Reproductive autonomy and pregnancy decision-making among young Ghanaian women

ABSTRACT

Decision-making regarding the outcome of a pregnancy may include participation of the woman herself, her sexual partner, parents, family, and/or community. This paper examines who had the most say in the outcome of young Ghanaian women’s last pregnancy and whether this correlated with her level of reproductive autonomy (RA). We analysed cross-sectional data from 380 previously pregnant young women in urban Ghana. We measured communication and decision-making RA using modified scales ranging from 3 (low RA) to 12 (high RA). We tested unadjusted associations between the RA sub-scales and who made the pregnancy decision (self, partner, both together, or someone else) and used multinomial regression models to understand these associations when controlling for sociodemographic, reproductive history, and social context variables. In final models, a one-point increase in decision-making RA was associated with an adjusted relative risk ratio of 0.79 (95% CI: 0.66–0.93; p = 0.006) of partner having the most say as compared to the woman having the most say. The communication RA scale was not associated. Programmes that increase RA may be effective in increasing women’s rights to execute decisions about reproductive health and outcomes. Future research should explore this notion and the role of pregnancy disclosure in this relationship.

KEYWORDS:

• Reproductive autonomy
• Ghana
• Pregnancy decision-making

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Dana Loll http://orcid.org/0000-0002-3353-3263

Paul J. Fleming http://orcid.org/0000-0001-9150-1254

Rob Stephenson http://orcid.org/0000-0002-9239-2640

Elizabeth J. King http://orcid.org/0000-0001-8465-4607

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant numbers K01HD080722-01, K12HD143815, T32 HD007339].