In this section, I’ll talk about planning your family, including a discussion on birth spacing methods. Then, I’ll tell you about some common female health issues you may experience. Both women and men can have control over when they become parents, which includes spacing their babies. However, planning a family isn’t always easy. There are many things to think about in choosing a birth control method, such as a woman’s health, how well each method works, side effects, and comfort level with using the method. If you just had a baby, planning your next pregnancy is important. Spacing pregnancies at least 12 months apart will give your body time to fully recover. Becoming pregnant again within a year of giving birth increases the chance that the new baby will be born too soon, which can be dangerous for the baby. There are many different ways to space your pregnancies. Not having sex is the only 100% sure way to prevent pregnancy. Another method is continuous breastfeeding. This means a woman exclusively breastfeeds her baby after birth and the baby does not drink anything other than breast milk. This method is only effective for 6 months. There are many benefits to breastfeeding. Early breast milk, which is thick and yellow, is called colostrum. It is very rich in nutrients and antibodies to help protect newborns. After a few days, the colostrum changes to mature milk, which has everything a baby needs to grow. A more long-term method is natural family planning, called natural family planning in English. With this method, sex should be avoided during the days a woman is most likely to become pregnant. There are about 9 or more such days in a month. Generally, these are 5 days before to 3 days after an egg is released from her ovary. There are several methods of natural family planning. One method involves using beads to track the days she is most likely to become pregnant. Another method involves taking daily temperatures since a woman’s temperature goes up slightly after an egg is released. The details of natural family planning are more complex than we can explain here. She will need to talk to her doctor or a natural family planning instructor to learn how to use this method. If a woman is trying to get pregnant, learning about her cycle can also help her achieve this goal. Now, I’ll mention some other birth control methods, just so you know what they are if they are mentioned by your doctor. Some methods involve material barriers to prevent the sperm from reaching the egg, like condoms. Condoms catch the semen and can also protect against sexually transmitted infections. The woman can also insert a device to cover her cervix so the sperm can’t swim up into her uterus. One example is the diaphragm, which comes in different sizes, so a doctor will have to order the right size for a woman. Other methods involve hormones, which require a doctor’s prescription. Hormones can prevent the egg from being released; they also make changes in the cervix to keep the sperm from joining the egg. Hormones can get into a woman’s body by several ways – a pill she swallows, patches she puts on her skin, a rubbery ring she puts in her vagina, or from shots There are also small implants to prevent pregnancy that can be put into a woman’s arm or into her uterus by her doctor. Finally, there are permanent surgical methods to prevent pregnancy if a man or woman are done having children. It is important for a woman to know about her options, and to talk to her doctor about what is best for her and her family. I think birth control is important and children will get a break and the mother will get a break too. Rest is healthy and beneficial for the children and the mother because if the children are spaced apart, when the child becomes a toddler, he will help the mother care for the newborn and with other chores. Her health will be good because she will have gotten some rest as well as the child, but if there is one after the other, they will get jealous. Jealousy and sickness will cause a lot of problems for the mother. She will suffer, therefore spacing the children apart is a very good thing. This is stated in Islamic religious law. How it helped me was that I rested when I spaced my children apart. My child grew up, but if the birth of the following child is too soon after the first, the child will not get a break because I wouldn’t have anyone to assist me with the first one, or my husband was at work or I don’t have any family, so they will give her a hard time. I cannot just take care of this one because they’re both the same and don’t understand. He will insist on being taken care of and will resist the new born because of jealousy. He will ask: Why are you taking care of this baby and will ask me to hold him instead. So, should I take care of the two babies? Do I do the house work? Should I go to school? What can I do? My life is being tested. I would advise other people to do like, to space children apart. I mean, the mother has to think about her health, the health of her baby and her effectiveness in the house and about their finances. Let’s review the female body again. There are 3 holes between a woman’s legs – the small hole where urine comes out of, the vagina where menstrual blood and babies come out of, and the anus where feces