Access to adequate contraceptives is fundamental for women and families, so as to be able to plan their family life. You will find more information on this subject in Women’s Health Centres, located in the federal capitals in Austria. They can offer you information about contraception in general and the best choice for each individual. Additionally, they can offer the necessary care and empathic professional treatment (e.g. in from of female interpreters!) for women, who have experienced flight situation and related possible traumas. Please have a look at the website: [www.oegf.at,] of the Austrian Association for Family Planning. Here you will find public hospitals offering family planning advisory and also affordable contraception (like the contraceptive coil).
8.1 Red flags
- Detailed explanations in the respective mother tongue are essential!
- Important for establishing confidence building is to explain the legal duty of confidentiality in Austria (a person working in health care is not allowed to give information about his/her patients to somebody else. He/she is legally bound to comply with professional secrecy)!
- Contraception and family planning are for most women and men unknown and unclear issues and are often misunderstood! Therefore, it is important to explain what is meant by contraception/family planning (e.g. that the woman and her partner are able to decide themselves, when they want to have children and how many)!
- Recommended contraceptives need to be discussed with the husband – this should be taken over by the women themselves!
- Condoms are a tabooed subject (they indicate illegitimate sex)! They would be taken into account only if the woman does not tolerate other contraceptive methods. Nevertheless, it should be necessarily explained, that the condom is the only contraceptive, which also protects against HIV and reduces the risk of getting a STD (Sexually transmitted disease)!
8.2 Please consider and explain well:
- Contraception does not imply that a woman will be less fertile. If she decides to set off contraception, she can get pregnant!
- Using natural contraception methods (as calendar and temperature method, etc.) is according to the differing menstruation courses of women affected by FGM, lacking knowledge of the calendar, ignorance in regard of measuring methods, etc., very difficult.
- Usually the contraceptive coil is placed in the uterus during menstruation (this is less painful, because the tissue is stretched). In principle, it can be placed at any time!
- Placing in the contraceptive coil to a woman with FGM type III with a narrowed vagina (vaginal stenosis) is in some cases very difficult and in others almost impossible – in this case, please recommend defibulation!
- If one contraceptive method does not work well for the woman, she can try out another one!
- The most suitable method may vary from woman to woman, e.g. in relation to interaction with other drugs, costs, availability, application method (is there enough time for regular taking), etc.
- The „pill after“ is unknown for many women – in this context, it is essential to explain the difference to „normal“ pill, it should not be used as a regular contraceptive, but only in cases of emergency! Please note that the “pill after” should be taken within the first 12 hours of conception and within max. 72 hours! In Austria, the “pill after” is available without recipe in pharmacies.
- Please ask if the woman uses traditional contraception (in different cultures there are different natural contraceptive methods such as special herbs, etc.). Explaining that these natural methods are not safe and do not prevent from sexually transmitted diseases and may have side effects, is essential!
- Breast-feeding and contraception are issues afflicted with many myths and superstition, etc. It is important to explain that breast-feeding is not really a contraceptive method and the woman may become pregnant, however!