Why some women still get pregnant while using family planning methods
By Tony Wafula, July 21, 2025Adelight Khayanje, a resident of Sango in Tongaren constituency, Bungoma County, had relied on the coil as a long-term contraceptive method, believing it would offer her full control over her reproductive health.
For 12 uninterrupted years, Khayanje, a mother of six, was on the coil and remained confident that she had made the right decision.
“I opted for the 12-year family planning method because I wanted to raise the children I already had and only plan for another child when I was ready,” she explained.
Further, Khayanje said that after the 12 years had lapsed, she had the coil removed at a local health facility. She successfully conceived and gave birth to her planned lastborn child. Everything seemed to be going according to her intentions.
“After giving birth to my lastborn, I went back to the hospital and had another coil inserted,” she said, adding that this time she was certain that she had closed the chapter of giving birth.
Felt disappointed
However, just three months after the procedure, Khayanje was shocked to discover that she was pregnant again.
“I was disappointed after getting pregnant, especially because it was not in my plan,” she recounted. “I had trusted the method and was shocked that I conceived even after getting the coil,” she added.
Khayanje strongly believes that the mistake may have stemmed from a poorly executed procedure.
“It’s possible that the person who inserted my coil did not do it properly,” she said.
Despite her personal experience, Khayanje, a Community Health Promoter (CHP), remains an advocate for family planning.
She emphasises that while contraceptives are helpful, they are not foolproof.
“Family planning methods aren’t 100 per cent perfect. Women and couples should be made aware of that reality,” she said.
Khayanje has now taken it upon herself to sensitise fellow women and families in Sango and surrounding areas about the importance of family planning while also educating them on the potential risks and limitations.
She commended organisations such as Marie Stopes for their efforts in helping families access reproductive health services in rural areas.
“Marie Stopes has played a big role in supporting couples in our villages to plan their families. We’ve seen reduced cases of unplanned pregnancies and more women are empowered to make informed choices,” she said.
“Let us not shy away from planning our families, but let’s also remember to follow up on our reproductive health and ask questions when things don’t feel right,” she affirmed.
Highly effective
The Kenya Demographic and Health Survey (KDHS) 2022 report shows that in Kenya, 70 per cent of sexually active unmarried women use any method of family planning; 59 per cent use 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 most commonly used methods among married women are injectables (20 per cent), implants (19 per cent) and pills (8 per cent).
Diviniza Ochwila, a senior nursing officer and reproductive health nurse at Bungoma County Referral Hospital (BCRH), confirms that although modern family planning methods are highly effective, there remains a slight possibility for a woman to become pregnant while using them.
However, she emphasised that several factors may contribute to this outcome.
According to Ochwila, it is true that some women on family planning methods can still get pregnant.
The risks are minimal, just about one per cent, but they do exist depending on individual circumstances.
She explains that factors such as inconsistency in using contraceptives and interactions with certain medications could compromise the family planning methods effectiveness.
“There are specific medications that interfere with the effectiveness of contraceptives. For instance, conditions like obesity and diabetes mellitus can affect hormonal balance and enzyme activity in the body, which in turn alters the way contraceptives work. That is why we always conduct a thorough medical assessment before giving any family planning method,” she said.
She further noted that other health conditions, such as breast and cervical cancer as well as pulmonary diseases, may also impact the suitability and performance of contraceptives.
Ochwila highlighted that women who opt for short-term contraceptive methods, such as oral pills, are particularly vulnerable to unintended pregnancies if they fail to adhere strictly to the prescribed schedule.
“These pills are meant to be taken daily at the same time. If a client forgets to take the medication or fails to follow instructions, the chances of becoming pregnant increase,” she said.
In such cases, she advises the use of back-up methods like condoms.
“One out of every 100 women using any form of family planning might still end up getting pregnant,” said Ochwila.
At Bungoma County Referral Hospital, Ochwila confirmed that cases of method failure have been reported even with correct usage.
She gave an example with intrauterine contraceptive devices (IUCDs), noting that although they are long-term and reliable, there are occasional complications.
“Some clients experience severe cramping after IUCD insertion. In such cases, they should take pain relievers like paracetamol, and if the pain persists, they must seek medical help immediately,” she said.
She explained that after insertion, the body may treat the IUCD as a foreign object. As a result, the device could be expelled without the client realising it, leading to an unintended pregnancy.
“That’s why we require clients to come back for follow-up visits one month after insertion, then during the third and sixth months. By the sixth month, the uterus usually adjusts to the device, reducing the risk of expulsion,” she affirmed.
Ochwila also emphasised the importance of expertise during IUCD insertion.
She noted that measuring the uterus before insertion is vital.
“If the uterus is below 4.5 cm, and we insert the device, it may not reach the correct position and could fall out. If the uterus is larger than 9 cm, the IUCD might not sit close enough to the endometrial walls, making it easier for sperm to reach the egg, which could lead to conception despite the presence of the device,” she said.
Need for education
Despite this, Ochwila assured that such incidents are rare.
“Roughly one in every 1,000 women with an IUCD might still conceive. When that happens, we advise the client to return for further consultations and monitoring.”
On condom use, Ochwila clarified that they are often misunderstood, adding that many people think condoms are just for pleasure, but they are also a valid family planning method.
However, she noted that improper condom use can result in pregnancy.
“We have witnessed cases where condoms burst during intercourse. If this happens and the client doesn’t seek emergency contraceptive pills, especially during ovulation, she could become pregnant,” she stated.
She also reported incidents of condoms slipping off and remaining inside the vagina.
“When this happens, semen is still deposited into the reproductive tract. If the woman is fertile and doesn’t take emergency contraception, she could conceive,” she said.
Ochwila stressed the need for education, proper medical assessments and consistent follow-ups for all clients using any method of family planning.
“Family planning is effective, but only when used correctly and with adequate medical guidance,” she said.
Ochwila said that to help communities understand and embrace family planning, Marie Stopes came up with awareness campaigns in the region, which have been beneficial.