Middle Eastern Women’s Attitudes and Practices Regarding Family Planning Methods

Introduction

Family planning can hasten a nation’s efforts to end poverty and realize its developmental objectives. Universal access to family planning and other reproductive health treatments is recognized as one of the most important objectives of the Millennium Development Goals (MDGs) of the United Nations.^1–3

The high fertility that results from not using family planning methods also raises the risks of health problems for the mother and infant, which lowers quality of life and limits access to jobs employment, education, and nutrition. Family planning methods can be very important for population dynamics, which aid in the nation’s economic stabilization and enable it get over the challenges posed by faster population growth. Unsatisfactory needs and poor family planning use can be explained by fear of negative impacts, rejection from couples, decrease knowledge, and social condemnation. Cultural variations have also been mentioned as having an impact on the use of family planning, particularly with regard to conventional expectations and aspirations for more children and lines. Access to safe abortion services and contraception methods is correlated with low incidence of unwanted pregnancy. After women choose which method.⁴ The ability of women to make freely chosen decisions on family planning needs and options, or to disagree with their husbands or partners on these matters, is known as women’s decision-making power in family planning. Couples that use family planning (FP) try to limit the number of children they have. Women make decisions about family planning use based on a variety of factors, such as delaying marriage, having access to reliable information, having open discussions about family planning options and needs with partners, family members, and the community, and making their own decisions about controlling their fertility, including using family planning methods more frequently.⁵

Family planning lowers maternal mortality and morbidity and helps prevent unintended pregnancies. Compared to other nations in the Eastern Mediterranean Region, Iraq still has a comparatively low prevalence of contraception (58%), and the country’s overall fertility rate (4.2 children per woman) and unmet requirement percentages (12%) are still rather high. Many public and commercial health facilities offer free or significantly subsidized services, but social, cultural, economic, or health care service limits may prevent many women from using them.⁶

Both men and women can plan their family sizes and prevent unwanted pregnancies, which not only increase maternal mortality but can also cause distress and anxiety. Reliable contraception makes this possible. Women in the Gaza Strip, Palestine facing challenges in using contraceptives, including user and viewpoints of the providers. Family planning services were not expected because most Palestinian women who visited the clinic had already chosen their method of birth control, with decisions being made by their husbands.^7–9 The primary motivation to improved access and support for women in the Middle East must be the experience growing up in the region and seeing firsthand the challenges and barriers women have when trying to obtain family planning. Challenges that impede the Middle East’s ability to get family planning services advancement in reaching family planning objectives, which exacerbates the region’s problems with gender equality and economic mobility. Prioritizing should be given to a number of important areas, such as lack of comprehensive education, healthcare infrastructure, economic restraints, religious influences, and stigma.^10–12

In the Arab world, balancing population growth, social and economic development, and environmental resources will also be aided by reducing unmet demand. Of all the regions in the world, the Middle East and North Africa region has the worst freshwater deficit.^13,14An analysis of Egypt’s 2008 DHS demonstrates that Egypt’s total fertility rate the number of births per woman during her lifetime would drop from 3.0 to 1. If women were able to successfully avoid having children as a result of unwanted pregnancies. 2.4 Unplanned pregnancies account for 14% of pregnancies in Egypt.^15,16

In nations where the rate of unwanted pregnancies is higher, the effect of lowering it on fertility would be even more pronounced. According to a research by the Higher Population Council of Jordan, if Jordan’s unmet family planning requirement had been decreased to half in 2009, that year’s total number of unplanned births would have been decreased by 10,000, or 6% of all births.¹⁷Compared to other wealthy nations, Saudi Arabia has a higher birth rate and overall fertility rate, and research has shown a correlation between these high rates and underdevelopment. Due to the swift expansion of the Saudi Arabian economy, there is a growing demand for the use of contraception and birth spacing.^18–21

In Lebanon, the overall count of births and cesarean sections is increasing.²² In Lebanon, the overall count of births and cesarean sections is increasing. There were 34 infant deaths for every 1000 live births, along with 23 births and 7 deaths per 1000 people. The population was rising at a pace of 1.6% per year, which was among the lowest in the Arab world. The 2.3 births were made by the average woman during her reproductive lifetime.²³

