Democratic Republic of Congo

Young Women Risk Stigma Against Contraception to Avoid Social Costs of Unintended Pregnancy

A government program in the Democratic Republic of Congo aims to increase contraceptive coverage to 19 percent, but accurate data on current contraceptive coverage is hard to obtain since women often use birth control in secret. An unintended pregnancy can lead to being ostracized, dropping out of school or even abandoning the newborn, and many young women have decided that it’s worth the risk of stigma to use contraception instead.

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Young Women Risk Stigma Against Contraception to Avoid Social Costs of Unintended Pregnancy

Merveille Kavira Luneghe, GPJ DRC

Medical products, including some related to contraceptives, sit on a table in the family planning room at Kirumba Health Center in Kirumba, Democratic Republic of Congo. Women say it’s difficult to get the contraceptives they need due to social stigma.

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KIRUMBA, DEMOCRATIC REPUBLIC OF CONGO — After Kanyere got pregnant at 17 years old, she vowed that it wouldn’t happen again.

Now 25 and a single mother to her 8-year-old child, she has discovered how difficult it is to keep that vow. It’s not considered acceptable for unmarried women to use contraceptives in this rural area.

“To have access to contraception, I was obliged to secretly seek contraceptive services from a nurse I knew so that no one could see me, because any attempt by a young girl to use things of that kind before marriage was something that brought shame on the whole family,” Kanyere says.

Kanyere asked that only her surname be published because of the stigma associated with using birth control.

But worse than that stigma would be another pregnancy. She’s hopeful that she’ll get married one day. Until then, she’ll secretly seek contraception.

“I cannot bear to bring my reputation into disrepute,” she says.

Women convicted of voluntarily terminating their pregnancy can be sentenced to up to 10 years in prison. Anyone who helps a woman have an abortion could serve a prison term of up to 15 years.

The secrecy surrounding contraceptive use among unmarried women in DRC means that there’s little data available, but locals say the practice is common – and that it has tempered infant and maternal mortality rates and reduced the number of abortions. Abortion is illegal in DRC except in cases when the mother’s life is in danger.

Contraceptives are saving lives, but unintended pregnancy rates remain high, says Jean Baptiste Nzanzu, a nurse serving as the head of the family planning unit at the reference health center of CBCA in Kirumba. Nearly half – 48.2 percent – of all pregnancies in the country in 2013 were unplanned and more than half – 56.5 percent – were unplanned in 2014, according to data collected by the Performance, Monitoring and Accountability Survey.

A 2014 family planning strategy by the DRC government, in a program run in part by Tulane University and funded by a grant from the Bill and Melinda Gates Foundation, aims to increase contraceptive coverage to at least 19 percent by 2020.

Data on abortion in DRC is spotty. Women convicted of voluntarily terminating their pregnancy can be sentenced to up to 10 years in prison. Anyone who helps a woman have an abortion could serve a prison term of up to 15 years.

In the Kirumba area, stories about newborn babies found in gutters and trash bins capture public attention.

Young women in particular are willing to use contraceptives secretly to avoid social stigma.

“I don’t want to become a single mom and a neglected member of the society as a result. In addition, pregnancy would cause me to drop out of school,” says Charmante Kasiwa Mwindiki, a 19-year-old student.

Kanyere Syaghuswa, 21, says she prays that her parents understand why she needs to use contraceptives. She’s seen young women her age become pregnant, then undergo abortions in deplorable conditions.

“The problem here is that our parents and those around us have trouble understanding how a young girl can use contraception. And yet, when she becomes pregnant, she becomes the laughingstock of the whole village,” she says.

Ndayaho Sylvestre, GPJ, translated the article from French.