Mothers bear brunt of bearing many kids

By Tsitsi Matope

ROMA — After giving birth to seven daughters in a two-decade search for a son, 36-year-old ‘Makatiso Sam and her husband from Nyakosoba village in Roma finally got a son last year.

It had never been this unemployed rural couple’s plan to have so many children but because of the need to secure the family name through a male offspring, ‘Makatiso had continued falling pregnant with the persistence finally paying off at the eighth attempt.

However, while the perseverance finally bore fruit for the couple, ‘Makatiso might pay a heavy price for the decision to keep trying for a boy-child.

“After having my first child at the age of 15, I never rested because of the mounting pressure to have a baby boy. Now, I occasionally have pain all over my body and sometimes feel very weak, which has forced me to continually take pain killers,” ‘Makatiso said.

She had come to collect some birth-control pills at the newly established family planning clinic in Roma — a joint venture of the Ministry of Health, Lesotho Planned Parenthood Association (LPPA) and French humanitarian-aid organisation Médecins Sans Frontières or Doctors Without Borders.

In addition to continued health complications, ‘Makatiso said the couple continually found it difficult to provide for the children.

With neither husband nor wife formally employed, the family was left with no choice but to live off their piece of land which, according to ‘Makatiso, does not always yield enough food and money to send the children to school.

“The hardship pushed my two daughters into early marriages. They both married just after completing their Standard Seven education,” ‘Makatiso said,

However, with her husband’s family name finally secured following the birth of their son, ‘Makatiso said the couple is not planning to have any more children.

Yet stories of women who end up having more children than they would have wanted, are not only widespread but also varied.

‘Makatiso cites the search for a baby boy as the reason for eventually having a large family but others, who spoke with the Lesotho Times at the Roma clinic last week, blamed their equally undesirable situations on lack of comprehensive maternal services at some health centres and inability to protect themselves against unplanned pregnancies and sexually transmitted infections (STIs).

‘Mamolebohang Taole from Ha Mokhohla, is one such woman who has now found herself with five children she cannot support.

Two weeks ago, the 25-year-old unemployed widow gave birth to a baby boy fathered by her partner who was against any form of birth control.

However, a few months before delivery, ‘Mamolebohang’s partner reportedly disappeared, leaving mother and child without the support they so desperately needed.

Taole’s husband passed away two years ago and left her with four children aged 10, seven, five and four.

“This man who fought me each time I suggested we use protection to prevent unplanned pregnancy and STIs has disappeared. Tell me how I am going to support this newborn alone.”

Taole said she has learnt the hard way and now wants a long-term birth control method such as the Intra-Uterine Device (IUD) commonly known as the Loop).

Another despairing woman, ‘Mathabo Mapetja from Ha Lebamang, said when she got married, she had not known bearing many children was what would make her an important asset in her husband’s family.

A mother-of-seven, two of whom have since passed away, Mapetja, 35, said her husband had asked her to bear him “many” children.

“My husband is an only child, so in order to compensate for that, he wanted us to have many children.”

Mapetja, who looked frail as she awaited her turn to consult staff at the clinic last week, said she was no longer planning to have more children as the one girl and four boys she has are enough.

“My last child is four years old while the others are 15, 13, 11 and seven, and these are enough. I am using the three months injectables and would like to continue using the same birth control method,” she said.

Meanwhile, the joint family planning service initiative, which takes place every Monday, attracts scores of women from different parts of Roma area every week.

The five-year programme sponsored by the United Nations Population Fund (UNFPA), seeks to improve maternal and child-health in areas where people would be experiencing difficulties to access such services.

Poor maternal health is attributed to the high maternal mortality rate — which is the rate of death of women during pregnancy, labour and up to six weeks after delivery.

According to Lesotho’s 2009 Demographic and Health Survey, maternal mortality has increased nearly three-fold over the last decade to reach 1 155 deaths per 100 000 live births.

About 58 percent of deaths are associated with HIV/Aids and tuberculosis, making childbearing a major risk in Lesotho.

In an interview on Monday last week, the Lesotho Planned Parenthood Association director, Makatleho Mphana, said various stakeholders are concerned about the high maternal deaths and are collectively making efforts to address the situation.

Mphana attributed unplanned families to the inaccessibility of services, particularly in the hard-to-reach areas and also lack of education on the benefits of birth-control and adequate information regarding the options available.

“It is against this backdrop that we came up with this joint programme, which is meant to bring services to the communities’ doorsteps and be able to provide a whole package of family planning services.

“These include education on maternal health in general and the various types of contraceptives both women and men can use,” Mphana said.

The programme is also providing free contraceptives and HIV-testing and counselling, Mphana added.

“Our main concern is the effects of unplanned families on the health of the mothers and the children. The mothers should have enough rest to allow their bodies to recover from the previous pregnancy.

“At the same time, ensuring they take precautionary measures against HIV is also a critical component of the programme and that is why we are also distributing both male and female condoms.

“We are advocating double-protection, which is using the condom together with other contraceptives such as the loop or oral pills.”

A visit to the Roma family planning clinic last Monday highlighted how the women now benefiting from the UNFPA-funded initiative used to struggle to access services.

More than 60 women came from far away villages such as Mokema, Ha Moitsupeli, Ha Lebamang and Thaba Bosiu for free contraceptives that included the three-month injectable, oral pills, the IUD or loop that can last 12 years and the five-year Jadelle implant.

The IUD is a small device, often T-shaped, containing either copper or levonorgestrel, which is inserted into the uterus, and is one form of highly effective, long-term reversible contraception.

Failure rate with the copper IUD is about 0.8 percent while the levonorgestrel IUD has a failure rate of 0.2 percent in the first year of use.

Among the types of birth control, they, together with birth control implants, result in the greatest satisfaction among users.

On the other hand, the popular Jadelle, is a set of two flexible cylindrical implants, inserted in a superficial plane beneath the skin of the upper arm.

However, the majority of women interviewed last Monday at the Roma clinic said before the UNFPA programme, they used to travel to faraway Maseru to buy contraceptives at various health centres and chemists.

Others, however, said due to accessibility challenges, they ended up with unplanned pregnancies thereby putting their lives at risk, particularly those that are living with the Human Immunodeficiency Virus (HIV) — the infection which causes the incurable Aids.

“In this area, we relied on the National University of Lesotho clinic because the St Joseph Hospital here in Roma doesn’t provide contraceptives,” one of the women found at the clinic ‘Malehlohonolo Thabana, said.

The St Joseph Hospital Acting Medical Superintendent, Dr Muila Kambulandu confirmed all Catholic health facilities do not provide contraceptives, condoms included.

“We only provide information and direct patients to the nearest health centres where we know they can get contraceptives. This is purely based on the position of the church which only promotes natural methods of family planning,” Dr Kambulandu explained.

She further said despite the church’s position, poor accessibility of birth control methods in the area is a major concern while the disadvantage of referring patients is that the hospital can never be sure they finally got the service they required.

The Roman Catholic Church has three hospitals which are Seboche in Butha-Buthe, Mamohau Hospital and Paray in Thaba-Tseka.

The church also owns several clinics dotted around the country, which all do not provide contraceptives on religious grounds.

However, the same hospitals are also
burdened by the high numbers of women who come for antenatal services — some after having unplanned pregnancies.

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