondering why Uganda’s couples have to sit back and get unwanted children while waiting for family planning services to come to the nearest trading centre. This is happening when they have a centuries-old, God-given and natural contraceptive measure. It may be taboo to talk about, but it’s also the healthiest of all the methods.

I am talking about the ‘Withdrawal’ or the ‘Push-and-pull’ method, as my old grandmother would call it. She says this method was used in her younger days as a natural family planning method and she wonders why it’s an ignored practice today.

“My husband would, upon reaching climax, pull out gently and spoof on the floor. This would leave us happy and safe from unwanted pregnancies until the last child would make two years,” she reminisced as we sat around the fireplace some time back.

Formal family planning was introduced in Uganda in 1957 with the aim of controlling the number of children families could have. People have since come to know and adopt the modern contraceptive methods. But some women face side-effect problems.

“I feel something like ulcers in my uterus. I have had swollen legs of late as well,” said one Sharon Atukunda, 23, who has been married for five years.

However, not even the government or our development partners have ever thought of the withdrawal method as an alternative to the orthodox contraceptives.

In a paper recently presented by Prof Augustus Nuwagaba on family planning in Uganda, the economist while linking population to household wealth, told his audience that with an unplanned population, Uganda is headed for trying times.

“A high population growth coupled with unemployment has caused all these political explosions. All this should be a wake-up call for the prioritization of health related issues,” he said.

Nuwagaba contends that practising family planning leads to the elimination of costs associated with unintended pregnancies and maternal and child health. According to him, Uganda would spend close to $268 million on unintended pregnancies, whereas on the other hand, if 50% of unmet needs for family planning were met, the cost of managing unintended pregnancies would drop to $105 million.

And if 100% was met, Uganda would only spend $32 million on unintended pregnancies. Some young women fear unwanted pregnancies even more than HIV. Besides, once genuine family planning methods are practised, even HIV prevalence is controlled as well, says Dr Chris Baryomunsi, an expert on family planning.

But Dr Jackson Chekweko, the Executive Director of Reproductive Health Uganda, an NGO promoting safe methods of family planning, said that if properly used, medical contraceptives present minimal side effects. He thus called on health personnel to ensure they prescribe the right pills. Some women handle injections very well while others handle the oral variants better.

Though many modern couples look at the withdrawal method with a lot of doubt, older parents still believe that it’s the most natural practice that ought to be rekindled.

National Planning Authority’s Prof Abel Rwendeire says: “we need a youthful and quality population which can translate into producers, not just consumers.”

But with young women scared by side effects from modern contraceptives, government should also aggressively promote the withdrawal method as an alternative to unplanned child births. Though reports suggest it suffers a high failure rate, our grandparents have proved that with practice, it can be applicable and successful.

The author is a journalist

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