My elderly aunt and I talked on the phone last week.
We had both watched the same documentary about midwives and the conversation turned to pregnancy and childbirth.
“You know, we didn’t know how to not have babies when we were young, your Nan and I”, she said.
“In the city [Melbourne], we just didn’t know how to stop it.” [I made some non-committal noises, hoping Aunty wasn’t going to talk at length again about how Nan’s prolapsed bladder used to fall out and she had to poke it back in again. I had only just eaten dinner.]
“In the country, in Bendigo, they knew how to stop getting pregnant.” [“Really?” I said, starting to check my emails.]
“In the country, they knew that you should soak a sponge in vinegar and put it up in there, and you wouldn’t get pregnant”. [Splutter. “What? Why? With what? In there? Oh, god, that’s horrible!”].
“Well, we had no other choice.”
And that, my friends, was the first time that I wished that my aunt had actually talked about Nan’s prolapsed bladder.
The idea that Australian women in the 1950s had to resort to putting salad dressing in their Lady Garden to manage their own fertility is pretty grim: women had so little choice and felt so very trapped.
But in some parts of the world, in our region in fact, this is still a reality for many women. There are women in the world today who are still not informed about contraception and other family planning options – and that lack of knowledge is often fatal.
In Timor-Leste, just a short one-hour flight from Darwin, one in four women do not have access to information about any form of family planning. This lack of understanding about contraception has contributed to Timorese women averaging about six births in their lifetime, which is the highest birth rate in Asia.1
Given this high birth rate, nearly 70 per cent of married women in Timor-Leste would like to use contraception or family planning options, either to limit the number of children that they have or to space their children. However, only 22 per cent of women actually use a modern form of contraception.2
In Timor-Leste, many factors contribute to low contraception use, but central to this is the lack of knowledge.
Take the story of Imelda: Imelda was 19 and deeply in love with her husband. Feeling weak and out of sorts, she went to the doctor who told her that she had a dangerous health condition. The doctor told Imelda that she should not fall pregnant as it would put too much strain on her heart. But the doctor did not tell her about any family planning options, nor did he check to see whether she was pregnant. Five months later, Imelda returned to the doctor in labour. As anticipated by her doctor, Imelda died giving birth to her daughter.3
Imelda’s death was avoidable. Imelda is one of many women who die because they do not know about family planning – the most important intervention to maternal death in pregnancy and childbirth.