A couple’s family planning journey

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A couples family planning journey From
ignorance and fear to a shared responsibility
Eighteen-year old Gudiya Devi loved going to
school but had to discontinue studies to get
married at the age of 15. Although she did not
have to join her husband immediately in Paimar
village of Wazirganj block in Gaya district, she
was told to learn household chores so she could
transition into the role of homemaker with ease.
She helped her mother with housework, cared for
her siblings and accompanied her father to the
fields. We will now follow spacing between our
first and second child. Since we already have one
child, our next child will be after three years
and irrespective of whether it is a male or
a female child, we will not go in for a third
pregnancy. Gudiyas health is important. If she
is healthy she can take care of herself and the
family Conditioning and traditional mindsets
shape views about marriage and childbirth Once
she turned 17, her husband came to take her.
Prior to leaving, her mother advised her how she
must make herself accepted in her marital home.
She must serve her in-laws and do their bidding
unquestioningly. Bear few children and settle
down to rearing them and caring for them without
resistance and complaint. That was to be her only
duty and purpose in life, she said. Gudiya
found the people and lifestyle in Wazirganj
different from back home. Her large extended
family were not very friendly and welcoming. She
remained stressed most of the time, anxious
about not upsetting anyone or doing anything that
was unacceptable. Her husband too was not too
forthcoming. He preferred talking to his mother
than to her and sought his mothers advice for
everything.
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Within few weeks of her coming to Wazirganj, the
local ASHA didi on one of her visits, tried
befriending her but Gudiya found herself unable
to communicate. She remained silent and afraid
to talk since opening up to an outsider did not
seem the right thing to do. Her mother-in-laws
presence was intimidating. Besides, most of the
conversations were dominated by her
mother-in-law and two sisters-in-law. When
Gudiya became pregnant within two months of her
marriage, everyone was relieved that she was
normal. It was her first pregnancy and she was
worried with lots of concerns in her mind. The
doctor also advised her bed rest and she felt
quite isolated but had no one to share her
feelings with. No woman should die due to
complications of childbirth Gudiya became close
to a neighbour, who too like her had got married
early and had moved from a distant village. She
was barely 26 years of age but had already borne
four children in quick succession. When she
became pregnant with her fifth child, Gudiya
tried taking care of her since she was extremely
weak and anaemic. One night when the woman went
into labour and was taken by her family to the
hospital, she developed complications and died on
the way. Neither she nor the baby survived.
Gudiya went into a state of shock on hearing the
news. She was unable to come to grips with the
tragedy. This was a turning point. She decided
to approach ASHA didi to understand more about
pregnancy and complications that can arise,
especially due to frequent child bearing. She
feared that her husband and mother-in-law would
put pressure on her to bear a second child and
she would not be able to say No. ASHA didi
explained to her about delaying and spacing
pregnancy and how it could give her time to
recoup and prepare herself in ways that would be
best for her health and the health of her
children. She also told her to try and discuss
with her husband so that both of them as a
couple could agree on giving a gap of at least
three years before having their second child and
more importantly to decide on a family planning
option in the interim in consultation with each
other. Getting husbands to take greater
ownership about family planning decisions Gudiya
knew that this was not going to be easy. Her
husband was one of those men who thought that
pregnancy, menstruation, abortion, miscarriage,
childbirth and things like urinary tract
infections and sexually transmitted diseases were
all female issues which men did not get into.
She shared her apprehensions with ASHA didi, who
on one of her subsequent visits brought the Zero
and Low Parity Pilot facilitator Jully Kumari to
talk to her. Both guided Gudiya on how to get
Sagar, her husband to be more involved in this
conversation, that impacted their life and that
of their children. Over a period of a few
months, Sagar began to become more receptive.
Especially when Gudiya shared her fears and
concerns, drawing parallels with her health to
that of her deceased friend and neighbours. He
did not want her to suffer or die due to any
negligence on his part. He agreed to join ASHA
didi in the conversations on family planning.
Gradually,
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• he began to see how important it was for husbands
  to be engaged and to work with their wives to
  arrive at joint decisions.
• Gudiya and Sagar decided to adopt the
  intrauterine device for a period of three years.
  Sagar also got Gudiya to get back to school and
  complete her studies. Today, the biggest change
  that can be seen in his thinking is when he talks
  to his mother and other family elders, telling
  them that he and Gudiya will jointly decide when
  to have their second child and will let them
  know whenever there is good news to be shared.
  This has given Gudiya a lot of confidence. She
  also feels it is her way of paying a tribute to
  her late friend.
• About the Programme In 2018, CARE launch a
  first-of-its-kind intervention where CARE
  introduced gender and sexuality in family
  planning programme focusing on zero (couples
  with no children) and low parity couples (couples
  with one child). The decision was based on
  finding from Currently Married Women of
  Reproductive Age (CMWRA) study which indicated
  that use of contraceptives was low and unmet need
  for spacing methods had only marginally
  increased.
• The pilot was started with three objectives
• Improve quality of interaction between ASHA
  workers and key target groups
• Increase couple communication around sexual
  reproductive health family planning
• Enhance negotiation communication skills of
  beneficiaries
• Posted by Family Planning Team (Health and
  Nutrition) CARE India
• Location Paimar village of Wazirganj block in
  Gaya district