Table 1 presents the characteristics of the young women interviewed in Bobo Dioulasso and Ouagadougou. As can be seen in the table, the majority of the women were in the oldest ages (age 23–24 years). Half of the sample were never married while the other half were ever married or currently in union. The sample is evenly split across the religious groups in both cities. That said, the current modern method used in the two cities varies with more implant users interviewed in Bobo Dioulasso and more injectable and condom users interviewed in Ouagadougou.
Findings from the in-depth interviews were examined under several key themes. These were: (a) perspective of religion’s acceptability of contraceptive use; (b) reasons and motivations for using contraception under perceived unsupportive religious circumstances; and (c) perceived consequences from one’s religious community for using contraception. It is worth noting that when the adolescents and youth were talking about their perspectives and experiences, they were often referring to two types of scenarios – married users, no matter the age; and unmarried users, often equated with questions around adolescent and youth use.
Perspectives on religion’s position on contraceptive use
During the interviews, the young modern method users were asked about their knowledge of their respective religion’s position on contraception. In general, all respondents had an understanding of the position of their religion on contraception. This knowledge was acquired either through direct contact with religious leaders or from their sermons on the topic. Others learned about their religion’s views on contraceptive use from discussions within their family and in some cases through personal readings of religious texts. Across all religions, generally the respondents felt that their respective religions are opposed to the use of contraception or any means to avoid becoming pregnant, no matter the age or marital status of the person using. For example, these two married young women talked about religious prohibitions against contraceptive use.
In the sermons they often say that it is forbidden to use contraceptive methods because it is a sin to do so.
Married Muslim Woman from Ouagadougou
Religion is against the use of contraceptive methods; whether it is the pill or the other methods, religion is against it.
Married Catholic Woman from Bobo Dioulasso
According to the young users, the prohibition of contraceptive use is based on religion’s perspective that a woman or couple should not limit the number of children they have. The child is considered “a gift from God” and the different holy scriptures (the Bible and Koran) as well as the religious communities across the religions have a strict position on this subject. Avoiding getting pregnant is therefore contrary to the will of the three religions included and therefore perceived as a sin.
In the church it is said during the prayers that the woman must never limit, nor space her births, the number of children that God gives you only you must give birth to them. It has never been written in the Bible that a woman can do family planning. Rather, it is written that the woman must have as many children as God will give her.
Unmarried Catholic Woman from Bobo Dioulasso
My husband himself is a practicing Muslim who has finished reading the Koran and who teaches the Koran to people, it was he who always told me that it is forbidden in Islam to use contraception. He told me never to use contraception, that the number of children that God has allowed all Muslim women must do and never seek to limit births. He also added that a child is a gift from God, it is God who gives and it is he who takes care of it and no one else ah (smile).
Married Muslim Woman from Ouagadougou
In the same sense, several respondents felt that their religion considers that the use of contraception to avoid becoming pregnant amounts to “terminating the life of a child” and this is considered a serious sin.
It is when we pray in church, we often open parentheses to say that if you do contraception, after death you will go directly to hell insofar as you kill children. That if God had planned five children for you and if you practice contraception for five before your marriage, it is your children that you are killing. Now after your marriage you want children when you have already killed them.
Unmarried Catholic Woman from Ouagadougou
Importantly, according to many of the respondents, the debate on the position of religion and contraceptive use is only relevant for women in union. Concerning single people, sex before or outside marriage is strictly prohibited and thus they should not be part of the discussion of religion and contraceptive use.
In the Muslim religion it is formally forbidden for the young unmarried woman to have intimate relations with a man outside marriage. In any case, the religious leaders talk about it and they advise young single women to get married before having intimate relations with a man. At this time they do not even talk about methods concerning them.
Married Muslim Woman from Ouagadougou
Nuanced views about religion and contraceptive use based on type of method and marital status
While overall, most respondents feel that their religion prohibits contraceptive use, there were some respondents who talked about ambiguities of religious doctrines and leaders’ statements about family size and family planning (FP).
No, it’s general. For them, they are against everything that prevents the birth of a child. But they also say not to make children more than our ability to care for them. Now how are you going to make sure a child doesn’t come? We want something and its opposite? It is complicated.
Married Catholic Woman from Ouagadougou
Some women acknowledged that some methods of contraception were more acceptable, and that use was considered appropriate for some married women. In particular, across the religions, some respondents felt that the use of traditional methods (i.e., withdrawal or rhythm method) is authorized for spacing births. In addition to these traditional methods, the condom was considered acceptable by some of the respondents across the religions.
