Women’s Autonomy and Family Planning Practices among Married Women in Coimbatore

Prof. R. Renuka¹ , Dr. M. Jeyarathnam²

¹Principal, Laxmi Meghan College of Nursing, Kasargod District, Kerala.

²Former Director, Dept. of Women's Studies Bharathiar University Coimbatore, Tamilnadu.

*Corresponding Author Email: renuganath@gmail.com

ABSTRACT:

BACKGROUND: Autonomy is the ability to obtain information and make decisions about one’s own concerns. Women’s autonomy in health care decision making is extremely important for better maternal and child health outcomes, and as an indicator of women’s empowerment. Gender based power inequalities can restrict open communication between partners about reproductive health decisions as well as women’s access to reproductive health services. In India, use of contraception is greatly influenced by women’s autonomy.

OBJECTIVE: This study was carried out to identify the relationship between women’s autonomy and family planning practices.

METHODS: A descriptive cross sectional survey was carried out to explore the relationship between the women’s autonomy and family planning practices among currently non pregnant married women. Data was collected from a conveniently selected sample of 56 married women using an interview schedule. Women’s autonomy was estimated through questionnaire which includes three dimensions of autonomy such as decision making autonomy, movement autonomy and control over economic resources. A number of socio demographic variables were used to investigate the association between autonomy and contraceptive use. Chi square test was used to test the significance of data.

RESULTS: While assessing the autonomy level of the women, 41% showed high decision making power, 55.3% were with moderate decision making power and 3.5% had no decision making power. In regard to freedom of movement 39.2% had complete freedom of movement, 33.9% had incomplete freedom of movement and 26.7% had no freedom of movement. Among 56 samples, 50% had control over their economic resources. Contraceptive use among these women was 53.6%; Decision making autonomy and educational level was significantly associated with contraception use.

CONCLUSION: Improvement in power equality and educational qualification among women are the effective and efficient methods to improve the use of contraceptive methods, on the other hand it may reduce unintended pregnancies as well as improve reproductive health outcome.

KEYWORDS: Married Woman, Autonomy, Contraceptive practices.

INTRODUCTION:

Women’s control over their own childbearing is a key component of reproductive health and rights. Almost all the social scientists and researchers agree with the fact that women’s autonomy has considerable impact on their reproductive behavior. Autonomy is the ability to obtain information and make decisions about one’s own concerns (Roy and Niranjan, 2004). Women’s autonomy in health care decision making is extremely important for better maternal and child health outcomes, and it is also considered as an indicator of women’s empowerment. ⁴ National Family Health Survey- III conducted in the year 2005- 2006 reveals that one in five births in India is either mistimed or unwanted resulting from inadequate contraceptive use. Nearly 20 percentage of married women in reproductive age are not using any form of contraception despite an expressed desire to limit/ space their next birth.³

Samina et al, (2008) conducted a cross sectional study to find out the effect of women empowerment on their fertility behaviour and to evaluate the association between women empowerment and use of contraceptives. 872 currently married women of reproductive age group were selected through systematic random sampling and data was collected through pre designed questionnaire. The results revealed that, there is a strong positive association between the levels of empowerment and contraceptive use. One could see that there is sharp increase in the percentages i.e. 41.2 (low) to 68.0 (medium) to 85.2 (high) (P<.001). When women were asked about the use of contraceptives 47.6% of low empowered while 78.9% of high-empowered women decided to use contraceptive methods by mutual decision of both the spouse (P<.001). On the basis of these findings, the authors concluded that women empowerment provides multidimensional aspects of security which ultimately influence the use of contraception.⁷

OBJECTIVES

· To examine the women’s autonomy on various dimensions.

· To explore the current use of contraception among married women

· To examine the major barriers to the utilization of family planning services

· To measure the influence of women’s autonomy on family planning practices.

METHODS:

Descriptive cross sectional survey design was adopted to identify the relationship between women’s autonomy and contraceptive use. Using convenient sampling technique a total of 56 married women in the reproductive age group having at least one child above 6 months were selected and data was collected through pre designed interview schedule which includes:

Part A: Indirect measures of autonomy:

Contain questions that measures women’s autonomy indirectly. It consists of general profile of women and her spouse such as age, education, occupation, income, religion, type of family, number of pregnancies and number of children.

