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Brenner C, Ugarte WJ, Carlsson I, Salazar M. Men's reproductive coercion of women: prevalence, experiences, and coping strategies-a mixed method study in urban health facilities in León, Nicaragua. BMC WOMENS HEALTH 2021; 21:310. [PMID: 34425798 PMCID: PMC8381564 DOI: 10.1186/s12905-021-01441-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Reproductive coercion (RC) is a common form of violence against women. It can take several expressions aiming at limiting women's reproductive autonomy. Thus, the frequency and how reproductive coercion can be resisted must be investigated. There is limited research regarding RC in Latin America. Therefore, this study aimed to measure RC prevalence and associated factors and to explore the women experiences and coping strategies for RC. METHODS A convergent mixed-methods study with parallel sampling was conducted in Nicaragua. A quantitative phase was applied with 390 women 18-35 years old attending three main urban primary health care facilities. Lifetime and 12 months of exposure to RC behaviors including pregnancy promotion (PP) and contraceptive sabotage (CS) were assessed. Poisson regression with a robust variance estimator was used to obtain adjusted prevalence rate ratios and 95% Confidence Intervals (CIs). In addition, seven in-depth interviews were collected and analyzed using qualitative content analysis. RESULTS Ever RC prevalence was 17.4% (95% CI, 13.8-21.6) with similar proportions reporting ever experiencing PP (12.6%, 95% CI 9.4-16.3) or ever experiencing CS (11.8%, 95% CI 8.7-15.4). The prevalence of last twelve months RC was slightly lower (12.3%, 95% CI, 9.2-16.0) than above. Twelve months PP (7.4%, 95% CI 5.0-10.5) and CS (8.7%, 95% CI 6.1-12.0) were also similar. Women's higher education was a protective factor against ever and 12 months of exposure to any RC behaviors by a current or former partner. Informants described a broad spectrum of coping strategies during and after exposure to RC. However, these rarely succeeded in preventing unintended pregnancies or regaining women's long-term fertility autonomy. CONCLUSIONS Our facility-based study showed that men's RC is a continuous phenomenon that can be enacted through explicit or subtle behaviors. Women in our study used different strategies to cope with RC but rarely succeeded in preventing unintended pregnancies or regaining their long-term fertility autonomy. Population-based studies are needed assess this phenomenon in a larger sample. The Nicaraguan health system should screen for RC and develop policies to protect women's reproductive autonomy.
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Affiliation(s)
- Cecilia Brenner
- Regional Office of Communicable Diseases, Uppsala, Uppsala Region, Sweden
| | - William J Ugarte
- Department of Women's and Children's Health, International Maternal and Reproductive Health and Migration Research Group, Uppsala University, Uppsala, Sweden
| | - Ida Carlsson
- Doctors of the World/Médecins du Monde, Stockholm, Sweden
| | - Mariano Salazar
- Department of Global Public Health, Global and Sexual Health Research Group, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden.
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Kupoluyi JA. Intimate partner violence as a factor in contraceptive discontinuation among sexually active married women in Nigeria. BMC WOMENS HEALTH 2020; 20:128. [PMID: 32552670 PMCID: PMC7302369 DOI: 10.1186/s12905-020-00990-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/12/2020] [Indexed: 11/23/2022]
Abstract
Background In spite of the well-established associations between socioeconomic and demographic factors and the high rate of contraceptive discontinuation among sexually active married contraceptive users, little is known in Nigeria about the relationship between contraceptive discontinuation and sexually active married women who have experienced Intimate Partner Violence (IPV). Methods The 2013 Nigeria Demographic and Health Survey data on women’s reproductive calendars and domestic violence were used to investigate the relationship between IPV and contraceptive discontinuation in a year period. A weighted sample size of 1341 women in a union in the domestic violence module, who have experienced IPV, and are using any contraceptive and are not sterilized in the 12 months periods was analyzed using frequency tables and chart, Pearson’s chi-square test, and binary logistic regression model. Results The results showed that women who have experienced any type of IPV are 1.28 times more likely to have discontinued contraceptive use although they are still at risk of becoming pregnant (aOR = 1.28, CI: 1.15–1.91; p < 0.05) than those who have not experienced IPV. The tertiary level of education (aOR = 3.94, CI = 1.67–9.29; p < 0.05), unemployed status (aOR = 1.97, CI = 1.07–3.62; p < 0.05), and higher marital duration of 20 years and above (aOR = 4.89, CI = 2.26–10.57; p < 0.05) significantly influenced women who have experienced any types of IPV to discontinue contraceptives even though they are still at risk of becoming pregnant than those who have not experienced IPV. Conclusion The study revealed that women who have experienced any form of IPV were significantly influenced by their education, occupation, the number of living children, and marital duration to discontinue contraception while still at risk of becoming pregnant. Thus, the study concludes that intervention programmes aimed at increasing contraceptive prevalence rate should be mindful of IPV which may affect women’s use of contraceptives.
