UNITED NATIONS POPULATION INFORMATION NETWORK (POPIN)
UN Population Division, Department of Economic and Social Affairs,
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Traditional beliefs part of people's lives

Network, vol. 17(1), Fall 1996: Fertility Awareness







Copyright 1996, Family Health International







Traditional Beliefs Part of People's Lives



Providers can use their knowledge of local fertility practices and

beliefs to promote modern contraception.







Many couples around the world use rituals, herbal approaches and

similar practices to regulate fertility for cultural, economic or

personal reasons. While many of these beliefs and practices are

completely ineffective as contraceptive approaches, and some are even

harmful, certain aspects of these indigenous beliefs can be used to

promote better family planning.



Practices that are not harmful (- such as rituals or storytelling )

may offer innovative ways to teach how the body works and about

modern contraception, or to encourage correct and consistent use.



Providers who familiarize themselves with cultural beliefs about

fertility may communicate more effectively with women and men about

their contraceptive options.  Programs may reach new groups of

clients if their services are considered part of the larger context

of a community's historical understanding about fertility.



Grace Delano, executive director of  the Association for Reproductive

and Family Health in Nigeria, says providers gain credibility by

teaching family planning in ways that do not exclude or ridicule

traditional beliefs.



"Even before the introduction of modern methods, Africans had methods

of fertility regulation," she says.  "I consulted with my mother, who

is 90, and I worked with traditional healers, to find out about the

traditional methods. I figured, if I start from the known, that will

make my entry into changing attitudes very easy. Whatever I say from

that point forward will be seen as part and parcel of  the culture."



Nigerian culture includes many myths, rituals and the use of herbs

in attempts to regulate women's fertility. Delano, who has written

a book to document popular concepts about fertility regulation in

Nigeria, works with local family planning organizations to help them

make use of these beliefs in the promotion of good reproductive

health care.



She advises providers to discuss with clients their personal beliefs

or practices. For example, some customs prohibit pre-marital sex, and

others call for a mother's abstinence for up to three years after

childbirth, which promotes proper birth spacing. In neighboring

Niger, the Committee on Traditional Practices which Affect the Health

of Women and Children (CONIPRAT) has identified several cultural

practices to be encouraged, including abstinence after childbirth and

delayed consummation of marriage until the bride reaches a certain

age.1 Delano instructs providers to take advantage of non-harmful

rituals to promote the acceptance of modern family planning.  An

existing Nigerian ritual, placing an object made of red feathers,

called a "teso", on the floor, is believed to make it impossible for

any man to have sexual intercourse with an adolescent girl until the

spell is removed.



Even simply discussing the teso can help women understand that family

planning is not new, and that attempts to reduce childbearing have

been practiced for millennia in almost every culture.



Many of these beliefs have no harmful effects on a woman's health,

and may help assure her of being in control of her own fertility.

These include ineffective notions that pregnancy can be prevented

when women avoid the sun or moon at certain times or wear charms,

including dead spiders, children's teeth, or leopard skin bracelets

(since leopards are believed to scare away unwanted pregnancy).

Drinking tea made from various harmless roots and weeds and jumping

up and down or sneezing after intercourse to dislodge the sperm are

other examples.



Counterproductive beliefs



Some customs and practices, however, may be dangerous or

counterproductive and should be discouraged. The Nigerian belief that

sex during menstruation will turn people into albinos is not harmful,

but may increase the risk of pregnancy. Since menses is a time when

women are typically infertile, prohibiting sex during menstruation

may encourage sex at times when women are more likely to be fertile.





The harmful practice of douching with hot water, salt, vinegar, lemon

or potassium after sex is common in African cultures, and should be

discouraged. This ineffective technique can introduce infection into

a woman's uterus and cause permanent damage, including infertility.



Other potentially harmful pregnancy prevention traditions include:

eating arsenic and castor oil seeds; drinking water used to wash dead

bodies; and soaking cotton wool in pepper and inserting it into the

vagina as a barrier method.2 The 28-bead necklaceIn nearly every

culture, jewelry has played an important role in sexual relations,

including beliefs about fertility.  For centuries, amulets and charms

have been used to promote romance, as well as to avoid pregnancy.



The Institute for Reproductive Health (IRH) at Georgetown University

in Washington, the Population Council in New York and the Center for

Research of Maternal and Child Disease (CEMICAMP), a non-profit

family planning organization in Brazil, plan to study the use of a

28-bead necklace to help women follow their menstrual cycle and to

be aware of when the risk of conception is greatest.



