Book Description

Universal access to reproductive health and the promotion of reproductive rights were key goals articulated at the International Conference on Population and Development in 1994. The role of contraception in meeting these goals is critical. Access to contraception helps women avoid unintended pregnancies, improves maternal and infant health by spacing births, and reduces the need for abortions. The benefits of modern contraception also extend beyond the realm of health to economic and social gains for women. Women who delay pregnancy are more likely to remain in school and participate in the labor force. While the past decades have witnessed significant increases in the provision of modern contraceptive methods, there are still more than 200 million women around the globe who want to delay or stop pregnancy, but do not have access to contraception. Women in South Asia and Sub-Saharan Africa suffer disproportionately from poor health related to pregnancy and childbirth, and thus, stand to gain the greatest benefit from investments in contraception policies and programs. In India, state-sponsored family planning programs have been promoted since 1951. The predominant focus has been on permanent methods, and female sterilization currently accounts for nearly 60% of modern contraceptive use. The use of non-permanent contraceptive methods, including oral contraceptive pills, injectable contraceptives, and intra-uterine devices, remains low. This dissertation sought to explore women's experiences with making decisions about, and using, non-permanent contraceptive methods, taking into account individual, family, and community influences. Building upon those women's experiences and their reasons for using non-permanent methods, this research then explores key opinion leaders' attitudes towards, and the policy landscape of, injectable contraceptives within India, a method that has been controversial within that country. Finally, a new theoretical framework of autonomy is proposed for analyzing women's reproductive and contraceptive decision-making, and rights to self-determination.