Given the huge benefit provided by contraception, it is important to ask why not all women that want to are accessing contraception.
Unfortunately, there are a number of barriers that stop girls and women from reliable and effective contraceptive use. These barriers are often inter-related and it is the intersection of numerous barriers that result in lack of access. The current blog post will break down some of these barriers:
- Culture and Religion
Individual and community religious beliefs
The teachings of some religions, in particular Roman-Catholicism, prohibit the use of contraceptives. This can mean that women of these faiths have to either not use contraception, or face huge ethical dilemmas if they want to undertake family planning behaviours. In some religions, different strands have different rules surrounding contraceptive use. For example, Orthodox Judaism has strict rules regarding when contraceptive use may be permissible, while Reform Judaism is much more relaxed on the issue.
Religious healthcare providers
The religious affiliations of healthcare providers may also influence a woman’s ability to access contraceptives. In many Western countries, a large proportion of healthcare providers are Roman Catholic. As a consequence, healthcare professionals may be unwilling or unable to provide women advice or access to more invasive contraceptive techniques, particularly methods that require.
- Legal, legislative and administrative barriers
Unsurprisingly, the legality of different contraception varies across different country across the globe, and has varied over the last 100 years. For example, the oral contraceptive pill is now legal in the majority of countries in the world. However, over-the-counter access varies throughout the globe. This interactive map indicates whether women are required to obtain a prescription from the doctor in order to purchase the pill. Interestingly, while women in countries such as Sudan, Afghanistan and India can obtain the pill without a prescription or screening, wealthier western countries such as Canada, the UK, the USA and Australia all require a doctor’s prescription to access the pill.
- Lack of knowledge
A simple lack of education regarding contraception options is another barrier for women to access contraception. For many women, sex education in the classroom is the primary way they learn about contraceptive methods. In countries with optional sex education or where sexual topics are taboo, girls don’t have the opportunity to learn about what contraception is available to them.
An individual’s geographical location can also serve as a barrier to comprehensive contraceptive use. For example, women living in rural areas will have a harder time locating family planning clinics than those in an urban setting. Additionally, this Physical proximity to contraceptive services – barrier for rural women compounds when considering any mobility limitations that may come from living outside of urban centres.
Financial Barriers and Cost
As is the case with most medical products, contraception can be costly. In many countries, the cost of contraception is borne through public health cover. In countries with a public health system, the cost may not be completely covered, placing the left over cost on the individual. Similarly, where public health systems are lacking, private health insurance can be unaffordable. Contraceptives, as well, may not even be covered by these insurers.
6. Living Arrangements
For women living in communal environments, a lack of privacy may prevent them from being able to engage in regular, effective contraceptive usage. For example, most contraceptive pills require a woman to take it daily. If a woman lives in a community where attitudes are predominantly negative to contraceptives, it may be difficult to find the privacy required.
- Emotional and Interpersonal barriers
While access to contraception is predominantly considered a woman’s issue, the role of the father is also an important determinant of contraceptive use. A potential barrier for access is any pressure that may be applied by the partner for the woman not to use contraception. In cultures where women’s rights to bodily autonomy are less culturally and legally considered, this pressure may be exceptionally unhelpful.
- Attitudinal barriers
Finally, in a number of cultures, it is a strongly held belief that the role of women is to bear children. For many women, this may be a belief that they hold. Accessing contraception, then, could be viewed as a woman failing in her role as a mother, which may be a deterrent from seeking contraceptive services.
American Congress of Obstetricians and Gynaecologists, Access to Contraception. Available from: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Access-to-Contraception
Online Doctor, Birth Control Around the World: Mapping Methods of Contraception. Available from https://onlinedoctor.superdrug.com/birth-control-around-the-world/
Overseas Development Institute, Barriers to Contraceptive Use. Available from: https://www.odi.org/projects/2596-barriers-contraceptive-use
United Nations Population Fund, Family Planning. Available from: http://www.unfpa.org/family-planning