Women's responsibility in family planning: Breaking the borders of disparities in choices

Do women's rights to have family planning make them solely responsible to use contraceptives even when a method does not suit her body? Given the limited choices and poor quality contraceptive services, how these responsibilities shape women's life in poverty prone rural areas and slums of Bangladesh? How do the poor and disadvantaged women make informed choices about family planning when they have little or no choice at all? A community participatory study through 24 participatory rural appraisal sessions and 790 free listing interviews with married women and men, and interview with community leaders and service providers attempt to find out women's problems in use of contraceptives. Appalling issues including side effects, lack of choices and limited access to quality of care relating to pills, injection, intra-uterine contraceptive device and sterilization emerged. Pills are the most popular methods followed by injection, but according to Demographic and Health Survey, about a half of the pill users discontinue the method within a year. Demographic and Health surveys have repeatedly revealed headache and dizziness as overwhelmingly common reasons for discontinuation but program managers failed to comprehend the underlying dynamics. This study reveals that these problems are not to be lightly taken. The side effects not only make women sick, they also become unable to perform household chores, which reduce their value in the family. As women are discriminatorily seen solely responsible for using contraceptives, they are trapped within the border of limited available methods despite side effects and serious concerns to health.