Unwanted births worldwide approximately 82% are caused by women who wish to prevent getting pregnant but are not utilizing an effective form of contraception.²⁴ The Arab world has a high rate of unwanted pregnancies, which burdens people, families, healthcare systems, and social and economic advancement.²⁵ A person’s ability to choose the quantity, timing, and spacing of their offspring is essential to preserving their reproductive rights. As described in numerous international agreements and human rights documents, reproductive rights stem from the fundamental rights to reproductive autonomy for all persons and couples, free from violence, compulsion, or discrimination. They cover rights related to getting married, starting a family, having children in a healthful manner, and being protected from HIV and other STDs.²⁶

Methods

Results

The analysis of this Table 1 shows that women are with average age of 32.23 ± 7.9 years in which the highest percentage is seen with age group of 30-39 years (40.4%). Regarding level of education, the highest percentage is seen with 22.7% of those who graduated from institute or college. The nationality of women distributed equally from various countries; Iraq (16.7%), Lebanon (16.7%), Jordan (16.7%), Yemen (16.7%), Egypt (16.7%), and Saudi Arabia (16.7%).

Table 2 indicates that women have high affective attitudes to uses family planning methods (total grand mean = 2.60); the mean scores indicate high among most of affective attitudes except (Contraceptives can actually make intercourse seem more pleasurable) and (Contraceptives are not really necessary unless a couple has engaged in intercourse more than once) that show moderate.

Table 3 reveals that women have high behavioral attitudes to uses family planning methods (total grand mean = 2.56); the mean scores indicate high among most of behavioral attitudes except (After a sudden intercourse, I use an emergency contraceptive method to prevent pregnancy), (I would practice contraception even if my partner did not want me to) and (I prefer that my husband be receptive to the responsibility of using contraceptive methods) that show moderate.

Table 4 depicts that women have high cognitive attitudes to uses family planning methods (total grand mean = 2.56); the mean scores indicate high among most of cognitive attitudes except (I think that the natural method is effective in family planning), (I think implantation is good for family planning) and (I think it is better to have a tubal ligation to prevent childbearing) that show moderate.

Figure 1 shows that women are showing a good level of attitude toward using of family planning methods (78.7%), (20.6%) of them are showing a fair level of attitude, while only one woman showing a poor level of attitude (0.7%).

Figure 1. Levels of Women’s Attitude toward using of family planning Methods (N=150).

Figure 2 illustrates that (86.7%) of women are using various family planning methods while only (13.3%) are not using these contraceptive methods.

Figure 2. Distribution of Women according to Use of family planning Methods (N=198).

Discussion

Total grand mean = 2.60 indicates that women have a high affective attitudes to using family planning methods; mean scores are high for most affective attitudes, with the exception of (Contraceptives can actually make intercourse seem more pleasurable) and (Contraceptives are not really necessary unless a couple has engaged in intercourse more than once) that show moderate.

Middle Eastern women face several potential barriers that can negatively influence their use of family planning methods. These barriers include affective, behavioral, and cognitive factors, each impacting the process in different ways. Key influences on these barriers were identified as the level of understanding of family planning, support from others (such as husbands, society, and friends), adherence to cultural and social norms, and the perceived priority given to family planning.

Despite the challenges that family planning still faces across the Middle East, many governments and civil society organizations are actively working to improve access to services, promote reproductive health education, and encourage open discussions within local communities.

Approximately 17% of married women worldwide, or over 100 million women in less developed countries, would prefer not to get pregnant but are not utilizing family planning. Unwanted or pregnancies might result from unmet contraceptive needs. Which puts women, their families, and society at risks. Approximately 25% of pregnancies in less developed countries are unplanned.²⁹ Challenges pertaining to reproduction can occasionally exist, such as (lack of sexual activity or prolonged intervals between sexual activity, fear of contraceptive side effects including bleeding, spotting, amenorrhea, or incidence of breast tumors or any other gynecological oncology). Furthermore, some women choose not to use contraceptives because they believe that they are not truly necessary until a couple has had multiple sexual encounters. This is especially true for women whose husbands work outside the home for a several days. The involvement of the husband frequently has a detrimental impact on women’s decisions to use or not use family planning methods. Instead, it pushes women to have a large number of children, particularly in rural countries where a large family is seen as a source of strength and pride for the father. In many cases the role of husband is negatively affected women’s decisions about use or abstain family planning methods. Rather the forces the women to have a lot of children, especially in rural societies that believe that the large number of children is a source of proud and strength for the father.