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Affiliation(s)
- Joseph Ayodeji Kupoluyi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Kriplani A, Sehgal R, Konar H, Vivekanand A, Vanamail P, Purandare CN. A 1-year comparison of TCu380Ag versus TCu380A intrauterine contraceptive devices in India. Int J Gynaecol Obstet 2019; 145:268-277. [PMID: 30919459 DOI: 10.1002/ijgo.12809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/30/2018] [Accepted: 03/22/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare TCu380Ag and TCu380A intrauterine contraceptive devices after 1 year of use. METHODS A prospective randomized controlled trial was conducted among healthy married women aged 20-35 years who attended the family planning clinics of three tertiary centers in India between August 1, 2015, to March 31, 2018. The TCu380Ag group (n=300) received one of three sizes of this device depending on uterocervical length: maxi (8.0-9.0 cm), normal (7.0-8.5 cm), or mini (6.0-7.5 cm). The remaining 300 participants received TCu380A. Follow-up was conducted at 3-monthly intervals to assess continuation rate, acceptability, efficacy, adverse effects, and complications. RESULTS The TCu380Ag group had a higher continuation rate than the TCu380A group at 1 year (84.0% vs 75.8%; P=0.01), with an efficacy of 99.6% versus 100.0% (P>0.05). Overall estimated continuation rates were 94.5% (95% confidence interval [CI] 91.7%-96.4%) and 88.4% (95% CI 83.2%-91.5%), respectively (P=0.026). Use of TCu380Ag was associated with fewer adverse effects (heavy menstrual bleeding, abdominal pain, or expulsion) when compared with TCu380A (P>0.05 for all comparisons). Discontinuation rates owing to adverse effects were 6.59% for TCu380Ag versus 13.26% for TCu380A (P=0.01). CONCLUSIONS Varying sizes of TCu380Ag could provide an alternative to TCu380A.
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Affiliation(s)
- Alka Kriplani
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohini Sehgal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Hiralal Konar
- Department of Obstetrics and Gynaecology, Calcutta National Medical College and Hospital, Kolkata, India
| | - Achanta Vivekanand
- Department of Obstetrics and Gynecology, Prathima Institute of Medical Sciences, Karimnagar, India
| | - Perumal Vanamail
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Chittaranjan N Purandare
- Department of Obstetrics and Gynaecology, Indian College of Obstetricians and Gynaecologists, Purandare Hospital, Mumbai, India
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Grace KT, Fleming C. A Systematic Review of Reproductive Coercion in International Settings. WORLD MEDICAL & HEALTH POLICY 2016; 8:382-408. [PMID: 28503353 PMCID: PMC5423714 DOI: 10.1002/wmh3.209] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Reproductive coercion is behavior that interferes with a woman's autonomous reproductive decision-making. It may take the form of birth control sabotage, pregnancy coercion, or controlling the outcome of a pregnancy. Perpetrators may be partners, a partner's family, or the woman's family. This article reviews the literature on reproductive coercion in international settings. In this review of 10 research studies, findings are presented on prevalence and type of reproductive coercion, associated factors, specific tactics, relationship with intimate partner violence and domestic violence (in-laws particularly), and implications for women's reproductive health. Findings highlight reproductive coercion as a subset of intimate partner violence that is poorly understood, especially in international settings. More research is needed on protective factors, how interventions can capitalize on protective factors, and the strategies women use to resist reproductive coercion. Policy implications and recommendations are discussed with particular attention to issues related to diverse social and cultural environments.
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Affiliation(s)
- Karen Trister Grace
- Johns Hopkins University School of Nursing, an Adjunct Instructor at Georgetown University School of Nursing & Health Studies, and is in clinical midwifery practice at Mary's Center in Adelphi, MD
| | - Christina Fleming
- Johns Hopkins University School of Nursing, an Adjunct Instructor at Georgetown University School of Nursing & Health Studies, and is in clinical midwifery practice at Providence Hospital in Washington, D.C
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Afolabi BM, Ezedinachi EN, Arikpo I, Ogunwale A, Ganiyu DF, Abu RA, Ajibade AA. Knowledge, non-use, use and source of information on contraceptive methods among women in various stages of reproductive age in rural Lagos, Southwest Nigeria. Open Access J Contracept 2015; 6:65-75. [PMID: 29386924 PMCID: PMC5683143 DOI: 10.2147/oajc.s80683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Contraceptives are advocated to be used against unwanted pregnancy and sexually transmitted diseases as unsafe abortion contributes to high maternal mortality in Nigeria while unwanted pregnancies have terminated the educational development of many females. Objective This questionnaire-based survey aimed to describe the knowledge, nonuse, and use of various contraceptive methods among women in different child-bearing age groups in rural Lagos, Nigeria. Materials and methods Between 2012 and 2013, 816 females in rural communities within Lagos State were surveyed for their knowledge, source of information, and use of contraceptives. They were grouped into early, mid, and late reproductive age. Statistical analysis of data harvested from respondents was carried out using STATA 13 software. Results In all, 816 females in different stages of reproductive age were involved in the study, among whom 19% were single, 78% married, 3% divorced, and 0.5% widowed. About 6% had no formal education, while the majority (81%) were of the Yoruba ethnic group. Married respondents were approximately thrice more likely to know of contraceptives than single respondents (χ2=29.9, P=0.000, odds ratio =2.9, 95% confidence interval =1.9, 4.2). Condom use was the most widely known and used method of contraceptive regardless of marital status and reproductive age status. Information about contraceptives was mainly from health facilities among married and divorced women and from school or educational institution among singles. Overall prevalence of contraceptive use was 51.9%. Nonuse of contraceptives was 43% among married women and 67% among singles. Knowledge of contraceptive method was negatively associated with marital status (t=−2.24, P=0.025) but positively associated with source of information on contraceptives (t=20.00, P=0.000). Use of contraceptives was positively associated with stage of reproductive age (t=1.94, P=0.05) and source of information on contraceptives (t=11.22, P=0.000), but negatively associated with marital status (t=−2.79, P=0.005) and religious belief (t=−1.89, P=0.05). Conclusion Knowledge and use or nonuse of contraceptives could be pivotal in designing adequate prenatal care to prevent unwanted pregnancy and consequently illegal abortion or possible adverse pregnancy outcomes such as low birth weight, preterm birth, and conditions such as small for gestational age. Data from this study can also be used to design penetrating health education on making pregnancy safer or living a healthy female reproductive life.
