Conjugal Power Relations and Couples’ Participation in Reproductive Health Decision-Making: Exploring the Links in Nepal

This article appraises conjugal power relations and explores the nexus between such relations and couples’ participation in reproductive health (RH) decision-making based on a field survey carried out in two population clusters in eastern Nepal. The findings show that husbands’ domination is ubiquitous with respect to all forms of power and gender privileges, which accords with a dominant-submissive model of conjugal relationship. However, decision-making in RH shows a more complex interaction between different sets of factors of power. Generally, family planning is perceived as a couple’s private issue whereas ante-natal care (ANC) is considered to be exclusively a woman’s health issue.High rates of women’s participation in joint contraceptive decision-making may be taken as encouraging. Yet, husbands’ domination is evident in directing wives to use contraceptives, choose their types and to terminate their application and in making decisions about seeking ANC service. Gender difference in RH decision-making is strongly attributable to unequal gender power relations, traditional gender roles and the financial cost associated with such a service. Since women’s low status and the existing hierarchical system are among the major factors that maintain unequal conjugal relations, integration of women’s empowerment and transformation of gender ideology into policies and programs would be one of the vital entry points for achieving an equitable and respectful conjugal partnership to enable women to claim their sexual and reproductive rights and ultimately to make their own informed decisions.