From cultural beliefs and bride price entitlement to fears of diminished masculinity and reduced sexual pleasure, many Nigerian husbands reject condoms and vasectomy, leaving their wives to bear the burden of family planning alone.

When the side effects of several contraceptives she used became too much to bear, a middle-aged mother of four, Amara Nwobi, summoned courage and walked into a registered pharmacy in the Somolu area of Lagos State.

Her goal was to enquire about contraceptive methods she could use to prevent another pregnancy.

As she interacted with the healthcare worker, our correspondent observed that Nwobi was quite knowledgeable about the several planning methods.

Whenever a method was mentioned, she’ll respond, “I don use that one before, I dey react to am.” This means that she has tried several methods and had reactions such as irregular menstruation, constant headaches and bloating.

As she left the pharmacy determined to go to the family planning unit of the Primary Healthcare Centre in her area for further counselling, our correspondent approached her to ask a few questions to which she obliged.

The mother of four explained, “Despite all these reactions I have, my husband will never agree to use a condom.

“He’ll say, ‘After I paid my wife’s bride price in full, I can’t use the condom with my wife. If I use it with her, what should I then use with ‘Olosho’?”

When asked if she had explained her reactions to the methods, Nwobi said her husband told her to enquire about other methods with the hope that one would be perfect for her.

Why would I use a condom with my wife?

Several married men interviewed by PUNCH Healthwise on their views about contraceptive use, especially the barrier method, condom, explained reasons for their reluctance.

A Lagos-based Software Engineer, identified only as Mahatma, said, “Condoms sometimes feel like an emotional barricade for men who prefer to have the skin-to-skin contact.”

The father of one noted that since he doesn’t need to protect himself from sexually transmitted infections, there was no need for him to use a condom with his wife.

Mahatma, however, was open to using other available, safe and reversible male contraceptives if his wife reacted to the available methods for females.

While the software engineer declined to undergo a vasectomy, he believes family planning “should be a shared responsibility but can’t be equal as it is mainly to protect the woman.”

For a print media practitioner and father of three, Ojonrewaju Lanre, he can only use a condom with his wife “for her health’s sake.”

He further explained, “I think it is cultural and religious. Culturally, it is against our belief system that a husband is using a condom with his wife. In my 13 years of holy matrimony, I have never used a condom with my wife. On a religious basis, my faith is against any artificial contraception. Condom is one of them.

“Bride price or no bride price, once you are married you have to consummate your union. Why use a condom? I use the withdrawal method.”

The father of three vehemently refused vasectomy, saying, “Not in this era of high rate of paternity issues. Once a man is considered not virile, then what’s the use of his masculinity? Psychologically, both partners will have insecurity and infidelity issues.”

Men feel safe with wives, so why condom?

A Lagos-based father of one, Oluwamuyiwa Oyedele, believes that most married people feel safe with their wives, “believing the wives know when it is safe for them to be impregnated. And many also enjoy having it raw with their wives, believing it’s a safe place for them.”

He, however, noted that paying his wife’s bride price doesn’t give him the right to have sex without a condom, stating that his wife’s comfort during the sexual activity was important to him.

Oyedele says he’s comfortable with condom use and couples should both be involved in contraceptive use.

A Client Relationship Manager, Odedeyi Williams, believes that men enjoy sex “raw,” stating that for the prevention of pregnancy, men can use the withdrawal method.

While the Abuja-based husband says he is only comfortable with the male barrier method of contraception, condoms, and likes the idea of male contraceptives, he believes family planning is “basically for women; men don’t have a womb.”

Williams further says he will participate in family planning to avoid unintended pregnancy.

PUNCH Healthwise earlier reported that despite the push for increased uptake of family planning services to regulate the country’s explosive population growth, some Nigerian men have vowed not to embrace vasectomy, a form of male birth control method.

The report showed that men are worried a lot about whether their testosterone levels and libido would drop, while some are particularly worried that they could suffer from erectile dysfunction after undergoing vasectomy.

Globally available and approved modern contraceptives for men are condoms and vasectomies. In some countries, spermicides are available, and research is ongoing to develop non-hormonal male contraceptive pills and gels.

PUNCH Healthwise spoke to some women who confirmed that their husbands do not use or agree to the use of male contraceptives and have allowed them to use whichever modern contraceptive was effective for them.

These women pray that someday, “better contraceptives for the men will be available so they can also be involved in the family planning process.”

Contraceptives don’t reduce men’s dignity– Urologists

Commenting on the matter, a urologist and President of the Association of Urological Surgeons, Nigeria, Prof Nuhu Dakum, said many men refuse to use condoms because it denies them the natural sensation they ought to enjoy during sex.

“Many men feel the natural sensation is dulled when they use a condom, so they do not want to use it. Many may also feel the insistence of a partner that they use a condom may be an indirect way of saying they are not trusted, thus casting doubts on their faithfulness,” he said.

He further noted that misconceptions such as “condoms are meant for unfaithful partners or those infected” prevent the uptake of the contraceptive method.

The don stated that many men also think that vasectomy or other ways of contraception are only for women.

Dakum further explained that condoms and vasectomy are “the two main contraceptive methods,” stating that “male pills are not fully developed, and spermicides as methods of male contraception are not popular.”

On the health consequences that may arise when family planning responsibility is placed almost entirely on women, the consultant urologist said, “The consequences may be the side effects of the female contraceptives on the women.”

He stated that health education of men and involving them during family planning counselling with their wives on contraception would further help to increase male adoption of contraceptives.

On his message to Nigerian men who believe that using condoms with their wives or undergoing vasectomy diminishes their manhood or their rights as husbands, Dakum said, “This is a misconception. No man’s dignity is reduced because he uses any contraception. It would reduce the burden on the women if men also get involved in contraception. Men are advised to get educated on the methods available and discuss with their doctors so they make informed choices on the appropriate method for them,” he said.

In an earlier interview with PUNCH Healthwise, a professor of Urology and Consultant Urological Surgeon at the University of Abuja and the University of Abuja Teaching Hospital, Oseremen Aisuodionoe-Shadrach, noted that the slow adoption of contraception among males was due to cultural beliefs, adding that it could be difficult to change the perceptions and mindsets.

The Reconstructive Urologist explained that the reluctance towards vasectomy is largely due to the surgical nature of the procedure and the psychological impact of “stopping their capacity to reproduce.”

He added, “Not many men will do a vasectomy. Not many men will even use condoms, as simple as it is, because they feel it is the woman who should routinely use contraception. Most of these things stem from cultural beliefs and are not psychological.

“First, because men think that it is women who should use contraception. You know, they think, culturally, it is the woman who gives birth. So, if you don’t want to give birth or want to space childbirth, you should use contraceptives.

“So, I think that it is just a cultural way because that was how it was devised from the beginning, and that was why female contraception started early.

“It was like, if we can get female contraception, then there will be no conception. So, of course, the introduction of barrier methods using condoms is not necessarily for male contraception, but for the prevention of Sexually Transmitted Infections, really.

“So in a logical sense, you would say that female contraception started with a cultural bias that since it is the woman who gives birth, then prevent that conception in the same woman.”