Association between Women's Perceptions of Domestic Violence and Choice of Contraceptive Method

Background: The prevalence of contraceptive use is low (18%) among reproductive age women in West and Central Africa (WCA). Little is known about social and cultural barriers to contraception among women in WCA. This study increases knowledge about potential barriers to contraception by examining the association between women’s perception of domestic violence (DV) and contraceptive method choice.

Methods: Data were from the 2009-2011 Multiple Indicator Cluster Surveys for women in seven WCA countries (n=80,055).  DV perception was measured as no, low, or high tolerance of wife beating. Contraceptive method was coded as none, traditional (e.g., periodic abstinence/rhythm, withdrawal), or modern (e.g., condom, the pill, diaphragm). Multinomial logistic regression estimated the odds of using traditional or modern methods versus none controlling for age, education, wealth, residence, parity, spousal age-difference and religion.

Results: Most women had no or low tolerance of DV (41%, 44%, respectively) and did not use contraception (81%).  In adjusted results, women with low DV tolerance had lower odds of using traditional or modern methods compared to those with no tolerance (odds ratio, OR,=0.87; 95% confidence interval, CI:0.78,0.98; OR=0.86; 95% CI:0.78,0.95 respectively). Women with high DV tolerance had 28% lower odds of traditional method use, and 38% lower odds of modern method use compared to women with no tolerance (95% CI:0.60,0.90; 95% CI:0.59,0.88 respectively).

Conclusion: Tolerance of DV is a significant barrier to contraceptive use. Policies that seek to increase the prevalence of modern contraceptive use need to consider perceptions about DV that may affect women’s use of contraception.