A SURVEY OF PARENTS ATTITUDE TOWARDS FAMILY PLANNING ( A CASE STUDY OF AGUATA LOCAL GOVERNMENT AREA, ANAMBRA STATE. )
This chapter focuses on the review of related literature aspect of this study. This study is reviewed in the following sub-headings
- The concept of family planning
- The different family planning methods are practices advantages and side effect.
- The different parent attitude towards family planning.
The Concept of Family Planning
Family Planning is a birth control method which aimed at assisting parents to choose when to have child rather than chance. It is also a way of life which parents and individuals think and voluntary decide on how many children they want and when to have them to ensure better living condition for the family. Family Planning was first tried in animals (camel,) by Arabians during their journey. They inserted stones inside the womb of the female to prevent pregnancy since pregnancy will weaken the camels and their journey will be delayed or prevented.
Family Planning started in 1912 by a Nurse (Margret Shangai) at New York City who tried to open the first family planning clinic because of high material death which killed Margaret’s best friend after her 12th pregnancy. In 1230, family planning services spread to Britain. Then its first inception in Nigeria came first in 1952. In 1976, planned parented hood federation of Nigeria (PPFN) came to Anambra State and many other private hospitals were known to be given family planning services.
According to Delano (2004), family planning is a means by which individuals or parents space the process of conception, pregnancy and child birth at internals mutually determined by both husband and wife in order to have the desired number of children they can conveniently maintain.
Indeed, family planning, is a process that is applied naturally or artificially to regulate the birth of children.
Population and family planning (2001) opined that family planning is a way be which individuals, couples and families exercise their base rights in the family formation process to improve their standard of living, health and life expectancy by deciding freely and responsively on:
- Spacing pregnancies and child birth appropriately
- Determining family size in relation to available family resources.
Newman (2007) sand that it is regulation of human reproduction capacity which involves the prevention of unwanted pregnancy by contraception techniques, either by abortion or by reducing the rate of exposure to pregnancy in order to protect the well being of the mother, child and the (2002) held the view that family planning is the use of variety of methods to permit parents to have intercourse while avoiding conception.
But generally speaking, all the above definition can be summarized thus: as the use of various methods e.g. pills, condom loops etc to parent conception so as not to allow any unwanted pregnancy. It is very important for health, survival and development of the family.
Family planning ensures that parents bear the number of children they can take very good care of. To support this view, Akimgba (2008) said, it is unreasonable to bring more children into the world than parents can afford to maintain well parents should produce only the number of children that their circumstance in life permit them to find clothe, educate and generally look after them properly in sickness and health.
Ugwuanyi (2006) said that the earth’s population may soon out run the earths resources. He was of the view that while population was growing at a geometric rate, resources were progressing arithmetically. The glaring effect of this phenomenon to him is famine, unemployment and mass death.
As a measure to check the every growing population, Malthus urged people to practice sex restraint since there can be no procreation without sex. Myles (2005) opined that it would seen to be a fundamental human right that parents should control their fertility and limit the size and spacing of their family, for involuntary parenthood creates many problems, social and financial as well as physical and emotional. In Nigeria, the Planned Parenthood Federation which is an affiliate of the International Planned Parenthood came up with define aims and objective for the organization.
The Objective are:
- To encourage the building up of health and happy families.
- To protect the health of mothers and children and reduce child mortality by spacing babies etc. Furthermore, since the inception of this organization, they have made profound effort to see that family planning is adopted throughout the federation.
Okpala (2008) defined family planning the interval at which conception pregnancy and childbirth come. It is advisable that the interval between one child and the other should be two or three years. Family planning is also a means of assisting parents who have difficulty in having children.
Family planning helps in sex selection using the ovulation method. Ideally family planning is indispensable to married couple. To understand of a woman’s menstrual cycle will help her choose any family planning method that will be suitable for her child spacing. Family planning is not sinful; it rather helps the Christian parents to be more useful to God.
Ugboaja (2008) views family planning as a way by which individual couples and families exercise their basic right in family from as in family living standard, health and life expectancy by deciding freely and responsively on when to start child bearing, how many to have, how to space them and then to stop it means also how help those who are infertile to have children.
