Gender and Contraception: A Proposed Conceptual Model for Research and Practice

Unintended pregnancy and birth, frequently due to contraceptive non-use or misuse, continue to be important public health problems. A large body of literature has examined women's characteristics related to contraceptive use. However, much of what is known about men and contraception has been obtained or extrapolated from interviews with women. In this paper, we first present an overview of unintended pregnancy and the link with contraception. We explore gender considerations in contraceptive decision-making and discuss the literature of men's role in contraceptive attitudes and practices both in the developing countries and in the United States. Because individuals who make contraceptive decisions are actually part of couples, we examine the recent literature on couple communication and the role of partner influence on contraceptive practice. Finally, we propose a conceptual model that can be used for studying gender differences regarding factors that influence contraceptive use. The model is comprised of a variety of factors influencing contraceptive use that include; (1) knowledge of contraceptive methods, use, and effectiveness; (2) structural/access, institutional, and financial factors that may present barriers to contraceptive acquisition and use; and (3) socio-cultural factors. These sociocultural factors include: (a) attitude (beliefs, values, perceived risk of pregnancy, cognitive assessment/acceptability of pregnancy, masculinity ideology, self-esteem, and self-efficacy); (b) the influence of significant others, including partners, peers, and family; and (c) sociodemographic factors including age, ethnicity, marital status, education, and income. This model should be useful in identifying gender differences in knowledge, attitudes, and practices about contraception and pregnancy so that efforts to reduce unintended pregnancy can effectively target both women and men.