Contraception Affects Women's Lives -- October 6, 1998

RESEARCH TRIANGLE PARK, NC -- Quality of life depends not only on good health and physical well-being, but also on a variety of other circumstances. These include family stability and harmony, the welfare of children, and freedom to enjoy various activities including leisure, education or community pursuits.

Having access to safe, effective, affordable and acceptable contraceptive choices can influence nearly all of these aspects in a woman's life, according to recent research by Family Health International's (FHI) Women's Studies Project (WSP). For example, women's decisions about having children and pursuing paid employment are seldom made independently of each other. Access to good family planning options can improve a woman's prospects for employment, resulting in both financial and personal benefits, including better self-esteem. This, in turn, can enhance the quality of life for all family members, WSP social scientists say in FHI's current issue of Network.

The scientists examined how contraceptive use influences women's lives in 26 studies conducted in 10 very diverse countries, with an eye on common issues that seem to emerge in nearly any cultural setting. While many studies have been conducted on how women's lives influence their use of contraception, very little research has been done on the reverse question -- how contraception and family planning services affect women's lives.

Whether women feel they benefit from contraceptive use, and if so, how, were fundamental issues in these studies. The project looked beyond the narrow focus of how contraception affects women's health to many other aspects of life, such as how contraception affects women as individuals, family members and participants within their community.

"While women perceive numerous benefits of family planning use, they also see negative consequences, such as family disapproval and method side effects, which can discourage them from taking control of their fertility," says FHI's Dr. Nancy Williamson, who guided much of the WSP research. Understanding these intricate realities of women's lives, she says, can help shape better family planning services that match women's needs and, ultimately, help improve people's lives.

Two general themes emerged from the research: that gender norms (the roles prescribed by society for women and men) play a significant role in shaping women's family planning experiences, and that family planning affects multiple domains of women's lives -- domestic, economic and community.

Fourteen more specific themes were also drawn from the studies. For example, most women in nearly any culture are convinced that practicing family planning and having smaller families provide health and economic benefits. On the other hand, when women's partners or others are opposed to contraceptive use, women are more vulnerable.

Domestic violence, for example, is often linked to reproductive health concerns. "The threat of violent behavior prevents women from protecting themselves adequately from pregnancy, abortion and sexually transmitted diseases," Naana Otoo-Oyortey, a gender consultant with International Planned Parenthood Federation in London, says in one Network article. "It leads women to defer to male decision-making on what form of contraception they are allowed to use, which may not be effective or right for them."

Domestic violence is widespread. One FHI study in Latin America found that 50 percent of women interviewed said they had been physically assaulted by their partners, and a third of them said they had been forced to have sex against their will. In the United States, about one in four women interviewed reported that she had been abused at least once by her partner, according to the World Health Organization's Women's Health and Development Programme.

Other WSP findings explored in Network articles include the impact men and other family members have on women's family planning decisions; how contraceptive use influences paid employment or career prospects; and what people say they want from family planning services.