In natural health (2000) Muanya defined family planning as using birth control method or total abstinence to have babies only when it is convenient and suitable for the parents. Incidence of babies being dumped on refuse heap’ gutter and some other hidden places is definitely product of unwanted pregnancies.
Derek (2002) said that family planning is available to help individuals and parents to choose if and when they will have a child or to choose the number of children that they will have. The choice depend on a complicated mixture of social, cultural and psychological influence, and today for the first time in history, men and women have reliable methods to enable them to make that choice freely and relatively easily.
THE DIFFERENT FAMILY PLANNING METHODS AND PRACTICES, ADVANTAGES AND DISADVANTAGES.
There are two major groups, namely,
- The traditional (Natural) Method
- The modern (Artificial) Method
- The Tradition (Natural) method: Delano (2008) viewed this as methods, practices, beliefs or customs handed down from one generation to another, which existed before the advent of modern contractive.
Okafor (2008) said that it is a method that helps the client to know the anatomy and physiology of her reproductive system. This enables her to know she is expected to ovulate, so that she will abstain from sex in order to avoid pregnancy. This will help the woman to know her fertile period and make use of it.
The traditional (Natural) method comprises these
– Abstinence
– Lactational Amenorrhea method (LAM)
– Rhythm (calendar) method
– Billings (cervical) method
– Withdrawal method (coitus interruptions)
– Abstinence Delano (2008) asserted that this is the most and the most effective method provided
– Lactational Amenorrhea method (LAM): According to Delano (2008), it is abstinence by prolonged lactation in which case; there is un-interrupted and prolonged breast feeding. It is believed that intercourse during breast feeding could result contamination of breast by sperm which could cause the death of the infant.
Okpala (2008) social that lactational Amenorrhea method (Lam) gives that mother ninety eight parent (98%) protection if she gives, ten-twelve breast feeds in twenty four house, breast feed, exclusively and has not bled after eight weeks since she delivered.
Rhythm (Calendar) method: “Freeman (2000) wrote that this is a method of family planning. In woman with the normal cycle ovulation will occur approximately fourteen day before the anticipated menstrual period. The ovum can duly survive for two days unless it is fertilized. OJikutu (2008) said it simply deals with the circulation of days in the menstrual cycle. The parents will look forward only to the safe period of the woman. This contains a number of days during which the woman cannot get t pregnant its reliability is less 100%.
According to Okafor (2007) this method requires a daily or calendar and biro or pencil. To be able use this method, it is very important to have kept a menstrual diary fort a period of six twelve months in order to:
(a)Have an idea of the menstrual
(b)Be able to guess the information to abstain from sexual intercourse during the fertile period if you do not went a baby or to have sexual intercourse at the peak of the ovulation in order to have a male baby. The safe period is thus during the first seven days and last ten days of the menstrual cycle. Derek (2002) said that this method was enthusiastically adopted by Roman Catholic who could organized that they were not preventing conception but were regulating births in a natural way.
Billing method: MC Sweeney (2005) in his opinion said that billing method is an entirely new method of natural family planning. It is not the safe period and does not involve the use of artificial methods. Billings method teaches a woman to recognize in her body one sign which tells her cleanly and without doubt that her ovulation is coming soon. This is the mucus sign. If is only used in the method. Once a woman is able to identify the time of ovulation and understand its significance, she knows how to control her fertility. Withdrawal method (coitus interruptus): Ojikutu (2008) said that historically it is regarded as the oldest. It is the act of removing the male sexual organ from that of the woman at the peak of ecstasy instead of discharging into the woman sexual organ, the made withdraw and discharges outside.
Derek (2002) in his opinion said that for many years, withdrawal of the penis from the vagina just before ejaculation has been used to avoid pregnancy. It relies, found to be the most usual method adopted. It relies, of course, on the ability of the man to recognize the sensation which occurs in his genitals just before ejaculation, and for him rapidly to withdraw his penis from the vagina and ejaculate outside. The risk of pregnancy is high and the pregnancy in sex is twenty five per hundred women.
