Women's decision‐making power can influence modern contraceptive use: Evidence from Bangladesh

Objectives It is generally believed that gender inequality and women's lack of decision‐making power may restrict women's use of modern contraception, leading to high rates of unwanted pregnancies, abortions, and deaths. Evidence shows that empowered women are more likely to use modern contraception methods, but few studies have investigated this across multiple domains of empowerment. Study design This study examined the associations between women's empowerment and modern contraception use in Bangladesh. Data from a sample of 16,834 married women aged 15–49 years from the Bangladesh Demographic and Health Survey 2017–2018 were analysed. Methods Complex survey weight adjusted logistic models were fitted to evaluate the associations after adjusting for clusters, strata, and sampling weights. Results indicate that just over half of the married women (55.7%) had used modern contraception methods. Women's empowerment was associated with contraceptive use, especially decision‐making power. Women who had medium or high autonomy of household decision making were likely to have 20% (AOR = 1.20; 95% CI: 1.04–1.39) and 27% (AOR = 1.27, 95% CI: 1.11–1.45) increased odds of using modern contraceptives compared to those who scored low in the decision‐making domain. The findings demonstrated strong evidence of direct influence of women's decision‐making power on modern contraception use. The results also found influence of several socio‐demographic factors including area of residence, husband's age, wealth index and mobile phone ownership on the use of modern contraceptives. Discussion Future interventions can focus on integrating women's empowerment into family planning programming, with a particular focus on enhancing women's autonomy in decision making.