Even among married women in Egypt, nearly all of who know about modern methods of family planning and almost 60% of who say they are currently using them, there are still plenty of misconceptions around birth control. There is the occasional rumour, less so now than in the past, that family planning is all a big plot by (choose one of) the West/Muslims/Christians to suppress Arabs/Christians/Muslims. The IUD (or loob, it is commonly called in Egyptian Arabic) is by far the most popular form of family planning for married couples in Egypt, for all the unusual side effects some women associate with it. “The walking IUD [that detaches from the uterus and starts wandering through the body], yes, it’s still a problem,” one Cairo gynecologist told me when I asked about the concerns he hears from patients. “It’s a very common story: that a girl put [in] an IUD, then she had sex, so the IUD got tied around the husband,” he laughed. “And they got stuck and they called an ambulance and they got wrapped in sheets and took them to hospital and separated them.” This even after 30 years of widely publicized family planning campaigns.
Oral contraceptives have their own lore. There are fewer stories these days of women becoming pregnant because they mistook the Pill for any old medication, like aspirin, but the story of “the baby that comes down with pills in his hand, if she takes the oral contraceptives” is still doing the rounds, according to this gynecologist. How oral contraceptives work and the importance of sticking with the regimen is still a mystery to many women, who just take them, on-demand, before or after intercourse. (Ironically, emergency contraception, which can be used up to 120 hours after intercourse, is rarely taken in the Arab region, although it is marketed in more than half-a-dozen countries, including Egypt. Both patients, and physicians, are largely in the dark as to where to get it and how to use it.)
In any case, women in Egypt don’t like the Pill: users often complain it means them feel weak and bloated—a serious problem for poor women when it interferes with their physically demanding routine. Women are not supposed to pray during menstruation, so the spotting which sometimes accompanies the Pill plays havoc with religious routines—should a woman pray or not? (The same rule about menstruation applies to fasting during Ramadan, so the flipside of this phenomenon is that sometimes devout women double up on their doses to block bleeding altogether so they can fast right through the month—with life-threatening consequences.)