Attitudes to contraception: Tradition and Religion
Berna Dilbaz
Turkey
Worldwide there are around 123 million women, mostly in
developing countries who are not using any contraceptive method despite their
desire for birth spacing or limiting the number of births. Furthermore as a
result of this unmet desire, an estimated 38% of all pregnancies occur all
aorund the world each year. Women’s lack of effective birth spacing and
fertility control puts their life and health under risk. Pregnancies which are
too early or too late in a woman’s reproductive life or too closely spaced or
unwanted carry higher health risks. Sexual abstinence is a very successful way
to avoid unwanted pregnany but is not feasable therefore contraception is the
key to avoid unplanned, unwanted pregnancies.
In order to use contraception people must be aware of the family
planning methods, regard their use as beneficial and be able to obtain the
method of choice. Therefore besides awareness and availability of contraceptive
methods, women’s and even societies’ perception and attitudes about fertility
and family planning methods play a major role in approval of family planning and
accepting to use a contraceptive method. Age at first marriage, desired family
size, son preference, premarital sex, women’s education and autonomy are factors
resposable for differences in fertility among various group of women. All these
factors are influenced by social, economic and cultural factors. Religion and
tradition has an undeniable impact on social and cultural structure of the
society.
Family planning behavior is under the influence of environmental
and individual factors. Social influences on fertility behaviour show the
importance of tradition. In some cultures there is a tradition of early marriage
and immediate childbirth and no birth spacing. Any contraception is perceived as
individual coercion and deviation form ancestral tradition. Traditions, like
unacceptance of premarital sex is a barrier against acceptance of teenage sexual
activity that might well lead to unprotected intercourse due to inadequate
information on family planning and sexually transmitted infections. The strength
of religious opposition to contraception is a major obstacle in individual’s
choice of fertility regulation. It is important to learn different religious
attitudes related to reproductive health problems when handling the health
problems and needs of a woman. Health-workers should be able to adress religious
and traditional barriers. National family planning programmes and policies
should also take the cultural differences into account in order to reach the
clients and increase the acceptance of health policies. Policy makers and
service providers need to evaluate the cultural structure of their society and
consider the differences in traditional and religous beliefs of different groups.
Service providers should be sensitive to cultural norms that affect the
behaviour of different ethnic groups.
The efforts to control fertility have been a common practice
even in primitive, preliterate societies in history. Inscriptions from ancient
Egyptians indicate that monogamous marriage was the norm, and various methods of
contraception existed. In the 4th century B.C. Plato and Aristotle advocated a
single-childed family.Aristotle advocated covering the cervix and vagina with
cedar oil as a contraceptive technique. In the 5th century B.C., Saint Augustine
condemned contraception even among married couples. The Kakun Papyrus dating
from about 1850 BC has references in the text showing whether a woman is fertile
and describes some contraceptive measures. The Hippocratic writers recommended
semen to be removed from the vagina and recommended gaining weight as an
anticonception measure. Primitive forms of contraceptive devices were described
and used by Greek and Islamic physicians. Contraceptive technology improved
dramatically with the beginning of 20th century and was accepted by many
societies.
Scientific advances and their use to improve quality of human
life do not always harmonise with the desire to follow faith, religious sayings
and tradition. Religion is a cultured phenomenon. Different religions have
different sayings about sexual behaviour and fertility. Religiosity or
acceptance of the teachings of a particular religion is a stronger determinant
of sexual behaviour than a specific religion per se
Many aspects of religiosity is found to be associated with
general sexual behaviour. Card et al. analysed six main categories of
determinants for and individual’s decision to use or not to use an effective
contraceptive method by reviewing 259 articles, monographs, and books:
demographic, sociopsychological, experiential or behaviorial, infromational,
including knowledge, husband and wife interaction, environmental. The groups
with relatively high fertility and low contraceptive use are people from a low
socioeconomic status, adolescents, people aged 40 and older, Catholics and
highly reliogous, unemployed women with many siblings or working women who do
not attach great importance to their careers and ethnic minorities.. The
evidence linking values and attitudes to fertility-related behavior is stronger
than personality traits.
Individual’s perceived importance of religion is important in
choosing a birth control method. Attitudes of 240 female Hispanic teenagers
towards the importance of birth control were examined and 4 predictors: primary
language, mother’s education, importance of religion and friends’ perceived
birth control use were found to be associated with attitude toward the
importance of birth control. Perceived importance of religion was significanly
related to lower scores of birth planning and little importance was related to
high scores.
The practice might divert from the religious teachings in some
settings. In a study aimed to analyze the relationship between religiosity and
contraceptive method choice among users of contraception in the Jewish
population of Israel, contraceptive choices of religious women were found to be
determined largely by considerations unrelated to religious doctrine such as
peer influences, cultural effects and acceptance of a particular religious
theology.
Although the Catholic Curch favours natural family planning and
has obstructed modern birth control programmes and practices in various part of
the world it came out that 91% of the Catholics were using illicit contraceptive
methods by 1971.
Religion is not a sole nominator in choosing a contraceptive
method and people from the same religion living in different settings can
practice contraception differently. Malian migrants in France continue to be
strongly pronatalist; men tend to oppose contraception, citing Islamic doctrine
while women increasingly justify contraceptive use in response to health
policies. More Islamic countires are establishing national family planning
policies. Secular Islamic countries; Turkey and Tunusia have liberal family
planning laws.
Cultural setting and tradition like son preference, fatalism
exert an important influence on reproductive behaviour, independent of economic
development. The concept of male dominance and superiority that is a part of
cultural heritage in some countries leads to early marriage, over-population and
a variety of health problem in both sexes (STD, unsafe abortion etc..). The
norms and traditions that are against limitation of the family size influence
the fertility decision-making process and lead to low contraceptive use.
Cultural traditions have strong influences on the acceptability of pregnancy at
an early age. In some cultures women’s autonomy like the possibility of women
using contraception without husband’s knowledge is regarded as a threat to
tradition. Children in some settings are seen as an asset as they are a task
force while young and care giver to parents when they are old.
Developments in science and technology raise new religous
questions that do not always have clear answers. Claims by women to autonomous
reproductive choices is an ongoing debate. Improvement in education and social
status of the women in the family and in the society are major forces that can
overcome the negative impact of tradition and other sociocultural factors.