5.5. Subjective norms influencing contraceptive use
5.5.2. The role of parents in influencing contraceptive discussions and use
Most of the participants commented that discussions about contraceptive use with their parents is forbidden and perceived as disrespectful. The following extracts illustrate some of their views:
It (discussions about sex) is a secret it is not African in the first place (Job, M, 30, I, PG, IN).
Because there is the cultural aspect of respect, I fear my parents and I cannot discuss with them sexual issues (Viola, F, 26, IN, PG, IN).
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Job and Viola seem to be saying that discussions about sex-related topics are evaded because sexual activity is considered a secret affair and so it should not be openly talked about.
The parent’s inability to freely talk about contraceptive use with their children seemed to relate to their expectations about their children’s sexual behaviours, and discussing such issues is going against their expectations. The following extracts illustrate the opinions of three participants:
My mum knows my girlfriend at home and she asked me if I was sexually active with her, she warns me not to do anything crazy with her. So am not sexually active at home so I can’t tell my mum about being sexually active with other girls because she will then say what a son I have raised so we can’t talk with our parents about this. She will think I am not a good child she has raised, I have been a good boy and there are many things I have done that I feel I should not be doing, she does not know about them (Melusi, M, 22, FGD, UG, SA).
On my case, most of other girls have that confidentially with their parents, they will be like screaming to them that now they are sexually active uh, (.) and besides that, they could kill me practically (Ntanzi, F, 18, FGD, UG, SA).
It is not hard, if I want to my mum is really free it’s only a matter of parental expectations obviously, I am actually 21 years I will be turning 22 soon, I can say I rushed into sex and I cannot discuss with my parent because if I say OK mum, I am no longer a virgin ha ha.
If it was not for that I would definitely do it (Leah, F, 21, IN, UG, IN).
The extracts suggest that the expectations held by parents that their children should not engage in sexual activities limits discussions about contraceptive use, even if young people are willing to engage their parents in such discussions. Therefore, young people would rather conceal their sexual behaviours from their parents in order to avoid their reactions. Melusi’s comments seemed to express guilt about his past behaviours which his mother is not aware of.
A comment from an Indian participant indicated that discussions about sexual behaviours are dependent on a parent’s openness to their children. The following extract illustrates her views:
I think it depends on who you are, even if you are open I can’t just tell them, it’s like disapproval on their side because it’s before marriage (Naomi, F, 18, FGD, UG, SA).
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Naomi seems to be highlighting similar issues raised Leah, Ntanzi and Melsui that, most parents are not open to discuss issues about contraceptive use with their children, even if children are willing to engage their parents in such discussions.
There were concerns raised by a female participant that parents can easily notice their child using contraceptives due to the impact a contraceptive has on the menstrual cycle. The following extract illustrates her opinion:
When you are staying at home and you are on contraceptives, your parents will see you and they will know what you don't want them to know about you, that you are having sex.
Like if you are on contraceptive may be, you don't go on your periods and if you don't go on your periods, your parents will know that you are on contraceptive because you are not asking for sanitary pads or whatever you using (Londeka, F, 20, FGD, UG, SA).
Londeka is raising similar concerns like other students that parents do not want their children to engage in sexual activities, and due to noticeable changes in their menstrual cycle, young women may be reluctant to use contraceptives. This may put them at risk of pregnancy.
There were reports from a female participant who shifted the blame on parents for being too rigid to discuss sexual behaviours with their children thus making it difficult for children to initiate such topics. The following extract illustrates her opinion:
I think the problem starts with the parent, as a parent you should talk with your child, not every day but about every step of life, like when you reach the age you are now in a stage of what and what so if they don’t talk about it, it is not easy for you as a child to approach your parent and talk about that (Phumi, F, 24, FGD, UG, SA).
Phumi seems to be saying that parents should be blamed for their children's sexual behaviours for not speaking openly about such behaviours to their children who have come of age.
The findings suggest that parents’ reticence to discuss sexual behaviours with their children may leave children with insufficient information that could enable them to evaluate the outcomes of performing behaviour, for instance, using contraceptives or engaging in risk taking behaviours, in a rational way as argued in the theory of planned behaviour (Ajzen, 1991). Parent’s reluctance to share information on contraceptive use with their children may give room for children to seek information about contraceptive use from unreliable sources like peers or the internet. These are some of the issues raised by most of the participants in the study.
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Although contraceptive use seem permissible in marriages as a family planning method, family members like the mother-in-law may influence the decision-making processes of their daughter in-law about the use of certain methods of contraception. The following extract illustrates the opinion of a married female participant:
Like my mother-in-law, she does not subscribe to contraceptives. I don't know (.4) there is a way they used to do it like counting the months and know your ovulation, fertile days (.) they are really discouraging the young people (Khozie, F, 28, I, PG, IN).
Khozie seems to be saying that her mother-in-law is against the use of modern contraceptives but approves of using natural contraceptive practice where a woman is expected to monitor her fertility by identifying fertile and infertile days during each menstrual cycle. Although Khozie talked about contraceptive practice her mother-in-law approves, she resolved to stick to the method of contraception of her choice which is the regular contraceptive pill as indicated in an interview extract reported in an earlier section of this chapter. Khozie was pregnant with her second child at the time of the study an indication that the method she was using did not interfere with her fertility.
Khozie’s argument suggests that women make efforts to prevent the risk of pregnancy despite the expectations of others on how women should manage their fertility. This relates to the argument in the theory of planned behaviour that people make rational decisions to perform behaviour, for instance, prevent the risk of pregnancy.
5.5.3. The role of public and private health care providers in influencing contraceptive use