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Affiliation(s)
| | | | - Iwara Arikpo
- Institute of Tropical Disease and Research, University of Calabar, Calabar, Nigeria
| | | | | | - Rashidat A Abu
- Health, Environment and Development Foundation, Yaba, Lagos, Nigeria
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Sharma M, Joshi S, Nagar O, Sharma A. Determinants of intrauterine contraceptive device discontinuation among Indian women. J Obstet Gynaecol India 2014; 64:208-11. [PMID: 24966507 DOI: 10.1007/s13224-014-0516-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 01/21/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To determine intrauterine contraceptive device (IUCD) discontinuation rate and its causes and related factors among women attending the OPD/family planning clinic in Mahila Chikitasalaya, SMS Medical College, Jaipur from January 2012 to December 2012. METHODS 387 women who had an intrauterine device (IUD) inserted during the last 1-5 years were interviewed during their visits to the OPD/family planning clinic. Sociodemographic characteristics for all women were described using frequency distribution. Life tables were used to describe the proportion of women who discontinued IUD at various time intervals. The main outcome measure was IUD discontinuation. RESULTS The incidence of IUD discontinuation in the first year following insertion was 16.79 %. Approximately 31 % of the study sample continued using their devices after 5 years. The average duration of IUD use was 36 months. Of the 387 women, 56 % discontinued IUD use because of a desire to conceive, 27.7 % because of side effects, 15.36 % because of opposition from the woman's family, and 1.5 % because they were sexually inactive. The most common side effects reported as the reasons for discontinuation were bleeding, infection, and pain. Discontinuation was inversely related to the age at insertion, the number of living children, and the sex of children. Previous contraceptive users were significantly less likely to discontinue IUD use. CONCLUSIONS The crude cumulative rate of IUD discontinuation was 16.79 % during the first year, suggesting a need to tackle the problem of discontinuation through effective educational strategies and counseling techniques. Desire to have a male child still predominates among Indian families. The average duration of IUD use in majority of the females was about 36 months (45 %), thereby fulfilling its objective of spacing between children as laid down by the WHO (2 years spacing between pregnancies). About 31 % of the women continued using IUCD even after 5 years. It is crucial to correct misconceptions and identify the lack of correct and complete information both among the providers and the acceptors, to improve the effectiveness of family planning programs.
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Affiliation(s)
- Megha Sharma
- Obstetrics & Gynaecology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Shubham Joshi
- General Medicine, SMS Medical College, Jaipur, India
| | - Oby Nagar
- Obstetrics & Gynaecology, SMS Medical College, Jaipur, 302004 Rajasthan India
| | - Akash Sharma
- Pediatrics, Dr. S.N Medical College, Jodhpur, India
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Modelling geographical variations and determinants of use of modern family planning methods among women of reproductive age in Nigeria. J Biosoc Sci 2012; 45:57-77. [PMID: 22739073 DOI: 10.1017/s0021932012000326] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Summary Understanding the level, trend, geographical variations and determinants of use of modern family planning (FP) plays a major role in designing effective interventions leading to increased usage. This study assessed these characteristics of FP use in Nigeria using data from the 2003, 2005 and 2007 National HIV/AIDS and Reproductive Health Survey, a national population-based household survey. A Bayesian geo-additive procedure was used, which provides flexible modelling of non-linear and spatial effects at a highly disaggregated level of states. The findings reveal considerable geographical variation in the use of modern FP in Nigeria, with a distinct north-south divide. Furthermore, a significant trend in the use of modern FP was evident, with an increase between 2003 and 2005 followed by a decline between 2005 and 2007. The effect of respondent's age was non-linear, and use of modern FP was found to differ significantly between never-married and currently/formerly married respondents. Awareness of FP methods and knowledge of where to get/buy FP services/methods were found to be significantly associated with usage. The findings provide policymakers with tools to prioritize the use of scarce resources for implementing FP and reproductive health interventions.
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