- The Modern (artificial) method: Okafor (2008) emphasize that it is a means of using artificial means to stop normal functioning of the body Example
– Intrauterine contraception (IUD)
– Condom
– Oral contraceptives
– Injectable contraceptives
– The occlusive Rubber cap/diaphragm
Tubal Liquation
– Vasectomy and the sterilization
Intrauterine contraceptive (IUD): glasebikan (2009) viewed IUD as being chosen increasingly by woman who wish to avoid pregnancy. In the 1920s a Garman gynecologist used a silver or gold deviance which he introduces into the womb. Inside the uterus the copper slowly ionizes and this affects the egg. Before the IUD is inserted, the health worker will examine the women venially so that the size position of the uterus can be determined. Once this has been done, the IUD is put into the womb painlessly and easily. The best to put an IUD into the uterus is in the last days of menstruation, at a postnatal visit or just after an abortion. About two women in every hundred become pregnant while wearing an IUD. The IUD is a small plastic or plastic into the womb or plastic and copper objective into womb. It prevents the woman’s egg and the man’s sperm from joining. It is very effective, it does not interfere with sexual is expensive. It may be painful when the IUD is inserted or removed.
Side Effect:
- Some woman experience heavy menstrual periods
- It is easier to get inflammatory disease
- Myles (2005) said in his opinion that applicable plastic 100p is introduction into the uterine cavity. Fertilization actually occurs but embedding to inhibit. The effective IUD are lipped 100p, the T coil and the graveyard copper – 7 device cases have seen where pregnancy has occurred while the device was in use. The user should regularly check to ensure that the device is still in the uterus and this is indicated by a stand of nylon thread hanging from the cervix. The most common in Nigeria is the copper T.380
Osuala (2002) suggested that the IUD may be used by older ladies who have 907 children and in who through examination has been affected to exclude pelvic inflammatory disease and fibroid, of the womb. The international planned parenthood (1996) pointed out that the use of IUD cause excessive bleeding following the insertion, pain, low backache, male discomfort and vaginal discharge.
Singleton (2005) described IUD as a method of family planning for many years IUD come in variety of shapes and sizes and are inserted into the womb by a doctor using a special inserter to position the devices correctly. Once the IUD is in positions, the woman should be taught to check the tail (strings) of the device to ensure it has not been expelled or has not been drawn upwards due to enlargement of the uterus of pregnancy has occurred
Advantages
- There is an immediate return to fertility after removal
- The rate of ectopic pregnancy is reduced
- The device offers effective contraception for at least five years.
- Some woman experience weight gain, acne and headache.
- The experience of heavies and more painful periods
Federal ministry of health and human service (2009) describe IUD as a long term method. TCU – 380A IUD lasts at least. It is very effective, reversible and no effect on breast feeding.
Hatcher (2007) said that IUD is a small, flexible plastic frame. It is in served into a woman’s uterus through her vagina almost all brands of IUDs have one or two strings, tried to them. The strings hang through the opening of the cervix into the vagina. The user checks that the IUD is still in place by touching the strings. A provider can remove the 100 by pulling gently on the strings with forceps
Types
The Ten-380A (widely available and lasts at least 10 years and the MLCU = 375 (which cast for five years).
Advantages
- Very Effective
- Increased sexual enjoyment no need to worry about pregnancy
- Immediately reversible.
Side Effects
- Menstrual periods may be heavier and longer
- Pelvic inflammatory ectopic pregnancy.
- Does not protect against ectopic pregnancy
Condom: According to Hatcher (2008), condom is a sheath or covering, made to fit over a man’s erect penis. The condom is known by many different brand names. Most of them are made of thin latex rubber while some are coated with dry lubricant.
Different sizes, shapes, colours are texture may be available. It can prevent both pregnancy and sexually transmitted diseases organism in the vagina from entering the penis condom users have less then half the risk of HIV infection.
Advantages
_ It prevent STD, including Aids as well as pregnancy when used correctly with every act of sexual intercourse.
- Easy to keep on should in case sex occurs unexpectedly
- Usually easy to obtain and sold in many places.
