Do you know your fertile days? Most women don't – KDHS

More than half of women in Kenya do not know their fertile window – the days in a woman’s menstrual cycle when pregnancy is possible, a new analysis suggests.

Only about 38.1 per cent of Kenyan women, or four in every 10, are aware. 

The dearth of knowledge is highest among young women, who also report the highest rate of unplanned pregnancies.

Researchers analysed data from the 2022 Kenyan Demography and Health Survey, encompassing 16,901 women of reproductive age, to make this conclusion.

Their analysis was published in the journal Contraception and Reproductive Medicine two weeks ago, in an article titled "Knowledge of fertility period among reproductive age women in Kenya: a multilevel analysis based on 2022 Kenyan demographic and health survey."

 "Knowledge of the fertility period aids women in refraining and engaging in sexual intercourse to avoid and to get pregnant, respectively," the researchers said. 

The knowledge of the fertile period is one of the science techniques used to delay pregnancy. Although it is a highly effective method, most women lack correct knowledge about it and end up with unintended pregnancies and some undergo through unsafe abortion.

However, the success rate of this method is lower than that of modern contraception.

The five days near ovulation or during the ovulation are the fertile days — when one is most likely to get pregnant. To prevent pregnancy one must avoiding sex or use another birth control method on those “unsafe,” fertile days. There is almost no chance of getting pregnant if you have sex before or after the fertile window.

Several factors were found to influence awareness of the fertility period.

 "Women's age, educational status, contraceptive use, media exposure and distance from health facilities were significant individual factors," the authors said. "Meanwhile, place of residence and community-level education were critical community factors."

Older women were more likely to be aware of their fertile window. "The odds of knowledge about the fertility period increased with the age of women," the researchers said, aligning with similar findings from Ethiopia, the US and Spain.

The study elaborated that "women who are at a later age in their reproductive lives had more precise awareness of their fertility period than those who are just starting."

Education played a pivotal role in fertility awareness. "Women who attained secondary and higher education had better knowledge about the highest conception probability period compared to those with no formal education," the study said. 

Modern contraceptive users were more likely to be informed about their fertility period. This could be attributed to the counselling and information provided during family planning services, which enhance awareness of reproductive health.

The study calls for enhanced education and media outreach to improve fertility awareness. The authors said as Kenya grapples with low contraceptive prevalence and high unmet needs for modern contraception, such initiatives could play a crucial role in family planning and reproductive health.

Kenya is working to move from the current modern contraceptive prevalence rate of 57 per cent to the envisioned 64 per cent, by 2030.

Injectables remain the most popular contraception method favoured by 35.5 per cent of all women using modern family planning methods.

The second most popular method is implants at 31.5 per cent and pills at 12.6 per cent, the KDHS 2022 report shows.

Currently, 14 per cent of married women aged 15-49 have an unmet need for family planning, which limits their ability to prevent unintended pregnancies and plan their families. 

Wide disparities, however, exist with counties such as Marsabit, Tana-River and West Pokot recording a higher unmet need for family planning at 38 per cent, 37 per cent and 29 per cent, respectively.