jane called to tell me a girl had arrived. â i understood her to mean her sister had come from brazil. "no" she said "i had a baby girl". i was surprised. i congratulated her, but in the back of my mind i was worried she had graduated from our eipp program at the guidance center 10 months earlier with her third child. at that point, jane told me she did not want more children, her life was already complicated enough. for years earlier, jane traveled from brazil to boston with her two young sons to reunite with her husband. she crossed the rio grande at night clinging to an intertube and grasping her boys
terrified by the sounds and smells in the churning water. once she got to boston, she thought her troubles would be over, but they had just begun. her sons had difficulty adjusting to school, her husband could not keep a steady job. jane was overwhelmed, depressed and felt worthless. i met jane when she was 5 months pregnant with her third child, michael, and began working with her. over time, eipp helped her in many ways. our social worker provided parenting support and the boys received additional services in school. once michael turned 1, eipp services ended. it had been almost a year since i last spoke with jane.
and the news about her fourth child, michaela, made me wonder how to provide better health education. after the phone call, i sat down with jane and asked her about her plans for birth control. about birth control pills, she said her friend had told her she would die. and she worried about remembering to take her pill every day. about the iud, jane said, "another friend told me, each time you had sex you have to adjust your iud and that is gross" before her fourth baby was born, jane signed papers for a tubal ligation but this procedure never happened. there was no doctor on call to do the surgery so she was told to return in six weeks. jane explained, " i couldn't go back to the hospital, " "who would take care of my kids? and i did not want my baby to stop breastfeeding."
we assume birth control education happens in the doctor's office and that it is a straight forward procedure of choosing a method. little did i know family planning is not as simple as rattling off a list of options or handing out brochures. jane taught me that if women are afraid of birth control,they will not use it.
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