Family Planning Advocate, Postpartum Expert, and Mom: An Interview with Ninabina Davie Kitururu
Interview by Faith Tabifor, Coordinator, Reference Group and Global Initiatives, Family Planning 2020
Ninabina Davie Kitururu is a Tanzanian FP2020 Youth Focal Point, a member of the International Youth Alliance for Family Planning, and a youth advocate working with the Tanzania Youth and Adolescent Reproductive Health Coalition. At 21, she also became a mother.
Now, she describes her experience as a young first-time parent, underscoring the need to prioritize the often overlooked and neglected needs of young, first-time parents.
What sparked your interest in reproductive health? Why are you an advocate?
After I completed high school, I volunteered with a company that placed girls in different hospitals to learn about gynecology. I witnessed many girls come into the hospital mentioning they would not use contraceptives, but instead monitor their cycle. This was because they were misinformed about contraceptives. They believed it would have negative effects on their fertility or cause cancer.
I was once one of those girls.
I believed all the myths and did not use contraception, and as a result, I became pregnant. This made me realize that I needed to use contraceptives, so I became inquisitive, started learning more about the various family planning methods, and chose to use a method that works for me. After my experience, I felt compelled to share my knowledge and advocate for the use of modern contraception to prevent other young girls who are misinformed from getting pregnant just like I did.
As an advocate, I love that I am able to interact directly with young girls, give advice and share my personal experience. Working at the hospital made me see the beauty that lies in having a choice and educating girls about different family planning methods. It brings me joy knowing that I’m a positive agent of change in influencing the decisions young girls make regarding their sexual and reproductive health.
As a young first-time parent, can you describe your experience and the challenges you faced?
I got pregnant at 21. I was still in University and faced a plethora of challenges throughout my pregnancy and after my delivery. As a student, it was challenging navigating through life daily: my social life plummeted, I lost my friends, my grades dropped significantly, and I received stigma from my professors who would often say, “Why are you pregnant? You are not married.” I used to skip lectures and wear big clothes to hide the pregnancy, but one can only hide for so long. I felt helpless as people didn’t take me seriously in school as I continued to struggle to juggle life as a student and a young pregnant girl.
Despite these challenges, I was privileged to be working at the health care center which resulted in me having easier access to health care services during my pregnancy. I was lucky because this is not the reality for most women who struggle to have access to basic health care services. I witnessed other young women get neglected by health care providers — no one bothered to attend to their needs, they hardly received any counseling and the women were less comfortable discussing their health issues with providers. Because I knew most of the doctors and nurses, I was more comfortable approaching them, however, when I would see a new health care practitioner, I was stigmatized.
My supportive family was a positive — I had help from my parents and that was the turning point. They were supportive throughout my pregnancy and delivery process and were always eager to ensure that my child was in good health. The father of my child was also very supportive. At the hospital, the women who came in with their partners were attended to first, and those that did not had to wait in line and were attended to last. Having my partners’ support whenever possible made the process easier and prevented stigma.
I was privileged to have health insurance from my university, which enabled me to have some access to health care services. However, I did not have the best experience accessing antenatal care and postnatal care. The nurse assigned to me was dismissive of my needs and left me on the delivery bed right until the moment I was about to give birth. I was not offered any pain relief or support from the nurses, even though the delivery rooms were not busy. I thought to myself, “I’m the only one here, can I get more attention?” I felt as though I was being stigmatized and punished because I was young, and it was only when I started screaming from pain that the nurses came back to the delivery room.
Do you remember when your provider first counseled you on postpartum family planning (PPFP) options? Did you talk with your provider about family planning options at subsequent visits?
Providers did not ask if I wanted any contraceptives. Instead, they would ask “where is the father?” I was not offered any postpartum counseling or contraception because I was not married. According to the providers, if you are not married you do not need it. It was disheartening seeing other older women receive postpartum care, but because I was young, I could not get the same treatment. In order for me to get contraceptives, I had to go to a youth friendly health center. At the youth health center, I was able to comfortably discuss the different options available and understand their effects.
It’s okay to be a mother. It’s okay. It is scary, but it is okay. You should not feel bad because you are a young first-time parent. It is also okay to ask for help — ask a mother, ask an auntie, and get as much support as you can.
Reports indicate that in Tanzania, only 13 percent of women have the recommended number of postpartum care visits. What are the biggest hurdles young first-time parents face in this aspect?
From my experience, if you deliver your baby at a public hospital in Tanzania, it is easier for providers to tell you the different family planning services available and what contraceptive methods they provide. But when it comes to a private hospital you must tell them what you need. That is what I experienced giving birth at a private hospital — after I delivered, no one bothered to tell me what to do.
Stigma is also one of the biggest hurdles and is most common in the public sector, but in the private sector it differs depending on the health provider. As a young first-time parent, you come in scared and face providers who stigmatize you saying, “That’s why we tell to wait, you’re too young. That’s why we tell you to wait until marriage.” This absence of a supportive environment pushes young first-time parents away from receiving the recommended postpartum care.
Looking back at your personal experience, what can be done differently to create a supportive environment for young first-time parents?
I think it is vital to ensure all young mothers have access to contraceptives. During pregnancy, standard blood tests are administered, and I believe that just as these blood tests are required, women should also be provided with a method of contraception of their choice. It should be part of healthcare providers’ check lists.
What are some steps you would like to see taken regarding youth engagement and advocacy for issues surrounding first-time parents? How do you think FP2020 can support this work?
I would like to see organizations become more engaged with this topic and create spaces where young people can be active participants in discussions surrounding first time parents. More partnerships should also be developed between youth, community-based organizations, and healthcare providers in order to address this issue and strategize collaboratively to develop solutions. This would create opportunities for information sharing and enable young people to voice their opinions.
As a youth focal point, it would be great to have FP2020 provide more technical support to young people. It would be beneficial to have more youth-focused sessions where youth focal points can share their knowledge and experiences regarding Postpartum Family Planning (PPFP) and Post-abortion Family Planning (PAFP).
What advice would you give a young girl in Tanzania? What advice would you give a healthcare provider who sees young mothers such as yourself?
It’s okay to be a mother. It’s okay. It is scary, but it is okay. You should not feel bad because you are a young first-time parent. It is also okay to ask for help — ask a mother, ask an auntie, and get as much support as you can. It can be daunting to speak to healthcare providers about contraceptives and make decisions on your own, so ask a friend or relative to support you through the process. Always question what is given to you by healthcare providers — it is your right to ask so that you are knowledgeable and not misinformed.
To a health care provider, I would say, “it doesn’t matter my age, I am still a mother and I need the same services as a 30-year-old.” Healthcare providers should have the same sense of obligation in providing services to young first-time mothers. A mother is a mother regardless of her age.