comes out of. If a woman has had the Pharaonic form of FGC, the urine hole may be covered up, hidden under her scar. It is important to know that after her scar is opened, her urine will come out stronger. Before, it would dribble out around the scar; when the urine hole is exposed, it can come out more forcefully, naturally. It is important to know that performing FGC on girls under 18 years old is against the law in the U.S. It is also illegal to take girls out of the U.S. to undergo FGC. Some states have laws against performing FGC on adults as well. One of the reasons is because of the health problems FGC may cause. Not everyone who has the procedure will have problems; but, complications are common, especially with the Pharaonic form of FGC which covers the hole where the urine comes out of and restricts the vaginal opening. Complications right after the procedure include infection and too much bleeding, which can lead to death. Later complications can include recurrent urinary tract infections, pain with periods, pain with sex, and difficulty getting pregnant. There may be more problems during childbirth as well. Some of these complications can be relieved by opening the scar. Ideally, the scar should be opened before becoming pregnant, depending on the woman and her husband’s preference. If a woman is already pregnant, the scar should be opened before childbirth; this should be discussed during prenatal visits. After childbirth, a woman may desire to have parts of her scar put back together to restore her own sense of normalcy, or as a result of cultural or familial pressures. This may not be allowed in certain states, and some doctors may not be comfortable with this procedure. In fact, depending on which doctor you go to, there may be varying levels of familiarity with FGC. No matter the doctor’s attitude towards FGC, every woman deserves to be treated with respect by her doctor. Now, let’s talk about a common female health problem: urinary tract infections. In English, this is called UTI. The urine hole is the outside end of a short tube in the body that connects to the bottom of the bladder, which is a sac where the urine is held until it comes out of the body. The bladder is connected at the top by two long tubes that lead to the kidneys, one on either side of the body. Kidneys are the organs that filter a person’s blood and get rid of extra fluid in the body. The kidneys make urine from blood and the urine goes into the bladder. If bad bacteria get into the hole where urine comes out of and go into the bladder, they can cause a urinary tract infection or UTI. Not urinating frequently enough and not being able to completely empty the bladder increase the risk of getting a UTI. FGC also increases the risk of getting a UTI. Signs of a UTI include pain or burning when urinating; an urge to urinate, but not much comes out; urine that smells bad or looks different than usual; pain or pressure in the lower belly; and fever. A woman should contact her doctor if she has any of these signs. This infection can easily be treated with antibiotics. Make sure to follow the doctor’s instructions for taking the antibiotic. A UTI during pregnancy can cause problems, such as having the baby too early. If not treated, a UTI can also spread up to the kidneys, which can cause serious health problems. A doctor can tell if a woman has a UTI by testing the urine. However, if a woman has had the Pharaonic form of FGC resulting in covering the urine hole, any urine sample collected by the patient will not be reliable because the urine is mixed with vaginal fluids. The mixing of fluids makes it difficult to know if the infection is from the bladder or not. Even so, the doctor may still want a urine sample. Discomfort in the genital area can also be from vaginal infections, including sexually transmitted infections that we discussed earlier, as well as other causes, such as yeast infections, called yeast infection in English. Yeast is different from bacteria. There is usually some yeast on human bodies, including in the vagina, but when it grows too much, it causes an infection. Signs include pain with urination, a thick white vaginal discharge, and itching or soreness around the vagina. Yeast infections aren’t cured by antibiotics; antibiotics can actually make the problem worse. Another type of medicine is needed. The doctor will probably ask detailed questions about the woman’s symptoms to determine the cause of her discomfort. As you can see, there is much to learn about women’s special health issues. Our bodies are worth knowing about. Talk to your doctor if you have more questions. We hope the health information you have learned in this video will be helpful to you, whether you are coming to resettle in the U.S., are newly arrived, or have been here for a long time. Women need to learn about their bodies to have good health, which we consider part of successful resettlement. Remember, your doctor can be a resource for you; you should feel free to ask her any questions about your health. If you have access to the internet and can read English, you can find much more about women’s health on this website: www.womenshealth.gov. There are other informative Somali-language health education videos on the internet as well. Take care of yourself.