Autonomía reproductiva asociada al uso de métodos anticonceptivos en mujeres en edad reproductiva

Borges, Ana Luiza Vilela; Dias, Ana Cleide da Silva; Ale, Carolina Cavalcante da Silva

doi:10.1590/1983-1447.2023.20230072.en

Brasil

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Original Article • Rev. Gaúcha Enferm. 44 • 2023 • https://doi.org/10.1590/1983-1447.2023.20230072.en linkcopiar

Autonomía reproductiva asociada al uso de métodos anticonceptivos en mujeres en edad reproductiva

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo: Verificar los aspectos sociodemográficos asociados a la autonomía reproductiva entre mujeres urbanas, especialmente en relación al uso de métodos anticonceptivos.

Método: Estudio transversal realizado con 1252 mujeres, entre abril y junio de 2021, utilizando la versión brasileña de la Escala de Autonomía Reproductiva. Los datos se analizaron mediante regresión lineal múltiple.

Resultados: Las puntuaciones medias de las subescalas fueron 2,5 (DE=0,3) (Toma de decisiones), 3,8 (DE=0,3) (Ausencia de coerción) y 3,6 (DE=0,4) (Comunicación). En comparación con las mujeres que informaron no usar métodos anticonceptivos, las mujeres que usaron métodos de barrera o conductuales y las que usaron LARC mostraron un mayor nivel de autonomía reproductiva en todas las dimensiones de la Escala (p<0,001). Otros aspectos asociados a la autonomía reproductiva fueron la educación, la raza/color, la religión, el grupo socioeconómico y la convivencia, según cada subescala.

Conclusión: El tipo de método anticonceptivo utilizado se asoció estadísticamente con la autonomía reproductiva en todas las subescalas.

Descriptores: Autonomía relacional; Toma de decisiones; Planificación familiar

Variables	n	%
Age
18-24	382	30.5
25-34	567	45.3
35-49	303	24.2
Race/ethnicity
White	810	64.7
Black	396	31.6
Yellow and indigenous	46	3.7
Education
Up to high school	82	6.5
Incomplete higher education	321	25.6
Complete higher education	849	67.8
Religion
No religion	498	39.8
Catholic	394	31.5
Protestant	186	14.9
Other	174	13.9
Socioeconomic status
A	248	19.8
B	755	60.3
C/D/E	249	19.9
Paid jobs
No	332	26.5
Yes	920	73.5
Region of residence*
North	41	3.6
Northeast	129	11.1
Central-West	99	8.6
Southeast	744	60.2
South	146	12.6
Cohabitationwith a partner
No	498	39.8
Yes	754	60.2
Previous pregnancy
No	860	68.9
Yes	392	31.3
Contraceptive method in use
None	294	23.4
Barrier and behavioral methods	419	33.5
Hormonal method	235	18.8
LARC	304	24.3
Total	1252	100.0

Item	n	%
Decision Making Subscale
1. Who has the most say about whether you use a method to prevent pregnancy?
My sexual partner or someone else	1	0.1
Both	556	44.4
Me	695	55.5
2. Who has the most say about which method you would use to prevent pregnancy?
My partner or someone else	7	0.6
Both	368	29.4
Me	877	70.1
3. Who has the most say about when you have a baby in your life?
My sexual partner or someone else	5	0.4
Both	758	60.5
Me	489	39.1
4. If you became pregnant but it was unplanned, who would have the most say about whether you would raise the child, seek adoptive parents, or have an abortion?
My sexual partner or someone else	2	0.2
Both	673	53.7
Me	577	46.1
Freedom from Coercion Subscale
5. My partner has stopped me from using a method to prevent pregnancy when I wanted to use one.
Strongly agree	4	0.3
Agree	16	1.3
Disagree	109	8.7
Strongly disagree	1123	89.7
6. My partner has messed with or made it difficult to use a method to prevent pregnancy when I wanted to use one.
Strongly agree	8	0.6
Agree	41	3.3
Disagree	116	9.3
Strongly disagree	1087	86.8
7. My partner has made me use a method to prevent pregnancy when I did not want to use one.
Strongly agree	13	1.0
Agree	44	3.5
Disagree	129	10.3
Strongly disagree	1066	85.1
8.If I wanted to use a method to prevent pregnancy my partner would stop me.
9. My partner has pressured me to become pregnant.
Strongly disagree	3	0.2
Agree	23	1.8
Disagree	122	9.7
Strongly disagree	1104	88.2
Communication Subscale
10. My partner would support me if I wanted to use a method to prevent pregnancy.
Strongly disagree	30	2.4
Disagree	25	2.0
Agree	234	18.7
Strongly agree	963	76.9
11. It is easy to talk about sex with my partner.
Strongly disagree	34	1.9
Disagree	67	4.2
Agree	323	23.5
Strongly agree	827	63.4
12.If I didn’t want to have sex I could tell my partner.
Strongly disagree	1	0.1
Disagree	18	1.4
Agree	368	29.4
Strongly agree	865	69.1
13. If I was worried about being pregnant or not being pregnant I could talk to my partner about it.
Strongly disagree	2	0.2
Disagree	10	0.8
Agree	249	19.9
Strongly agree	991	79.1
14. If I really did not want to become pregnant I could get my partner to agree with me.
Strongly disagree	13	1.0
Disagree	78	6.2
Agree	419	33.5
Strongly agree	742	59.3
Total	1252	100.0