Side Effects
- Latex condoms many cause itching for a few people who are allergic to latex
- It makes sex less enjoyable
- There is possibility that condom will break during sex.
Singleton (2005) described condom as methods of contraception which make use of appliance which prevent direct insemination of ejaculated sermon into the creviced canal. For maximum efficacy, a condom must be used for every act of intercourse.
Byrd (2008) viewed it as heath worn by the man; specimidal jelly is smeared on the outside of the condom for maximum safety a new condom should be used on each occasion, though not absolutely reliable Essien (2008) defined it as a contraceptive or prophylactic sheath worm on the penis during sexual intercourse condom is a safe and effective methods of birth control and protects against broad range of sexually transmitted diseases (STD) such as syphilis.
Oral Contraceptive Pill Hatcher (2007) said that women who use oral contraceptive pill swallow a pill everyday to prevent pregnancy. It is best for breast feeding women. They do not seek to reduce milk production mistakes in pill taking lead to pregnancy. It should be taken everyday without breaks. It is very effective when used correctly.
Advantages
- Can be used by nursing mother.
- No estrogen size effect
- No risk of weight gain and acne
- Can help to prevent positive
Side effects
- Changes in menstrual bleeding and irregular period
- Headaches and breast tenderness
- Do not prevent ectopic pregnancy
- Not highly effective taken unless
Sigleton (2005) views pills as combined oral contraceptive that have or three different tables. His designed to closely mimic the normal endogenous cyclical hormonal activity interference with absorption activity or metabolism of the constituent A the combined pill may occur with certain drug so reducing their effectiveness.
Byrd (2008) opined that pills is one of the most reliable contraceptives, its failure rate is less than 2 percent and it is easy and convenient to use, because if affects the endocrine glands. Women who use it often from some changes in their bodies. There may be increase in their weight because of the increase in their appetite. The breast size may increase while the menstrual flow and cramping may decrease.
Federal Ministry of Health and social sources (1999) viewed pill as special tablet which women will swallow every day to prevent Nancy. There are different kinds of pills 28 very pill and riding pill too the pills stop the woman from want another body she will discontinue the use of pills
Advantages
- It is very effective (97%-99%)
- It reduce menstrual penis
- No heavy menstrual flow
Side Effects.
– It can causes nausea
– The women using it can either gain or loss weight
– Headache and fainting can also occur
_When women stop taking pill it can take longer time before they become pregnant.
Olasebikon (2009) said, it is advisable that young girls and unmarried women should be on pills which they can take everyday. Under the method, menstruation will continue. Those on pills do report irregular bleeding or occasionally sporting of blood to their doctor
According to Guardian (2000) pill was found convenient and easy to use taking the contraceptive pill can play havoc with a woman’s ability to pick the perfect partner because it suppressed her sensitivity to the chemical in women, sweat according to now research.
According to planned parenthood Federation of Nigeria Report (1999) Nigeria women prefer using contraceptive pill as the most favorable method of birth control of the one hundred and thirty thousand Nigeria that visited the family planning center, nation wide, fifty eight thousand three hundred and eighteen representing 44.85% choose pills, followed by twenty thousand –five hundred], six hundred and fifty six representing 19.73% who choose intra-uterine.
Derek (2002) said, pills was first used in 1955, the number of women taking the pill at any one time has increased to over sixty five millions. Today’s pills contain less estrogen and less gestagen than the original pills and so is a much safer product.
The pill is a method of contraception most favoured by women.
The two hormones may be used singly or together, given by mouth. Population Reports (2000) viewed pills as the contraceptive that prevents pregnancy very well when used correctly. Taking a pill is easy and women who stop taking the pill can get pregnant again.
Injectable contraceptive: Federal Ministry of health and social services Journals (2007) described the injectable as injection given to women to prevent pregnancy. There are two types of injectable, the one given every three months (Depo Provera) and the one given every two month (Noristerat). The injectable contains hormones that prevent the women’s body from releasing an egg every month. It does not affect the man and woman during sex.
Population Report (2007) described injectable contraceptive as a method by which a woman get an injection of Depo Provera(DMPA) every three months. These injections stop the woman’s body from releasing egg. With no eggs, the women cannot become pregnant. They are the most effective temporary family planning methods.
