“If the Woman Doesn't Prevent, You Will Become Pregnant”: Exploring Male Involvement in Contraceptive Use Preceding Unplanned Pregnancy in Sierra Leone

Abstract

Globally, millions of unintended pregnancies occur each year resulting in a host of social, economic, and health-related problems. Improving knowledge of and access to family planning services is an effective way to prevent unintended pregnancy, and research suggests that men's involvement promotes greater contraceptive uptake. To explore this issue, we assess contraceptive knowledge, attitudes, and behaviors among Sierra Leonean men who experienced an unplanned pregnancy. Findings indicate that men's participation in family planning was limited due to barriers including inadequate knowledge about contraception, poor access to services, and gender norms that consider family planning a woman's responsibility. As a result, men often resorted to a pattern of control that put the onus of contraceptive use on women and blamed women when they became pregnant, without considering their own role in pregnancy prevention. We suggest that family planning policies and interventions both engage men and address the barriers to their participation in reproductive health.   "If the Woman Doesn't Prevent, You Will Become Pregnant" March  Studies in Family Planning ()  "If the Woman Doesn't Prevent, You Will Become Pregnant"

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“…In most LMICs, FP, like child-rearing, has largely been seen as a woman’s responsibility and domain. 30 Certainly, the demands of pregnancy and the brunt of pregnancy-related morbidity and mortality fall on her. Consequently, FP service provision has long been oriented to reproductive-age women, and women are the main users of contraception, including PMs.…”

Women’s ability to negotiate safer sex with partners by contraceptive status among a nationally representative sample of married women in Nigeria

“…The program should seek to promote the use of contraceptives as a joint responsibility of men and women in marital unions. This is important because many men as observed in a recent study [ 23 ] consider contraceptive use to be the responsibility of women.…”

“…The threshold of women's autonomy is the ability to negotiate safer sex with partners. Such negotiation in many developing countries where patriarchy remained dominant is likely to lead to a positive change in existing gender norms within marital or sexual relationships, which may translate into improving women's capacity to protect themselves from sexually transmitted infections [22,25], unintended pregnancies [23], and other adverse health outcomes [26,27]. In this paper, we assessed the prevalence of women's ability to negotiate safer sex by contraceptive status, and also examined the determinants of women's ability to negotiate safer sex among contraceptive users and non-users.…”

“…Many studies have documented how women's lack of power to negotiate safer sex elevates their risks of sexually transmitted infections including HIV/AIDS, as well as unintended pregnancies, and abortion [18][19][20][21][22]. A recent study in Sierra Leone [23] observed that the rate of unintended pregnancies will continue to increase if women do not take the initiative to protect themselves. Two Nigerian studies [24,25] particularly reported that ever-married women were more likely to be infected with HIV compared to unmarried women in the country.…”