Variables	Reproductive Autonomy Scale
	Decision Making			Freedom from Coercion			Communication
	Mean	SD	p-value	Mean	SD	p-value	Mean	SD	p-value
Education
Up to high school	2.6	0.3	0.071	3.7	0.5	<0.001	3.5	0.4	0.002
Incomplete higher education	2.5	0.3		3.9	0.3		3.7	0.4
Complete higher education	2.5	0.3		3.9	0.3		3.6	0.4
Race/ethnicity
White	2.5	0.3	0.020	3.9	0.3	<0.001	3.7	0.4	0.730
Black	2.5	0.3		3.8	0.4		3.6	0.4
Yellow and indigenous	2.4	0.4		3.8	0.3		3.7	0.4
Socioeconomic status
A	2.5	0.3	0.010	3.9	0.3		0,001	3.7		0.4	0.247
B	2.5	0.3		3.9	0.3	3.6		0.4
C/D/E	2.6	0.3		3.8	0.4	3.6		0.4
Religion
No religion	2.6	0.3	<0.001	3.9	0.3	0.183	3.7	0.4	0.014
Catholic	2.5	0.3		3.8	0.4		3.6	0.4
Protestant	2.4	0.4		3.8	0.4		3.6	0.4
Other	2.5	0.3		3.9	0.3		3.7	0.3
Paid jobs
No	2.6	0.3	0.045	3.8	0.3	0.873	3.6	0.4	0.141
Yes	2.5	0.3	0.045	3.8	0.3	0.873	3.7	0.3	0.141
Cohabitation with a partner
No	2.6	0.3	<0.001	3.9	0.3	0.468	3.7	0.4	0.120
Yes	2.5	0.3	<0.001	3.8	0.3	0.468	3.6	0.4	0.120
Previous pregnancy
No	2.5	0.3	0.118	3.9	0.3	0,012	3.7	0.4	0.040
Yes	2.5	0.3	0.118	3.8	0.4	0,012	3.6	0.4	0.040
Contraceptive method in use
None	2.5	0.3	<0.001	3.8	0.4	<0.001	3.5	0.4	<0.001
Barrier/behavioral	2.4	0.3		3.9	0.2		3.7	0.3
Hormonal	2.6	0.3		3.8	0.3		3.6	0.4
LARC	2.6	0.3		3.9	0.3		3.7	0.3
Total	2.5	0.3		3.8	0.3		3.6	0.4

Variables	Decision Making			Freedom from Coercion			Communication
Variables	β	CI 95%	p-value	β	CI 95%	p-value	β	CI 95%	p-value
Age	0.02	-0.01;0.06	0.167	-0.004	-0.008;-0.001	0.019	-0.005	-0.009;-0.001	0.020
Education
Up to high school	-	-		-	-	-	-	-
Incomplete higher education	-0.04	-0.12;-0.11	0.291	0.14	0.06-0.22	<0.001	0.13	0.04;0.23	0.006
Complete higher education	-0.03	-0.11;0.04	0.394	0.16	0.08-0.24	<0.001	0.12	0.03;0.21	0.011
Race/ethnicity
White	-	-		-	-	-	-	-
Black	0.01	-0.02;0.05	0.531	-0.05	-0.09;-0.01	0.009	-0.006	-0.05;0.04	0.788
Yellow and indigenous	-0.12	-0.21;-0.03	0.012	-0.03	-0.12;0.07	0.559	-0.002	-0.11-0.11	0.974
Socioeconomic status
A	-	-		-	-		-	-
B	0.03	-0.02;0.08	0.199	-0.03	-0.08;0.02	0.194	-0.04	-0.09;0.02	0.189
C/D/E	0.09	0.03;0.15	0.003	-0.09	-0.14;-0.03	0.003	-0.01	-0.08;0.05	0.732
Religion
No religion	-	-		-	-		-	-
Catholic	-0.03	-0.08;0.01	0.116	-0.04	-0.08;0.07	0.105	-0.06	-0.12;-0.01	0.012
Protestant	-0.11	-0.16;-0.05	<0.001	-0.02	-0.07;0.03	0.483	-0.03	-0.10;0.03	0.334
Other	-0.04	-0.09;0.02	0.169	-0.02	-0.07;0.04	0.551	-0.005	-0.07;0.06	0.883
Paid jobs
No	-	-		-	-		-	-
Yes	-0.03	-0.08;0.01	0.123	0.01	-0.03;0.05	0.581	0.07	0.02;0.13	0.004
Cohabitation with a partner
No	-	-		-	-	-	-	-
Yes	-0.09	-0.13;-0.05	<0.001	0.02	-0.02;0.07	0.279	0.01	-0.04;0.06	0.620
Previous pregnancy
No	-	-		-	-		-	-
Yes	-0.02	-0.07;0.02	0.363	-0.01	-0.06;0.03	0.573	0.006	-0.5;0.06	0.817
Contraceptive method in use
None	-	-		-	-		-	-
Barrier and behavioral	-0.13	-0.18;-0.08	<0.001	0.11	0.06;0.16	<0.001	0.14	0.09;0.20	<0.001
Hormonal	0.02	-0.03;0.08	0.373	0.06	0.01;0.11	0.043	0.03	-0.03;0.09	0.345
LARC	0.07	0.02;0.12	0.009	0.09	0.04;0.14	<0.001	0.14	0.07;0.19	<0.001

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