Development of a Reproductive Autonomy Measure to Predict Contraceptive Use

Ushma D. Upadhyay, University of California, San Francisco
Shari L. Dworkin, University of California, San Francisco
Tracy Weitz, University of California, San Francisco

While studies have examined the effect of women’s empowerment on contraceptive use, lower fertility, and birth spacing, no specific measures are available to measure reproductive empowerment. We developed a theory-based, validated instrument to measure reproductive autonomy. A pool of 26 items was developed and included in a self-administered iPad survey among 1,892 women at 13 US family planning clinics and 6 abortion clinics. Factor analysis revealed 14 items grouped into 3 factors under the construct of reproductive autonomy: coercion (alpha=0.82), communication (alpha=0.74), and decision-making (alpha=0.65). Construct validity was demonstrated by a random effects model where the coercion subscale (AOR=1.33, p=0.02) was positively associated with unprotected sex and the communication subscale (AOR=0.68, p=0. 0.005) was inversely associated with unprotected sex. The Reproductive Autonomy Scale offers researchers a reliable instrument to assess a woman’s ability to carry out her reproductive choices and to evaluate interventions that aim to increase women’s empowerment.