Akina Mama wa Afrika (AMwA)

Feminist Leadership Development

This year teenage pregnancy has increased by 1% for the first time since 2006!

According to the 2016 Ugandan Demographic Health Survey, 25% of adolescent girls aged 15-19 in Uganda are either pregnant or already mothers. The average age for a Ugandan child to first have sex is 16 but the average age for a Ugandan person to first buy a condom is 23. This means that between the ages 16 to 23, most Ugandans are having unprotected sex.

I am 19, I grew up in Canada, and interning to Akina Mama wa Afrika. I have been on birth control pills since I was 14. My government allows me to access birth control for free until I am 19. There are youth clinics where young girls can go to receive free birth control, STD testing, family planning advice, abortions; all without her parents knowing. The people who work at these clinics do not promote sexual activity in young girls, they are trained in counselling and support and they help the girls to make the safest and healthiest decision for them.

By failing to educate girls on safe ways to access contraceptives and family planning, the Ugandan government is putting them in danger of unsafe abortion and even worse, death during childbirth. Although some of these young girls survive the birth of a child, they are often left alone with little or no care since the father in most cases is either a child himself or married. At this very young age, it is rare for the girls to have any marketable skills to provide for their families and as a result, they resort to sex work. 

The fact is that many young girls in Uganda are sexually active, whether or not it is consensual. 25% of them are pregnant or mothers and something needs to be done. In order to save these girls from death during childbirth, from unsafe abortions, from sex work, and from futures lost to early motherhood, the ministry must allow them to be educated.

Now, sex education does not mean teaching abstinence. Teaching abstinence is teaching non-sexual education. It’s like teaching medicine to doctors and only using patients who are not sick. The purpose of sex education is to teach young people how to have SAFE sex. This means contraceptives. Contraceptives make sex safe. Condoms help prevent the transmission of disease and pills help prevent pregnancy.

There is a common misunderstanding of birth control and its possible side effects. This is due to rumours and assumptions that go unchecked. So here are the realistic health concerns: There are 10 most common side effects to birth control pills:

1) Intermenstrual spotting; approximately 50% of women on the pill experience this in the first 3 months of starting the pill, and 90% of those women stop experiencing it after the first 3 months. It is light bleeding, hence the term spotting, cause by either the uterus adjusting to having a thinner endometrial lining, or the body adjusting the different hormone levels. In any case, it is not serious, it is not damaging to the woman’s health, and the pill is still effective while spotting.

2) Nausea; some women experience nausea when first taking the pill. Taking the pill with food can usually help this and nausea usually goes away quickly after the body adjusts. This is also not a serious medical concern.

3) Breast Tenderness; some women experience growth or increased tenderness in their breasts. While it can be uncomfortable, this is not a serious medical concern and can be reduced by lower intakes of caffeine and salt. This also usually goes away after the first 3 months of taking the pill.

4) Headaches; some women experience headaches or migraines as a result of taking the pill. While this does usually improve after the body adjusts, it can be dealt with by trying different brands if birth control. The headaches are cause by the types and amounts of hormones in the pill, so all it takes is finding the right pill for you. Again, this is not extremely common.

5) Weight Gain; studies have shown no reliable relationship between weight gain and taking the pill, but many women report to have experienced weight fluctuation when taking the pill.

6) Mood Changes; a study has shown that birth control can be associated with smaller cortical thickness measurements in the lateral orbitofrontal cortex. This can be relates to stimuli intake and is believes to be connected to depression, but further studies need to be conducted.

7) Missed Periods; sometimes while on the pill a period may be skipped. However, this can also be caused by stress, illness, travel, or other health issues and is not considered to be a serious health concern when caused by the pill.

8) Decreased libido; the hormones in contraceptive pills can reduce libido (sex drive) in some people. 9) Vaginal discharge; this can be a change in the amount or nature of vaginal discharge, but is not harmful.

10) Visual changes with contact lenses; hormone changes caused by the pill can cause fluid retention, which can change the way that contact lenses fit.

None of these side effects are severe or require medical attention unless they persist beyond the first 3 months, which is uncommon and can usually be addressed by trying another brand of pill.

Some other side effects that do require attention but are rare are: abdominal/stomach pain, chest pain, severe headaches, blurred vision, swelling or aching in the legs and thighs.

The only possible fatal side effects are heart attack, blood clots, and stroke. However, these are usually paired with family or health history related to these issues.

Birth control pills can actually be used to help with: regulation of periods, heavy periods, painful periods, PMS, acne, hair loss, excess hair growth, and decreasing the risk of cysts, ovarian cysts, pelvic inflammatory disease, and ovarian and endometrial cancer.

Sterilization and difficulty becoming pregnant are not even considered to be risks of taking birth control pills.

Unfortunately, the ministry ignores these facts and chooses to take a blindly conservative approach to the issue, claiming that supplying adolescents with sex education and safe services for prevention of pregnancy will lead to higher rates of sexual activity. The fact is that we cannot stop young girls from having sex, but we can stop them from losing their lives because of it and we can give them a safe space to go when the situation is already dire. Many Members of Parliament already know this, but they are not confident enough to openly advocate for sexual education for adolescents because of the possible political repercussions they could experience. 

The Ministry of Health refuses to choose a stand on this topic so often that the people do not even know what the law surrounding abortion is. The Ministry continues to release new policies and retract potential policies showing that they are in support for one moment and in conflict the next. This is confusing to the people, and it needs to stop. The Ministry needs to take a stand on the issue and protect the young women of Uganda.

The allegation that support was withdrawn due to a change in the policy that would offer contraceptives to 10 year olds is entirely false. The policy change that they are referring to has nothing to do with the age of the recipient of information and everything to do with what information they receive. Up until now, the sexual education policy has applied to all children of 10 to 19 years. The new policy suggested that two programs are created, one for children 10 to 15 and one for children 15 to 19, so that the younger portion of the demographic does not have to be exposed to the same sexual content as the older portion, and contraceptives can be made available only for the older portion.

We call on the Ministry of Health to take a stand and protect the girls of Uganda from maternal mortality.