Reproductive autonomy and contraceptive use among women in Hanoi, Vietnam

Abstract

Objective: Reproductive autonomy (i.e., power to control and decide about contraceptive use, pregnancy and childbearing) could determine a woman’s capacity to use contraception. Although the Reproductive Autonomy Scale was developed to quantitatively assess women’s reproductive autonomy, it has not been validated in any population outside the United States. Study design: We conducted a cross-sectional study of reproductive-age, sexually active women in Hanoi, Vietnam, who did not desire pregnancy. We administered a questionnaire containing the Reproductive Autonomy Scale and calculated composite scores of the measure’s three subscales: (1) decision-making power, (2) freedom from coercion and (3) communication ability. To assess internal consistency, we calculated Cronbach’s alpha score for each subscale. We used logistic regression to evaluate differences in subscale scores between women who did and did not engage in unprotected sex in the past month. Results: Analysis is based on 500 participants; of these women, 17% (n=85) engaged in unprotected sex in the past month. Subscales had moderate to high internal consistency (Cronbach’s alpha: 0.65–0.87). Mean subscale scores did not vary between women who did and did not engage in recent unprotected sex. Unprotected sex in the past month was not associated with decision-making power (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.49–1.20), freedom from coercion (aOR, 0.94; 95% CI, 0.52–1.67) or communication ability (aOR, 1.69; 95% CI, 0.92–3.09). Conclusion: Findings highlight the need to develop and validate a new measure for reproductive autonomy for populations outside the United States or to adapt the existing measure for these contexts. Keywords: Contraception, Unprotected sex, Reproductive autonomy, Measurement, Vietnam