While contraceptives have grown more popular, Bangladeshi men remain woefully behind women in using contraceptives. The use of modern male contraceptives – condoms and vasectomies – is rather low, even as it gradually improves, according to authorities.
Rahim used condoms and his wife took pills. But when the pills weakened her, he opted for a long-term contraceptive in the form of no-scalpel vasectomy (NSV) – a procedure that permanently sterilizes a male without using any sharp surgical tools.
“My wife suffered immense pain when she was giving birth to our only daughter. So we did not take any more children. For her sake, I opted to undergo NSV."
But Rahim, who works at a private firm, has access to better medical facilities which are not as accessible to members of lower income groups.
Among the less affluent men, the traditional Islamic contraceptive ‘Azl – withdrawal before ejaculation –remains the norm. As most of them are practitioners of conservative Islam, the majority of men expressed reluctance to discuss their sexual practices to a female correspondent.
However, a number of married women offered their experiences with their husbands.
Shahnaj Begum, a 36-year-old mother of five, said though her husband Delowar uses condoms, he prefers that she use contraceptives, quoting him saying: “Contraceptives are for women, not men.”
The response was to Shahnaj’s request for Delowar to get a vasectomy. She instead underwent ligation – a surgery that ties up a woman’s fallopian tube to prevent insemination.
‘There are long-term contraceptives for men?’
Hamid, a 36-year-old rickshaw-puller, responded negatively when asked if he was aware of any long-term birth control measures for men.
“There are long-term contraceptives for men?” he exclaimed.
Dr Nurun Nahar Begum Rosy, program manager of the Clinical Contraception Services Delivery Program under the Directorate General of Family Planning, said: “Male participation in family planning is very important to support their wives. Most of them think it is the woman’s responsibility, but the truth is that women are bearing the burden along. If both men and women share the responsibility, every step, no matter how hard, becomes easier."
Use of contraceptives 2016-2018
According to data provided by the Directorate General of Family Planning, there has been a steady increase in condom usage and NSV surgeries performed between 2016 and 2018.
The latest data from January to May 2019 reports 87,82,780 condom usage and 35,15,904 NSV surgeries performed.
Year | Condom | NSV |
2016 | 22,026,135 | 92,43,653 |
2017 | 22,678,875 | 94,27,847 |
2018 | 22,996,912 | 96,44,584 |
Perils of long-term use of short-term contraceptives
“Pills or injections have adverse effects if taken regularly. Women suffer many hormonal diseases if they take these for a long time. They can also induce irregular bleeding, vomiting, and headache," said Dr Abu Sayed Hasan, program specialist, Sexual and Reproductive Health (SRH) at the United Nations Population Fund (UNFPA).