Development and Validation of a Reproductive Autonomy Scale

Abstract

No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as "reproductive autonomy." We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selected through factor analysis and grouped into 3 subscales to form a Reproductive Autonomy Scale: freedom from coercion; communication; and decision-making. Construct validity was demonstrated by a mixed-effects model in which the freedom from coercion subscale and the communication subscale were inversely associated with unprotected sex in the past three months. This new Reproductive Autonomy Scale offers researchers a reliable instrument with which to assess a woman's power to control matters regarding contraceptive use, pregnancy, and childbearing, and to evaluate interventions to increase women's autonomy domestically and globally.

Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa

“…study highlights the need for a new approach to conceptualization, measurement and methodology in order to gain better insights into the process of women's autonomy and its effects in Africa (Blanc, 2001;Schatz and Williams, 2012;Upadhyay et al, 2014).…”

Adaptação cultural e confiabilidade da Reproductive Autonomy Scale para mulheres no Brasil

“…The Reproductive Autonomy Scale was developed and validated by professors/researchers at the Department of Obstetrics, Gynecology and Reproduction at the University of California, and allows to assess a woman's power to achieve reproductive autonomy. (7) This instrument is composed of 14 items, subdivided into three subscales: decision making (questions 1 to 4), absence of coercion (questions 5 to 9) and communication (questions 10 to 14).…”

Restricted reproductive rights and risky sexual behaviour: How political disenfranchisement relates to women’s sense of control, well-being and sexual health

“…Put another way, limited reproductive control is associated with reduced psychological well-being and more risky sexual behaviour. This is important because while it is known that a lower level of reproductive control (as such reproductive coercion) is associated with higher rates of unwanted pregnancy (Upadhyay et al, 2014), there was previously limited evidence that reproductive control is associated with measures of well-being. Our results also build on studies that focus on interpersonal control and how this relates to the use of contraceptives, or not (Tschann et al, 2002), by showing how social structural conditions impacting sense of control may also impact risky sexual behaviour.…”

“…Reproductive control is a complex concept related to reproductive autonomy (a women's ability to make autonomous decisions with regard to her reproductive health) and reproductive coercion (the direct and deliberate interference on a women's attempts to either avoid or become pregnant; Grace & Anderson, 2016). Literature on these constructs is in the early stages of development (Upadhyay et al, 2014), tending to focus on women's personal control over their contraceptive use (Tschann, Adler, Millstein, Gurvey, & Ellen, 2002) rather than perceived restriction in accessing contraception, or control over other elements of reproduction and sexual health (e.g., pregnancy itself, sexual health screening), or control related to wider structural forces.…”

“…In examining the role of perceived control in sexual health, it is important to look beyond general control and examine reproductive control. Reproductive control is defined as a woman's perception that she is able to make autonomous decisions with regard to her sexual health (Moore, Frohwirth, & Miller, 2010;Upadhyay, Dworkin, Weitz & Foster, 2014). Control of women's reproduction can be exerted by other sources, including partners, parents or peers, through economic, emotional and financial means (Moore et al, 2010).…”