What is allowed in the Muslim religion on FP is above all the use of methods such as condoms, the rhythm method or women who are educated calculate their cycle, there is also the method coitus interruptus. These are really methods that we do not say that the religion has forbidden because that is what many married Muslim women use.
Unmarried Muslim Woman from Ouagadougou
To a lesser extent, some young women felt that the use of FP from a religious point of view was accepted provided that the woman had the prior consent of her husband/partner.
As far as married women are concerned, we always say that your use of FP depends on your husband, if he wants you to have a child, that’s it, if he wants that much, he’s the one who decides.
Unmarried Protestant Woman from Ouagadougou
Reasons and motivations for using contraception under unsupportive religious circumstances
Despite perceived religious injunctions on the use of FP and the awareness they have on this subject, the young women interviewed noted their reasons or motivations for their contraceptive use. The reasons or motivations given were diverse but similar across the different religions and can be distinguished according to the marital status of the young women. The majority of young women in union mentioned as the first reason for using contraception the difficulties inherent in contemporary life, in particular financial difficulties in coping with the care of the family. This imposes the need to space children and sometimes limit births.
I say we have no choice, it’s because of real life. I told you what I do for work; my husband is also a trader and the market is not stable. If you have a child in school and other children in the private sector, will you be able to get by? It’s difficult. Religion also says that abortion is not a good thing and in order not to condemn you with God, it is better to take the path where you can justify yourself later.
Married Catholic Woman from Ouagadougou
Nowadays life has become very hard. For example, if you do not use contraceptive methods and each time you give birth to children and the spacing between them does not exceed a year like that and if your husband does not have enough means it is difficult. Also, the children have to attend [school], you have to feed them, take care of them so when there are many of them and then there are not enough means there it is difficult; this is the reason why I decided to use the contraceptive method. I use FP I know it’s not good in the Muslim religion but I hope God will forgive me one day.
Married Muslim Woman from Ouagadougou
The young married women also mentioned reasons for use related to the health of the mother and the child.
It is true that our religion does not support the use of contraception, may God only forgive us because I thought about my health before making the decision to do so. I thought about my child’s health before I did. I saw that if I space my births well I can take good care of them.
Married Muslim Woman from Ouagadougou
For young married women, they bear the brunt of the consequences and burdens associated with pregnancy and childcare. For this, they use contraception for their own well-being despite the religious discourses that oppose this.
Other men refuse, but it’s up to you, the woman, to think about it because the man doesn’t care, it’s you who will be there with very young children lined up and you can’t do anything. He will get up to go about his business and leave you with your children. For this, even if no one tells you, you must try to do FP unless you yourself are insane.
Married Catholic Woman form Ouagadougou
Concerning young unmarried women, the main reason cited for use is related to social, family, and religious sanctions that can result from pregnancy before marriage in a context where cultural and religious norms emphasize abstinence until marriage, a practice that is increasingly difficult for girls to respect. Pregnancy before marriage is considered a dishonor for the family and the consequences include stigmatization of all kinds and in some cases the repudiation or expulsion of the young woman from the family circle. Thus, the use of contraceptive methods is perceived as a means for unmarried young people to be sexually active but also to protect themselves from the sanctions and other consequences which could result from an unwanted or extramarital pregnancy.
Ah if you see that I myself put religion aside and went to do it, it’s because it’s personal. I went to do… it’s getting pregnant, that’s the problem. You see in family, especially us the Mossis [ethnic group] even, we are complicated. If a child (a girl) becomes pregnant, she is divorced from the family, as long as they do not do certain things to fix it (tradition), you cannot return (to the family); so I went to do so as not to get pregnant; I want to honor my parents and those from where I go to pray.
Unmarried Muslim Woman from Bobo Dioulasso
That’s what I said, it’s because of what our community members say, because if you have a child before marriage, we’ll insult you that you got pregnant while you’re going to the church.
Unmarried Catholic Woman from Bobo Dioulasso
Overall, for these young, unmarried religious women, the reasons for violating religious prescriptions by using FP are all social and cultural. While young brides use contraception mainly to space births, single people use it to delay the onset of fertility, which is poorly accepted if it happens outside marriage. Sanctions and stigmatization of all kinds constitute the main fear pushing young unmarried women to use FP.
Use of contraception and religious practice
The young respondents were asked directly about their use of contraception and how this relates to their religious beliefs and practices. Some of the respondents reported that their contraceptive use does not affect their religious practices or beliefs, that is, they were able to separate these issues.
