I made the choice
By Diepiriye S Kuku
On a hot afternoon in early September, we made our way to the clinic of Dr. Renu Singh Gehlot, a practicing gynaecologist, located at Panki Road, Kalyanpur, on the outskirts of Kanpur, close to the famed Indian Institute of Technology. Renu Singh shares a modest reception area with a pediatrician, a clever arrangement, as this duo takes care of both mother and child from the same premises. Half-a-dozen benches occupied with chattering mothers and wailing children greet us as we settle on stools inside the doctor's chambers, awaiting her arrival. Today, we were also scheduled to meet some of her patients who had been using the injectable contraceptive, DMPA. Dr. Singh's clinic is registered as a Dimpa Network clinic, which means that she counsels eligible clients on the benefits of using DMPA as a contraceptive, as one of the various options available to Indian women who are looking for a safe and effective method of contraception. Among the many benefits that the method, it is a fact that DMPA is an excellent way for spacing families as it is fully reversible which means that once its use is discontinued, the woman can have another child when she wants. In addition, DMPA is safe for lactating mothers, as it does not affect the quality and quantity of mothers' milk. DMPA additionally reduces the risks of Anemia as well as cancer of the ovaries and uterus.
What is most interesting is that Dr. Renu Singh's clinic is part of a growing network of DIMPA clinics, of which there are 49 in the city of Kanpur alone. There is also a provider base of 262 Ob./ Gyns. + GP's who offer DMPA injectables as a contraceptive choice to their patients in the city.
The young and attractive Renu Singh is a warm, sympathetic person, close to the hearts of her patients, many of whom are married, many of whom refer to her as "Doctor Didi" or "Bhabhiji". Patients readily share with Bhabhiji very confidential details as she extracts vital information on 'their health and lifestyle histories with a gentle smile and an encouraging demeanor. Patients are not at all hesitant about talking about their marital history, childbirth and contraceptive usage, which itself represents a sort of evolution in gender equality. These subjects were hitherto 'taboo' and were never discussed with strangers, or with anyone else, for that matter. Yet, here were these women were completely at ease, talking about why thy opted for DMPA as a method of contraception.
The vibrant doctor tells us that she has been prescribing DMPA for the past six years, and counsels her patients to use the method particularly post – Caesarean, if they are lactating, or if they have a history of heavy bleeding during menstruation. Some of her patients have been on the injectable for over three years. Others are here today for their third or fourth shot, a date that needs no reminder because these women say they are so thankful to have found this new method of contraception!
As we wait, there is a buzz outside- the first patient has arrived. Dressed in a vivid blue sari, 25-year-old Prabha Rani Yadav walks into the clinic to meet us. Once the introductions are over, she gives us a bright smile and tells us, " I have been married for two-and-half years. I have one daughter who is a year-and-half old. She is outside, with my husband who has brought me here." We ask why she chose the Sui (injection), and wanted to know when she start using DMPA. Bubbling with enthusiasm, she tells us that she has one girl and doesn't want any more children. She said that after her daughter was born, she got pregnant again within the first six months of the birth of her child as she was not counseled about contraceptives after childbirth. She did not want another child so she came to Bhabhiji (Dr. Singh) for MTP. After MTP, Bhabhiji counseled her about different contraceptive options, and once she had discussed the subject with her husband, she chose DMPA. Initially, the fact that she needed to come to the doctor for an injection once in three months was the most appealing aspect of using DMPA. Now, she fully praises the method, "I am very happy with one child and to me the fact that she is a girl child is a matter of pride. Nowadays, there is no difference between a girl and a boy- see what women are achieving! I think DMPA is a very good method of contraception. There is no jhanjhat- just come in once in three months for an injection. I have no more tension about conception, no side effects. It is also a very sasta (cheap) method. The best part is that I chose this method after discussing with my husband. We didn't consult or discuss with anyone else. It really suits me, and I am very pleased. I tell all my friends about it and I encourage them to try it for themselves."
Through the course of the afternoon we meet another of Bhabhiji's clients, a 25 year old mother of a one-year-old child. The young mother has come for her third DMPA injection; she expresses great happiness over her choice of contraception.
We leave with a sense of satisfaction that finally, finally, some sort of woman's empowerment is taking place in our country. That itself is enough to make any one feel good!
About the Author
Diepiriye S. Kuku-Siemons, MPH (Tulane) is a researcher/writer/consultant based in New Delhi, pursuing a PhD in Sociology focusing on urban sexuality and globalization. His primary areas of interest are Reproductive Health Justice and Public Health Communications.
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