Pacific women and contraceptive use: what are the barriers?

The issue of contraceptive side effects always arises when I’ve had the opportunity to talk to women from various Pacific island countries about their contraceptive use. Women often express worries about contraceptives because they’ve heard they have unwanted effects or health risks. Sometimes women have been incorrectly informed through the stories that circulate amongst communities regarding what contraceptives do (stories that get told everywhere). Sometimes women’s fears have grounding. Rarely do women receive reliable, quality information about contraception.

These are anecdotes: whether this is more widespread is not clear. (Although a UNFPA study in the Solomon Islands many years ago found women’s concerns about side effects were a barrier to use.) Now new evidence from other parts of the world highlights how worries about side effects and health risks are likely to be more than an anecdotal reason why Pacific women don’t use contraceptives. The renowned Guttmacher Institute has published a study based on surveys across 51 countries (none in the Pacific) exploring why married women who don’t want more children are not using contraceptives. They find that concerns about side effects and health risks account for 23 to 28 percent of married women who had an unmet need for contraception.

The study recommends that along with the well-understood need for access to a range of contraceptive choices, women need appropriate information, education and counselling. In my conversations with women, this is often something that is missing and something they will not necessarily seek out. In a situational analysis I conducted for UNFPA, talking with women with disabilities, they often received information about sexual and reproductive health issues from female relatives. I suspect this is likely for most women. The Guttmacher research provides evidence we can infer from to Pacific countries, reinforcing the fact that women not only need a range of contraceptive choices, but also accurate information, education and support.