Hatcher, Rinebart, Blackbum, Geller and Shelton (2007) had described injectable contraceptive as a means by which woman who use this method received inject able contraceptive method of contraceptive are the desire to a highly effective method that is independent of intercourse when other method are either constrain or in some cases dislike by the woman
Advantages
Population Reports (2002) stated these advantage targets as:
- Very effective
- Does not interrupt sex
- May help protect against pelvic infections
- May increase amount of breast milk when used by a breastfeeding woman.
Size Effects:
May cause headaches, breast tenderness, moodiness, nausea, less sex drive.
Does not protect against sexually transmitted disease including Hiv/Aids
The occlusive Rubber cap/diaphragm: it is also called Dutch cap and is inserted into the vagina prior to coitus and also remove not less than eight hours after wards. The woman using this does vaginal examination and obtains her ‘cap’ size. She is also shown how to insert and remove it Spermicidal jelly or cream is smeared on it, inside and outside, before insertion for additional protection (Diehi, 2004) vaginal diaphragm cap consist of a thin rubber dome which has a coiled metal spring in the rim. They are made in size and the woman will be examined and given the size most suitable for the vagina.
Derek (2008) asserted that, the place of the diaphragm as a method of birth control should not be minimized. If maintained properly can be used for one or two years before being changes.
Ojikutu (2008) viewed it as mechanical barrier that is inserted at the tip of the womb before sexual intercourse so that sperms are prevented from traveling into fallopian tube.
Singleton (2005) viewed diaphragm as the barriers contraceptive which initially requires fitting by a trained doctor or nurse and the woman must be educated in the correct use of the appliance. The diaphragm positional diagonally across the cervix, the vaginal vault and much of the anterior vaginal wall
Tubal Ligation: Population Report counseling guide (2007) described tubal legation as where the tubes that carry a woman’s egg to the womb are blocked. After the tubal legation, the woman will still menstruate but she well not be able to have children again. It noted the disadvantages as the difficult to reverse and in rare event the women cannot become pregnant.
In the view of freeman (2000) he said that couples who seek permanent methods of family planning use this method.
The woman is permanently prevented from having children.
Neither fertility nor sexuality is diminished.
According to Derek (2002), it is a permanent method of birth control. In this case, operation consists of cutting out a portion of the oviducts. If a segment of the tube is exercise and the cut and tied, the sperms cannot reach the ovum and pregnancy will be prevented.
Singlotion (2005) described tubal ligation as methods, used for the sterilization of women; all involve blocking the fallopian tubes. This prevents the egg reaching the uterus to fertilize the egg; hence conception does not take place.
Hatcher (2007) said that it provides permanent contraception for women who will not want more children. It is safe and simple surgical procedure. It can usually be done with just local anesthesia and light sedation.
Advantages
– Very effective and helps protect against ovarian cancer
Side Effects.
- Internal infection at the incision
- Injury to internal organs
- No protection against sexually transmitted disease (STDs) including Hiv/Aids.
Vasectomy and the sterilization.
Derek (2002) opined that increasing numbers of men are becoming interested in vasectomy as the operation provided an easy, relatively painless method of making a man sterile without interfering with the couple’s sexual enjoyment. Vasectomy merely prevents the sperm from being ejaculated. The testicle remains and functions normally and does not have any fewer sexual desires.
According to population reports counseling guide (2007), the tubes that carry sperm from the testes to the penis still cut.
The man still produces semen but there is no sperm in nit. His sexual partner cannot be pregnant. Vasectomies are not castrations. The man is able to have just as he did before.
Also, according to Health care (2000, Sept), the rapid growing rate of the country’s population are in support of government new population policy vasectomy is an alternative.
Attitude of parents towards family Planning
Parent’s attitude will be discussed thus:
- Conceptual background on attitude.
- Influence of gender on attitude of parents towards family planning
- Influence of religion inclination on attitude of parents towards, family planning
- Conceptual Background on attitude.