The first bead of the necklace is red to indicate the first day of

menses, and the next seven beads are brown, indicating a time of

infertility. These are followed by 11 white beads designating the

fertile window, with fluorescent beads indicating a woman's peak days

of ovulation. A black rubber band marker is moved from bead to bead

to follow the cycle. The fluorescent beads for peak days of ovulation

glow in the dark, a vivid reminder when the necklace is near a

woman's bedside at night.3"In spite of  the negative attitude of most

providers toward natural family planning (NFP) methods, every survey

in Brazil shows that rhythm is third in prevalence of use, after

surgical sterilization and the pill," says Dr. Anibal Faundes of the

Universidade Estadual de Campinas in Sao Paulo, who helped initiate

the study concept and is a study consultant. "That means there is a

demand for the method and that cannot be ignored.  Many couples that

use it, however, use it incorrectly. Any kind of gadget that can help

couples use rhythm more effectively should be used." In Brazil, IRH

and CEMICAMP plan to follow 100 couples to see how easily they learn

the necklace method, and propose following 2,000 couples eventually

to test its contraceptive effectiveness.



Other cultural habits



Just as the bead necklace provides a technique for teaching fertility

awareness, a variety of other customs or practices that have no

connection with human fertility can be adapted to encourage better

family planning.



In order to introduce oral contraception to women in rural villages

in the Philippines, Dr. Juan M. Flavier, president of the

International Institute of Rural Reconstruction, has used local

agricultural practices to explain how the pill works. People in an

area where string  beans are grown, for example, know that lime juice

can be used to prevent bean pods from opening and releasing their

seeds. This traditional knowledge offers an excellent way to explain

how the pill can prevent a woman's ovary from releasing an egg.



To help women remember to take pills daily, Dr. Flavier encouraged

women to devise their own reminders. In one village, five women

adapted an old custom of shouting out evening gossip across the

village center.  The woman who remembered to take the pill first each

evening would yell out a reminder: "Let us drink our secret!"4In

Bolivia, women in the region of Chuquisaca seek easier ways to

monitor their fertility. In this region, it was typically thought

that women were most fertile during and immediately after their

menstrual period ( just the opposite of what is true.5 IRH is working

with Catholic Relief Services to test a "simple rule calendar method"

of family planning.  The simplified rule would help women recognize

their fertile time, without requiring them to chart or monitor

physical changes in mucus or body temperature.6Providers would choose

from among four NFP formulas, depending upon the client's cultural

background and needs.  While the traditional calendar method is

available, there would also be a very easy rule, called the "blanket

rule," that simply requires abstinence from the ninth day of a

woman's cycle until the 19th day.  IRH plans to study the

effectiveness of teaching the simple rule method.



"There are some populations who want to space children, but do not

want to use a modern method, yet the traditional calendar approach

can be so intensive," says Virginia Lamprecht of IRH. The modified

approach recognizes these cultural preferences and limitations, she

says.



( Sarah Keller





References





1 Family Health International.  Proceedings: Regional Conference on

Increasing access and Improving the Quality of Family Planning and

Selected Reproductive Health Services in Francophone Sub-Saharan

Africa, Ouagadougou, Burkina Faso, March 12-17, 1995.  Durham: Family

Health International, 1995.



2 Delano G. Guide to Family Planning, New Edition.  Ibadan: Spectrum

Books Ltd., 1990, 25.



3 Institute for Reproductive Health, Georgetown University, Center

for Research on Maternal and Child Disease.  Evaluation of the

"Collar" Method of Natural Family Planning.  Washington: Georgetown

University Medical Center, December 1995.



4 Flavier JM. How to bring pills to the villagers.   Singapore J

Obstet Gynecol 1984; 15(1): 103-8.



5 Seidman M, Cachan J, Mojica R, et al.  Traditional knowledge into

modern practices: Improving reproductive health.  Presented at

American Public Health Association annual meeting, November 2, 1995,

San Diego, CA.



6 Lamprecht V, Grummer-Strawn L. Development of a new algorithm to

identify the fertile phase of the menstrual cycle.  Georgetown

University Medical Center, Institute for Reproductive Health.

Unpublished paper.





Copyright 1996, Family Health International. Any part of this text

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