Autonomy in the reproductive health of quilombolas women and associated factors

Evaluation of the psychometric properties of the Reproductive Autonomy Scale for use in the UK

BACKGROUND

Reproductive autonomy-control over outcomes including contraceptive use and childbearing-is a human right and vital to women's empowerment. Those whose reproductive autonomy is threatened by the structures and relationships in their lives are at risk of coercion and unplanned pregnancy and could benefit from additional services. The Reproductive Autonomy Scale (RAS) was developed in the USA to assess women's reproductive autonomy; this study evaluates the RAS for use in the UK.

METHODS

After testing, the RAS was incorporated into an online survey of women of reproductive age. Those who were sexually active were asked to complete the RAS, which was evaluated according to classical test theory. Reliability was assessed via internal consistency and a 3-month test-retest. Construct validity was assessed using hypothesis testing and confirmatory factor analysis.

RESULTS

For 826 women the RAS was highly acceptable, with a response rate of >97.7%. Almost the whole range of reproductive autonomy scores were captured. Internal consistency was good, with a Cronbach's α of 0.75. Test-retest reliability was fair-good with an intraclass correlation coefficient of 0.67. Construct validity analysis found the scale to be valid based on our hypothesis that among women who want to avoid pregnancy, those with higher reproductive autonomy will be more likely to use contraception. The three-factor structure of the scale was confirmed on confirmatory factor analysis.

CONCLUSION

The RAS is valid and reliable for use in the UK. This tool holds potential utility across research, clinical practice, health interventions and policy development.

Association between rural workers’ sociodemographic and reproductive characteristics and their reproductive autonomy

ABSTRACT Objectives: to verify the association between sociodemographic and reproductive characteristics with rural workers’ reproductive autonomy. Methods: a cross-sectional study, with a sample of 346 women and application of the Reproductive Autonomy Scale. Multinomial regression was performed to analyze associations between independent variables and outcomes. Results: in the analysis of subscales “Decision-making”, “My sexual partner or someone else such as a parent”, “Both me and my partner” and “Me”, women experienced greater reproductive autonomy in relation to their partners. For outcomes “Decision about which method to use”, “When to have a baby” or “About unplanned pregnancy”, the highest prevalence was for category “Me”, with statistically significant associations. Conclusions: the sociodemographic and reproductive characteristics among the most vulnerable women, in terms of the social, economic and cultural context in which they are inserted, may be associated with greater difficulties in exercising reproductive autonomy.

Associação entre as características sociodemográficas e reprodutivas com a autonomia reprodutiva das trabalhadoras rurais

RESUMO Objetivos: verificar a associação entre as características sociodemográficas e reprodutivas com a autonomia reprodutiva das trabalhadoras rurais. Métodos: estudo transversal, com amostra de 346 mulheres e aplicação da Escala de Autonomia Reprodutiva. Foi realizada regressão multinomial para análises de associações entre as variáveis independentes e desfechos. Resultados: na análise das subescalas “Tomada de decisão”, “Meu parceiro sexual ou alguém da família tem mais a dizer”, “Eu e meu parceiro sexual” e “Eu decido”, as mulheres experimentaram maior autonomia reprodutiva em relação aos parceiros. Para os desfechos “Decisão sobre qual método utilizar”, “Quando ter um bebê” ou “Sobre gravidez não planejada”, as maiores prevalências foram para a categoria “Eu decido”, com associações estatisticamente significante. Conclusões: as características sociodemográficas e reprodutivas entre mulheres mais vulneráveis, tratando-se do contexto social, econômico e cultural que estão inseridas, podem estar associadas a maiores dificuldades para exercerem a autonomia reprodutiva.