New studies find women in Africa use covert methods for family planning

Women in Ethiopia, Nigeria and Uganda are often pressured by family and through societal expectations to have more children, but commonly resort to covert or indirect means of contraception to maintain some reproductive autonomy.

This is a central finding from a cross-country study led by researchers at the Johns Hopkins Bloomberg School of Public Health, United States (U.S.).

The findings were presented Wednesday at the 5th International Conference on Family Planning (ICFP) taking place November 12 to 15, 2018 in Kigali, Rwanda.

The investigations by researchers were part of a larger project known collectively as the Women’s and Girls’ Sexual and Reproductive Empowerment (WGE-SRH) study.

In one analysis of the WGE-SRH being presented at the conference, the researchers found that women’s motivations to become pregnant were not only based on their own values, but also shaped by external pressures from husbands, families and communities.

“In northern Nigeria, motivations to bear more children were particularly prevalent in polygamous families, where wives secured their influence and children’s inheritance through childbearing,” one of the researchers said.

A second WGE-SRH analysis found that both male and female interview respondents tended to consider sex principally a marital obligation and a means of procreation.

Sexual pleasure was often an afterthought, and sex outside of marriage was seen as wasteful—except in Uganda, where married men frequently pursued extramarital partners and even married women could do so without sanction if their husbands failed to support them financially.

However, even men and women reporting multiple partners considered faithful monogamous relationships the ideal.

Similarly, in a third analysis, the WGE-SRH team found evidence of widespread covert use of contraception in all three countries, including long-acting injectable contraceptive methods, among women who felt that they could not voice their reproductive choices directly.

For some women, covert use of contraception resulted from disagreements with their husbands over having more children. For others, it was a strategy to delay commitment to a new partner or distance themselves from a failing relationship.

The WGE-SRH study was designed to explore the motivations and constraints women experience and the choices they make concerning sex, contraception and pregnancy.

Ultimately, the researchers have used their findings to construct a cross-cultural index to measure women’s sexual and reproductive empowerment.