May 07 2014
James and Jena Lee Nardella
Originally published in The Tennessean, May 3, 2014
When we married in December 2007, we knew we wanted to enjoy the adventure of marriage together for a while before having children. So, we concocted a whimsical battle cry: “Baby Free Until 2013!”
In summer 2013, after thoughtful conversations, we decided to go off birth control. And lo and behold, we quickly became pregnant. The battle cry worked.
As we watch Jena’s belly grow, we realize how fortunate we were, especially as some of our closest friends and family have not had nearly as much ease. We also recognize that for many, contraceptive access and the ability to time pregnancy are not universal.
You see, we work for two organizations that provide health care to HIV-infected and affected people in Africa, and we have been given a unique window into the lives of many girls, women and men in countries like Kenya, Uganda, Zambia, Ethiopia, Rwanda and Central African Republic. For our friends in that part of the world, the nuanced discussion of family planning is very different than the one we hear in the U.S.
In Lwala, Kenya, 16-20 percent of the adult population is HIV-positive. The Lwala Community Hospital is providing more than 1,000 HIV patients with life-saving medical care. Many of these patients come to us for contraceptive options.
Try to imagine that you are our friend Maurice. You are facing some frightful questions because you are HIV-positive, but your wife, Betty, is not. A nurse explains to you that the hospital is out of condoms, so you must abstain from sex or risk infecting Betty. The nurse says the condom shortage is nationwide and there is nothing she can do.
Imagine that you are our friend Sarah. You are just 13 and a new mother to a premature baby boy named Moses. You have had to drop out of school to care for your new child. You did not plan on getting pregnant, but an older relative forced himself on you while he was drunk. Your parents know about the rape but have decided not to confront the relative and instead blame you. Your circumstance makes you one of the 300 pregnant teens who delivered their babies at Lwala Community Hospital last year.
When you bring Moses in for immunizations, you ask the nurse for birth control pills, but she tells you they are not available to you without parental permission. “How do I avoid getting pregnant again?” you ask.
For us as Americans, these seem like unimaginable predicaments related to contraception — catch-22s with life-altering consequences. But, sadly, these stories are not unique in Africa.
We are Christians, propelled by our faith in a loving and merciful God to do the work we do. Most of the year, we make our home in Tennessee. We are not abortion-rights activists or “lefty liberals.” We understand why some people of faith are hesitant to support increased access to contraceptive choices. But our view has been broadened through our experiences and the many conversations we’ve had with families in Africa.
The nuanced circumstances of couples like Maurice and Betty, or young teenagers like Sarah, cannot be addressed with one-dimensional responses. We must take seriously the complexity and urgency of the dilemma for many around the world. International policies, politics and financing must do more to account for the real predicaments people face.
We believe that families have the right to time their child-rearing; protect themselves against HIV; and pursue healthy, productive and prosperous lives. We believe that teenage girls should be able to avoid unintended pregnancies and the difficult decisions and desperate measures that sometimes follow. And we believe that access to contraception is critical to reducing poverty and promoting health.
As we welcome our newborn baby, we invite you to join us in respectfully broadening the conversation around contraception to include the perspective and urgency of our friends in Africa.
James and Jena Lee Nardella live in Nashville. James is executive director of Lwala Community Alliance, and Jena is co-founder of the nonprofit Blood:Water Mission.