Information, youth, and the challenge of infertility

Tuesday is the day for the fertility clinic and the young women in the queue have all had a challenge getting pregnant. Most of them are young, and outwardly in great shape. Not a single one looks unhealthy, or malnourished. Their faces betray a profound melancholy, the only sign that anything is amiss.

I only find out why they were standing there when I get into a conversation with an older woman standing with them. The conversation turns to the subject of family-planning and she points at the women before launching into what is for me a detailed overview of the science of contraception. She explains that years of using family planning pills and injections has brought on something like an outbreak in the numbers of women who find themselves going through great difficulty conceiving.

So extensive is the problem that the district hospital has designated a day on which the affected women get to learn more about their condition and also share information with the doctors on what is in these numbers a recent phenomenon. Ironically, the clinics are set-up much in the style of the very family-planning clinics where women are brought together and taught the benefits of birth control programs.

"So when did the rain start beating us?" I asked.

She is quick to respond: "when we deserted our values and decided to pursue sex for pleasure. Chastity is no longer valued and the role of grandmothers and aunts is now only peripheral."

Upon reflection, I wonder at how true her sentiments ring. Graduating from high school now opens the doors to a period of carefree sexual adventures. More and more, the girls who restrain themselves are seen as backward and repressed.

The problem however, is that the very society that allows and encourages young girls to give themselves up to this passion, cannot accept in that girl the consequences of her freedom. So it is that the girl must be free to have sex as she pleases, but this must never lead to pregancies. Pregnancies would disrupt her education and career, the security and support of having a partner may be denied her and the social consequences of her pregnancy in our increasingly religious society will be hard to bear. The psychological burden of ostracisation and perhaps even rejection by her family, are added to by the financial burden of caring for a child in an economy with sky-high inflation and endemic unemployment. Deprived of the social security net of the past, pregnancy is for many young girls a terrible undertaking, one to be avoided at all costs.

And so it is that we start taking contraceptive pills very early on in life. This causes our hormones to adjust, and may lead to such problems as irregular periods or in extreme cases, to prolonged postponement of the menses. But this is just a small part of the problem. Contraceptives have been blamed in scientific studies for everything from lower bone densities, strokes, heart-attacks, increased incidences of cancers and blood clots to an increased susceptibility to venereal disease.

What further exacerbates an already messy situation is the fact that unlike other drugs, these contracptives are often taken in secret, without the careful attention and constant supervision of a physician. While many can and do get away with it, there are few who can claim to have enough information to make truly sound decisions.

The challenge therefore is to appreciate the dangers of contraception and the necessity of information in deciding what to use, in what quantities and for what periods. It is not enough to be able to access this over the internet, or to diagnose oneself on the basis of the musings of a random blogger. Like with most things, look hard before you leap.