Attitude according to Rezler (2003), is a relatively enduring organization of beliefs around an object, subject or concept which predispose one to respond in some preferential manner. He contended that there is tendency to react to the object in a negative way depending on the beliefs.
Doob (2007) viewed that attitude as an implicit drive producing response considered socially significant in the individual society. He emphasized that attitude affects how an individual acts feshbein and Anderson (2005)defined attitude as the evaluative dimension of a concept and the sum of strength of beliefs about the objects and the evaluation aspect of beliefs. Okoye (2003) argue that attitude is made up of values, feelings and beliefs. His contention was that our values direct our feelings and finally our beliefs of concept is based on what we value, and how we feel about that concept.
- Influence of Gender on the Attitude of Parents towards Family Planning: Majority of the male parents do not support their wives practicing family planning for social and moral resources.
Akigba (2008) said that apart from the mistaken motion that their father had thirty or more children they would have ten each, many Nigerian male parents do not approve contraceptives for their wives to be harlots.
For health reasons and fear of side effect associated with family planning, some female parents have negative attitude towards it.
Delano (2008) was of the view that half of the women not using oral contraceptive —– simple survey in Canada replied that they would not use oral contraceptive in the future an idea of spacing but they think that this can be performed through some rituals and they have litter idea that modern contraceptives are also uses for this purpose. He said also that some Ganda women in east Africa gave him such impression that they do not understand spacing because it is possible that the child one stopped from coming would be the best in the family.
Influence or religious inclination on parent’s attitude towards family planning
Religious belief played some role in the parent’s attitude towards family planning many people in Aguata Local Government Area and religious and their belief played very important role in their acceptance of family planning.
Some parents believe that it is against God’s wish to control birth by the use of contraceptives. Some parents advocated that man cannot control birth, only God can control the process of birth and death because children are gifts from God. Some of the literature reviewed shows that the above factors also one applied to other places in the world.
To support the above view, Cample (2008) said that 97% of the Jews, 90% of the Protestants and only 50% of the Catholic respondents were favouring family planning. They also observed that the more the Catholic went to church, the less they were in favour of birth control.
Stoekel and chquihuri (2003) carried out a survey between Muslims and Hindus on their attitude towards family planning is Bangladesh. The findings from the study indicated that there is significantly greater proportion of Hindus who approved family Planning than Moslems.
To support the above view too, daily times (2009) wrote that it was quite unfortunate that there are certain beliefs attached to birth control in our present environment. Thus, some women think that they have a number of babies sitting in their womb, waiting to be delivered or else mothers will suffer some retribution. Moreover, some women believe that the practice of birth control will lead to infertility during their reincarnation. But if there were true, most American women should have been practicing family planning for many years age. Hence, there was no evidence that American women are less fertile than their Nigeria counterpart.
Summary Of Literature Reviewed
It is an act of indiscipline for parents to produce children if they could not adequately cater for the. The proper application of family planning will help parents have limited number of children.
Akingba (2008) pointed out that it is unreasonable to bring more children into the world than the number a parent can afford. He also suggested that there was need for family planning practices so as to reduce the ——– of venereal disease and illegal abortion. Majority of the families in Aguata Local Government Area are not agriculturist, therefore, too many children are not needed to work in the farm. Since many of them are business men and women, civil servants with fixed salaries, then too many children will be a burden on the parents.
Amobi (2004) supported this aim and said that it would be suicidal for parents to have large families at a time of austerity, high school fees and rentage.
Moreover, for newly married parents family planning can be used to post one the first pregnancy until the couples is ready. This is very important in Aguata – a commercial city where many of the ladies got married to business men and civil servants at the most tender age. To support this, a group of world health organization (WHO) experts (2002) said that family planning will have a positive result on health when it is use to post one the first pregnancy until the women has completed her growth thus avoiding the double burden of growth and reproduction.
It has been found that the concept of the family planning is not new, even to developing nations. Nigeria parents had practiced abstinence long before now as a way of limiting family size.
Kosnile (2001) opined that before any parents will choose artificial method of contraception, special consideration should be given to side effects of given method.
Conclusively, some of the authors consulted agreed on the need for family planning, different family planning attitude towards family planning.