Because using contraception has never stopped me from always practicing my religion, it doesn’t stop me at all. Whether I use FP or not, it’s the same thing, I practice my religion without any problem. When I see my period only I cannot pray for four days and that is long before I start using the contraceptive method. So for me, I don’t see any negative impact of contraception on religious practice or belief.
Unmarried Muslim Woman from Bobo Dioulasso
Because we do, but while continuing to practice our religion. FP is like an aid that allows us to space births; it’s like they say help yourself and God will help you too. One does not prevent the other.
Married Catholic Woman from Bobo Dioulasso
Some of the young women did struggle with their contraceptive use and how this affects their religious practices and beliefs. The messages from their religion are important in affecting their decision-making to use or continue contraceptive use. This unmarried Catholic woman from Ouagadougou expresses these concerns:
I think that what I did is not good because it is a life that I eliminate so I think my faith is a little reduced, it is not complete insofar as my use of FP kills children and I think that after this dose I will stop contraception because I am killing children. (….) Because we were told in church that we kill children when we use FP. That we are reducing the number of children that God has given us.
Perceived consequences from religious community for using contraception
During the interviews, respondents were asked what were the perceived consequences or sanctions a young woman could face if her religious community found out that she was using contraception despite perceived religious prescriptions prohibiting its use. On this subject, some respondents, mostly single Christian women, mentioned consequences from the religious community, such as the denial and withdrawal of certain responsibilities that formerly fell to the young women in question and even a ban on frequenting the church.
Well, for example, if I had responsibilities in the church, they can remove me from my duties, I would no longer be responsible for these responsibilities. They can decide to punish you, but I don’t know but they can even tell you not to come to church for a long time, somehow they punish you.
Unmarried Protestant Woman from Ouagadougou
With us, if you are a young girl and you do the work of God, for example if you sing or if you perform, they will forbid you all that. You won’t be able to do anything for God yet. They’re going to write it down on a paper and read it before the whole church.
Unmarried Protestant Woman from Bobo Dioulasso
Notably, for the majority of respondents across the religions, the expectations of sanctions because of their contraceptive use were rare with the women acknowledging that it is difficult for their families and religious community to know that a woman is using contraception because use is systematically done in a hidden way. For them, the possible consequences that could result from the discovery of contraceptive use would mainly be counseling by religious leaders and also possibly community member stigmatization.
Ah, they will take it badly, it will not be good for me and the reputation of my family who attend the mosque. But it will never happen because I don’t see how they will find out that I use.
Married Muslim Woman from Ouagadougou
Others, on the other hand, consider that there is no need to fear possible negative consequences on the part of the religious community.
Like for example telling me not to come to the choir anymore? Or refusing to allow me to participate in church activities? No no !! They’re not going to do that, it’s not going to get to that level, they’re just going to advise you.
Unmarried Catholic Woman from Bobo Dioulasso
On the contrary, for some young women (mostly Christian) they did not foresee consequences from their religious community. In the end, these women report that the decision to use or not to use contraception remains an individual and private choice, a choice that the young woman or the couple make according to their realities and their well-being.
There is nothing that can happen to her because the others do not know what the person lives to judge her. Since the community doesn’t know why you did the FP, it can’t do anything to you. The use of FP can be a relief for the person; it is a responsibility that only engages the person so the community cannot say anything.
Unmarried Catholic Woman from Ouagadougou
Since it’s our life for both of us, my husband and I, we decide to do so. We are both Protestants and so we follow each other to seek paradise so it’s like that and it’s us who know how to do so that the family is in peace and joy.
Married Protestant Woman from Ouagadougou
Ultimately, according to the women, only God is able to pass judgment on their actions and not the religious community.
The religious community cannot judge people in place of God, that is not their task, it is God alone who judges. Everyone has their own problems and realities so the religious community cannot judge someone.
Unmarried Muslim Woman from Ouagadougou
No, I don’t mind my faith. It is in God that I believe, it is only he who can judge me. A human being cannot judge me. The fact that God does not test me because I use birth control does not bother me.
Unmarried Protestant Woman from Bobo Dioulasso
Overall, although some young women raised fears of sanctions from their religious community regarding the use of FP, for the majority, the consequences of this use can be summed up only in warnings, advice or limited stigmatization. However, the risks of sanctions, even if they exist, are not likely to curb their desire to use contraception, which for them responds to their current social and economic realities. Moreover, they believe that the use of FP remains a private matter that concerns only the young woman (and her husband/partner) and that only God can judge.
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