Association between women's autonomy and unintended pregnancy in India

Multiple studies from low-and middle-income countries have indicated that women's autonomy can play a key role in reducing unintended pregnancy. Such evidence is scarce in Indian context, where patriarchy prevails, and sociocultural norms limit women's participation in important decisions. Therefore, the primary aim of this study is to examine the association between women's autonomy and unintended pregnancy in India. Data collected as part of the National Family Health Survey-4 conducted in 2015-16 are used for the analysis. Information on a total of 205984 ever-married women was extracted from 699686 women aged 15-49 years. Bivariate logistic regression was used to examine the association of unintended pregnancy with women's autonomy, demographic, socio-economic, and social context variables. Multiple logistic regression was further employed to assess the effect of women's autonomy on unintended pregnancies after controlling various selected background characteristics. The study found that women's autonomy was a significant predictor of unintended pregnancy after adjusting different other covariates. For example, women with higher autonomy had 16% lower adjusted odds of having an unintended pregnancy than women with lower autonomy (OR adj = 0.84; 95% CI: 0.72-0.99). Moreover, other covariates such as age, children ever born, age at marriage, wealth status, and consonance over fertility exert a significant and robust influence over unintended pregnancy. The study recommends that policymakers design programmes to spread awareness about the importance of the decision-making power of women in household settings.