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Family Planning In Senegal: Which Imam Do You Listen To?

"This is the last one," says Yassin Diouf, 40, holding the youngest of her six children. Four others died. "Maybe [family planning] is forbidden by Islam, but women are so tired of giving birth. If you have the permission of your husband, I think it's good."

In the village of Mereto, Ngour Sen, 56, reclined on a green foam mattress next to a pile of massive rice bags in the seclusion of his storeroom. His 11 children and two wives loitered just outside in the yard, chatting while the women shelled peas. In the background, RSI, Senegalese state radio, droned. "We never switch it off," he said.

From religious leaders on talk shows to interviews with doctors, there has been a lot of discussion on the radio lately about contraception, referred to as family planning. That's how Sen's first wife, Yassin Diouf, 40, learned about the concept: a public service announcement. She told her husband, "I heard that giving birth every year is not good for the health of women, so I want to do family planning like I heard on the radio."

Not many Senegalese women have embraced family planning. The country of 13.7 million has one of the lowest rates of contraceptive use in the world: 16 percent. And the fertility rate is one of the highest: five births per woman. Diouf has given birth 10 times and has six surviving children; Sen's second wife, Sanou Ndiaye, 30, has five.

The women of this 94 percent Muslim nation hear a mixed message in the religious arena. The Quran promotes large families to expand Islam but also advocates breast-feeding and spacing births. An obscure passage permits traditional birth control in certain situations. As a result, some imams support modern contraception and others don't.

Grass-roots activists, meanwhile, have long pushed for increased access to contraceptives, pointing to economic and health benefits for women who have fewer children. Recently the government, with international support, has made a huge push for family planning. In 2012 Senegal committed to doubling its budget for contraceptives and set the goal of 27 percent contraceptive use by 2015. The latest stats show an increase in contraceptive use to 16 percent after years at around 12 percent.

In rural Mereto, the decision to try family planning isn't simple. First Diouf felt she needed her husband's permission; he suggested they go to the hospital to learn more.

Then they consulted the imam.

"Islam has a very, very, very important role in my life," said Sen, who talks about everything with his local imam, Oustaz Sherif Ousmane Keita, 35.

Keita believes Islam allows contraception; even his wife uses it. Both of Sen's wives have followed suit. But if Sen had gone to the other village imam, he may well have heard different advice.

That imam, Ibrahima Diallo, 40, thinks birth control is only permissible to put two years between children, the period prescribed for breast-feeding in the Quran. "In Islam we cannot say there is an ideal-size family, it is God willing. If it is two children that God gives you, that's good; if there's 20, that's good. Having a baby depends on God's will."

The disagreement between Mereto's two village imams presents a microcosm of the nationwide religious conflict.

"In the Quran we can find everything — we can justify to not do family planning or we can justify to do family planning," explained Codou Bop, a feminist and member of the Women Living Under Muslim Law network.

Women's health organizations and the ministry of health partner with imams who promote family planning. But some religious leaders think the pro-family planning preachers are sellouts.

Radio devotee Sen says, "I think of what Islam says first, then I do what I have to do." Both of his wives, along with many women, are less interested in religious input. Ndiaye, the younger of the two, says she thinks of the Quranic directive to multiply the Muslim population, "but my health is very important. If I die, they will forget me, someone else will continue to give birth, so my health is first."

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