Contraceptive communication and decision-making in Choluteca Department, Honduras: A qualitative study with couples

CONTEXT: In rural Honduras, contraceptive use remains low and fertility high. Power imbalances between genders have been noted to affect women's ability to meet stated fertility desires. Little information exists on what couple communication and decision-making about family planning looks like among Honduran couples in rural areas. METHODS: In 2010, interviews were conducted with 24 men and 24 women linked as couples and 15 additional women in three communities in rural Honduras. Coded transcripts and summary matrices allowed substantive themes to be analyzed by gender and dyad. RESULTS: Findings revealed that, in general, male partners had little knowledge of contraceptive methods and felt more strongly against using any form of contraception compared to their female counterparts. Reasons for opposing contraceptive methods primarily dealt with males' religious belief that contraception is a sin. Couples generally reported communicating about contraception to be easy, and appeared to have similar stated fertility goals. However, females perceived their male partners as more opinionated and ultimately the final decision-makers though most male partners described the decision-making process about contraception ending in mutual agreement. Whereas women framed a decision to use modern methods for birth limiting purposes, their partners described the decision in terms of protecting her “health” after a series of difficult pregnancies. CONCLUSION: Men and women appear to have different ideas and definitions of what conversations and decision-making about family planning entail. When communication about contraception, couples' immediate goal appears to be agreement rather than a discussion of each other's specific contraceptive goal.