Couples, Communication, and Contraception
October 27th, 2011 | Posted in Gender, Reproductive Health
by Kate Gilles, policy analyst
In an essay in the Sunday, Oct. 23 New York Times, Helen Epstein asks, “Could a ‘contraceptive talking cure’ work in Africa in our own century?” With this question, Epstein zeroes in on a critical aspect of successful family planning: communication between spouses.
As she goes on to note, researchers have long known that open communication between husbands and wives is positively and strongly associated with contraceptive use. Unfortunately, the presumption that men are the decision-makers and the taboo nature of sex means that most African couples do not frequently engage in frank discussions about family planning. Women may be afraid to raise the issue with their husband, assuming that he is opposed to contraception, while men may lack information about contraceptive methods and the benefits of family planning. This absence of communication is not only an impediment to contraceptive uptake, it is also a missed opportunity for increasing gender equity.
Empowering women to make decisions about family planning often means involving men as partners. Constructive men’s engagement is an approach that increases men’s support for women’s sexual and reproductive health, promotes gender equity, and improves the reproductive health of men as well as women. Reproductive health and family planning programs that seek to constructively engage men by fostering open communication and joint decision-making between spouses not only increase contraceptive use but also promote equality within the relationship and increase women’s decision-making power overall.
Family planning results in widespread benefits for individuals, families, and communities: healthier children; wealthier families that are better able to feed, clothe and educate their children; a stronger workforce; and reduction in domestic violence. When couples discuss and decide together to use family planning, those benefits are reinforced and enhanced by the process of communication and decision-making.
As a member of the Interagency Gender Working Group (IGWG), PRB is actively involved in gathering and disseminating evidence related to the intersection of gender and reproductive health, including constructive men’s engagement. The IGWG recently co-sponsored a three-part technical update on engaging men in family planning and ending gender-based violence. Materials from that event and more information on engaging men, promoting gender equity and couple-centered family planning programs can be found on the IGWG website. These materials reflect that the movement to engage men as partners has taken flight around the world. New and established organizations are partnering on research, programs and advocacy related to the role of men in family planning and reproductive health.
It’s time to have a conversation about couples’ communication, and recognize that involving men in family planning and reproductive health benefits men, women and the communities they live in.
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October 27th, 2011 at 11:40 am
Well-written and helpful. For those of us involved with healthcare, but outside the specific field of family planning, I particularly appreciated the focus on relationship/communication building.
October 28th, 2011 at 1:04 pm
In rural Senegal, where men continue to be regarded as the head of the household and ultimate decisiion maker, World Vision developed a strategy that focused on men. World Vision’s male staff first met with Mullahs and village elders (also all men) to discuss the health benefits of timing and spacing pregnancies for women (more time and energy to care for her family and work in the fields) and men (improved family finances with fewer, healthier children). After gaining their support, the male staff initiated group discussions with village men. Later, one father said ” Not coming to men first of all to discuss using contraception to time and space births, is like putting the cart before the horse.”
October 28th, 2011 at 3:37 pm
Caroline and Adrienne, thank you both for your responses. Relationships and couple dynamics are indeed critical for reproductive health generally and family planning specifically, and programs that seek to increase contraceptive use must take that into account to achieve meaningful change.
Adrienne, thank you for sharing World Vision’s experience. Save the Children piloted a similar program, targeting men through male peer motivators and focusing on the economic benefits of family planning, which may resonate more strongly with men than health benefits alone. Contraceptive uptake increased among participants, and the program was welcomed by both participants and their wives. (http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/Final-FP-Integration-Strategies-091508.pdf)
Although male involvement is undeniably important, the challenge is to engage men in ways that do not perpetuate harmful gender norms and that instead improve women’s status and gender equality. Fostering constructive communication between husbands and wives is one of the most promising approaches to achieving positive male engagement in family planning.
March 29th, 2012 at 1:24 pm
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