The population of Iraq has grown at an average yearly growth rate of 3% over the past three decades.³⁰ Which, together with Yemen and Palestine, is regarded as one of the highest in the Region.³¹At the moment, 70% of people reside in cities.³² Women in their twenties of the overall population, 20% are between the ages of 15 and 49.³³ With 22% of the population living below the federal poverty line and a comparatively high maternal mortality rate (50 deaths per 100,000 live births), poverty and unemployment are still high. There are disparities as well: the poverty rate doubles in rural areas, 22% of women are illiterate, and only 10% of the workforce is made up of women.³⁴

Women have high behavioral attitudes to uses of family planning methods (total grand mean= 2.56); the mean scores indicate high among most of behavioral attitudes except (After a sudden intercourse, I use an emergency contraceptive method to prevent pregnancy), (I would practice contraception even if my partner did not want me to) and (I prefer that my husband be receptive to the responsibility of using contraceptive methods) that show moderate.

Family planning service utilization decisions are influenced by a variety of service-related and demographic constraints. By comprehending and utilizing data on unmet need, policymakers and program managers can enhance family planning initiatives. Taking into account the traits of women and couples with unfulfilled needs and trying to remove barriers that keep them from selecting and utilizing family planning techniques.³⁵ Sometimes the desire for the most effective methods creates barriers that prevent women from using family planning methods successfully, these barriers include the method’s induction of serious side effects, such as severe headaches, severe depression, severe bleeding, and extreme pain in the chest or abdomen. Some women also prefer natural methods because they think they are safe and effective, and some women avoid family planning methods because they are religiously prohibited from doing so or because they cannot access them cost free, and many of them are low-income. Together, these barriers force women to have unintended pregnancies, large families with lots of children, and sick mothers who are forced to care for their large families.

Concerning attitudes related to cognitive the study shows that women have high cognitive attitudes to uses family planning methods (total grand mean = 2.56); the mean scores indicate high among most of cognitive attitudes except (I think that the natural method is effective in family planning), (I think implantation is good for family planning) and (I think it is better to have a tubal ligation to prevent childbearing) that show moderate.

In order to stabilize the global population, it is necessary to remove barriers that prevent all women from accessing high-quality contraceptive and family planning services. Prior studies on the obstacles to using FP services have emphasized the significance of focusing on factors other than physical access when analyzing obstacles resulting from administrative, cognitive, emotional, and cultural elements in addition to physical obstacles and method-specific obstacles.³⁶

There are various types of reported barriers for both the discontinued group and the non-users. Cognitive, cultural and demographic barriers were the main barriers that lead to not using/discontinuation of family planning methods followed by barriers related to the method itself and reproductive barriers. The administrative and physical barriers were the least reported ones.^37–39

In addition to social, cultural, and economic restrictions, Middle Eastern women continue to confront other obstacles in their quest for family planning services. This piece emphasizes the urgent necessity to remove these obstacles by disseminating promotional messaging. Providing counseling to women, particularly during postpartum visits, in order to dispel myths and assist them in making an informed decision. Providers in these fields should keep a variety of contraceptives on hand as well as offer counseling to help women and couples meet their contraceptive needs. This will allow women to select the methods that best suits their needs. Postpartum, breastfeeding, and menopausal women should receive counseling regarding their risk of getting pregnant, how to satisfy their family planning needs, and how to raise money to cover gaps in government programs. Governments can improve individual rights, growth population, and accomplish development goals particularly MDG 5, which calls for improved maternal health by reducing the unmet demand for family planning.^6,40,41

Conclusions

The findings of the study revealed that the majority of participating women held positive attitudes toward family planning methods. Furthermore, most of the women reported actively using some form of contraception. These results highlight a generally favorable perception and widespread acceptance of family planning practices among Middle Eastern women, reflecting both awareness and practical engagement in reproductive health decisions.