Part B: Direct measures of autonomy:

Contain questions that measures women’s autonomy directly under three dimensions namely,

Decision making power:

The questions include whether the respondent has decision making power regarding buying household / clothes, accessing health care and staying with relatives or friends. The woman is considered to have high decision making power if she has involvement in taking decision about all the three aspects. She is assigned with moderate decision making power if she has involvement in any one or two of the aspects and assigned low decision making if she has no involvement in any of the aspects.

Freedom of movement:

The woman is considered to have complete freedom of movement if she has freedom to go out with friends and to go for shopping or market. She is assigned with moderate freedom of movement if she has permission for any one of the aspect and assigned low freedom of movement if she has no permission to go out without the family members.

Control over economic resources:

Woman is said to have control over economic resources when she is allowed to set some money aside and to buy necessary household things.

Part C: Contraceptive practice:

Questions were included regarding the contraceptive method used, duration, problems encountered with the use of contraception and nature of treatment sought for the same. Also questions were asked from the non users regarding the reasons for not using any contraceptive methods. The reasons were grouped under Psychosocial factors, Cognitive factors, Administrative factors and Economic factors.

RESULTS:

While assessing the autonomy level of the women, 41% showed high decision making power, 55.3% were with moderate decision making power and 3.5% had no decision making power. In regard to freedom of movement 39.2% had complete freedom of movement, 33.9% had incomplete freedom of movement and 26.7% had no freedom of movement. Among 56 samples, 50% had control over their economic resources. On assessing the contraceptive practices 54% of them were using contraceptives. Among them 20% had undergone female sterilization, 33.3% were using condom, 12% were using Copper “T” and 2% reported that they were following natural contraceptive method. Among 56 samples, 46% are not using any contraceptive methods and the identified reasons were: not willing to use (34.6%), fear of side effects (26.9%) and inadequate knowledge (15.38%).

Figure – I Contraceptive practice among women.

Chi – square analysis showed a strong relationship between decision making power and contraceptive use (X²⁼11.445, Table value =7.815). Among indirect measures of autonomy educational attainment has strong association with contraceptive use (X^{2 =}6.915, Table value= 3.8) at 0.05 level of significance.

CONCLUSION:

Women’s control over their own child bearing is a key component of reproductive health rights. Fertility and contraceptive use in developing countries are associated with various markers of socioeconomic status, most prominent are women’s education and low autonomy; the well documented link between women’s autonomy, education and use of contraception plays an important role in development of family planning policies in developing countries.

REFERENCES:

1. Heeks, F. (2008). Fertility Preferences and Contraceptive Behavior of Women in Ethiopia, MSc dissertation, University of Surrey, Unpublished.

2. Hemmings, J., Wubshet, T., Lemma, S., Antoni, T., and Cherinet, T. (2008). Ethiopian Women’s Perspectives on Reproductive Health: Results from a PEER study in the Guraghe Zone. London: Marie Stopes International.

3. International Institute for Population Sciences and ORC Macro. 2000. National Family Health Survey (NFHS-2), 1998-99: India, Mumbai: IIPS.

4. Jejeebhoy, S. 1998. “Women’s autonomy in rural India: Its dimensions determinants and influences of context.” In Harriet B. Presser and Gita Sen eds., Women’s Empowerment and Demographic Processes by IUSSP, Oxford University Press, pp. 204-238.

5. Korra, A. (2002). Attitudes toward family planning, and reasons for non-use among women with unmet need for family planning in Ethiopia. Calverton, Maryland, USA: ORC Macro.

6. Sathar ZA, Kazi S. Women’s Autonomy and Gender Relations. Women’s Autonomy, live hood and Fertility: a case study of rural Punjab. Islamabad: Pakistan Institute of development economics; 1997. p. 33.

7. Samina et al, (2008). “Women empowerment and fertility behavior” International Family Planning Perspectives, Volume 29, Number 2, June 2003.

Received on 15.09.2015 Modified on 21.09.2015

Asian J. Nur. Edu. and Research. 2016; 6(2): 214-216.

DOI: 10.5958/2349-2996.2016.00039.2