Use of placenta rituals as family planning method
By Tony Wafula, June 24, 2025Long before the introduction of modern contraceptives, many African communities practised traditional birth rituals that served not only spiritual purposes but also functioned as forms of family planning.
Among these practices was the placenta ritual mixed with herbs, a method believed to influence fertility and determine the spacing or number of children a couple would have.
The World Health Organisation (WHO) reports that traditional family planning methods have experienced a global decline in use since 1990, with a shift toward modern methods.
However, traditional methods remain relevant, particularly in areas with lower overall contraceptive use or where individuals prefer them. The WHO emphasises the importance of access to a full range of family planning methods, including modern ones, for informed reproductive choices.
Traditional practices
In Bungoma, 78-year-old Florence Nakhumicha, a traditional birth attendant and herbalist, recalls how couples in her community would rely on placenta rituals to manage childbirth.
According to her, burying the placenta and umbilical cord mixed with herbs inside the house signalled a desire to stop giving birth.
“In those days, we did not have the modern family planning methods that people use today,” Nakhumicha said, adding that the placenta ritual was the only sure way for a woman to control how many children she wanted.
She explains that if a woman wished to stop having children, she would consult a traditional midwife, who would perform the ritual using natural herbs.
This form of birth control was deeply rooted in cultural beliefs and carried out with utmost respect and secrecy.
Despite her traditional background, Nakhumicha encourages the use of modern family planning today, though with caution.
“I support modern family planning but couples should have at least four children or more,” she advises.
“You never know what misfortunes life may bring. If you only have one or two children and something happens to them, you may end up with none.”
Expert perspectives
Nakhumicha began her journey as a birth attendant in 1974. Despite being illiterate, she has helped thousands of women give birth safely.
However, due to rising health risks associated with unskilled birth attendance, the Ministry of Health has asked traditional midwives like Nakhumicha not to assist with actual deliveries.
Instead, they refer women to hospitals for skilled delivery to avoid maternal deaths.
“Four years ago, we held a meeting with health officials in Bungoma. They asked us not to deliver babies anymore because of complications that may arise,” she says.
“Now, I have phone numbers of nurses at local clinics. If something goes wrong, I call them immediately.”
Dr Isaac Misiko, a researcher and consultant in herbal medicine, echoed Nakhumicha’s sentiments, noting that the placenta ritual was among the traditional family planning methods that couples used.
He explains that once a woman felt ready to get pregnant again, she would approach the herbalist, who would reverse the situation to allow her to conceive.
“The placenta ritual is not a permanent family planning method, as after undergoing the ritual, the woman can be given herbs to reverse the situation,” Misiko stated.
Misiko explained that if the herbalist who conducted the ritual died, there were special herbs used to reverse the effects of the ritual.
He revealed that traditional birth control methods also included unconventional practices such as collecting male and female sperm in a piece of cloth after intercourse and placing it beneath a water pot—a ritual believed to render the man sexually inactive.
He also mentioned that certain types of food consumed by men were thought to influence their sexual performance and fertility.
“The type of food consumed by both men and women plays a role in reproduction; there are some meals that activate libido,” he said.
Misiko expressed his disagreement with modern family planning methods, claiming they cause side effects in users such as heavy menstrual flows.
Family planning statistics
The Kenya Demographic and Health Survey (KDHS) 2022 reports that in Kenya, 70 per cent of sexually active unmarried women use any method of family planning, with 59 per cent using a modern method.
The most popular type of family planning method for sexually active unmarried women is the male condom. The use of implants is higher in rural areas (16 per cent) than in urban areas (7 per cent).
The KDHS further reports that 63 per cent of married women aged 15-49 use any method of family planning, with 57 per cent using a modern method and 6 per cent using a traditional method.
The most commonly used methods among married women are injectables (20 per cent), implants (19 per cent), and pills (8 per cent).
Transition to modern methods
Diviniza Ochwila, a senior nursing officer and reproductive health nurse at Bungoma County Referral Hospital, reveals that in the past, communities had not embraced modern family planning methods, saying it has been an uphill task for both healthcare workers and the community at large.
She attributed resistance from some communities to modern family planning methods to deeply rooted cultural and religious beliefs. According to her, these communities view contraception as a violation of their traditional values and spiritual doctrines.
Ochwila said that to make communities understand and embrace family planning, Marie Stopes came up with awareness campaigns in the region that helped people understand the benefits of modern family planning methods.
“We appreciate Marie Stopes because they have carried out frequent family planning workshops for healthcare providers, administrators, midwives and the community health promoters (CHPs) that have helped people understand the importance of family planning,” she noted.
Due to the values and religious beliefs held by some healthcare workers, nurses faced challenges in delivering family planning services, as these personal convictions often acted as barriers to service provision.
“When the Marie Stopes programme came, they were able to train healthcare workers to have the knowledge and to let them know that it is not about their value but about clients seeking the services,” she said.
Changing attitudes
Ochwila reports that in Bungoma, a significant portion of the community that was previously opposed to modern family planning methods has now embraced them.
According to her, increased awareness campaigns, community sensitisation, and the involvement of local leaders and health workers have played a crucial role in changing attitudes.
Many residents are beginning to understand the health and economic benefits of family planning, leading to a gradual shift from traditional beliefs to modern and medically approved methods of contraception.
“The opinion leaders, community health promoters (CHPs) and administrators have been trained in the communities and are the ones helping us in creating awareness about family planning methods,” she stated.
“The CHPs are people who visit the homes now and then on health matters, so when a health promoter visits a community, he or she is able to see and interact with them on how their health behaviour is. If they find that the family is having several young children or malnourished children, they would try and find out if the family has any knowledge about available family planning methods,” she said.
At Bungoma County Referral Hospital, Ochwila says they provide several family planning methods ranging from short-term to long-term. The short-term methods give clients an opportunity to return to the facility after three months to report on how the method has worked for them.
The available family planning methods include injectables, oral contraceptives, implants, intrauterine devices, vasectomy, and tubal ligation.
“Before the client is given a method, she should have an education process about it and her health history taken to ensure that they decides on the best method that fits,” she said.