Empowerment, sexual autonomy, and contraceptive choices: Recent evidence from Bangladeshi women

In low- and middle-income countries, women’s empowerment is a vital driver for overall development. Using data from the 2022 Bangladesh Demographic and Health Survey, this study investigates how women’s household decision-making power and autonomy over sexual rights influence contraceptive method choice among married women in Bangladesh. Findings show that 59% of women used modern contraceptives, while 10% relied on traditional methods. Multilevel multinomial logistic regression (MLMLR) analysis reveals that women with higher household decision-making autonomy and those who supported the right to refuse sex with their husbands were significantly (p<0.001) more likely to prefer either modern or traditional contraception compared to the reference category, “non-users.” Moreover, older women, those from wealthier households, women desiring more children, and those who had experienced child mortality were significantly less likely to choose traditional or modern contraception compared to non-users. Conversely, the likelihood of preferring modern or traditional methods was significantly higher among highly educated couples, those earning cash income, non-Muslim women, those who received visits from family planning workers (FPWs), and those with access to mass media. Community-level factors also influenced contraceptive method choices: Urban women and those from communities with higher levels of female education were more likely to use contraceptives than their non-user counterparts. The MLMLR analysis also found significant variations in contraceptive method choice across clusters and regions. The findings underscore the critical role of women’s empowerment, particularly in household decision-making and sexual autonomy, in shaping contraceptive behavior. Strengthening women’s agency at both individual and community levels through policies and programs, expanding FPW doorstep services, and empowering low-educated, rural women in household decisions may boost effective contraceptive use and advance Bangladesh’s family planning efforts.