Women's reproductive autonomy during the COVID-19 pandemic: a cross-sectional study.
Carolyne Souza de Moura Barbosa, Ana Cecília Silvestre da Silva, Géssyca Cavalcante de Melo and 1 others
PMID 39907388WHAT IT FOUND
Women in Alagoas reported high overall reproductive autonomy during the pandemic, mean 3.27 on a 1.00 to 4.00 scale.
Decision-making scored lowest at 2.65, while absence of coercion and communication were higher.
Key findings
01Total reproductive autonomy averaged 3.27 on a 1.00 to 4.00 scale, and decision-making was the lowest subscale at 2.65.
02Women aged 18 to 35 reported higher absence of coercion and communication scores than women older than 35.
03Most women used contraception during the pandemic (81.53%) and did not report difficulty obtaining it (87.26%), but 67.20% did not attend reproductive planning services or receive counselling.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that the pandemic caused changes in autonomy or that counselling improves autonomy. Recruitment was non-probabilistic and online through social media, email and WhatsApp, which requires internet access and may miss women with lower education or income. Of 404 initial participants, 314 were analysed; the paper says 22% of collected instruments were excluded for incomplete or unusable responses. The sample was not representative: 87.26% lived in the capital, 98.41% had more than eight years of schooling, and 87.26% self-identified as non-Black. Only 12.74% self-identified as Black, so the lack of significant race differences may not reflect the experiences of Black women. Results were self-reported and came from a convenience sample of women in one Brazilian state.
The easy way to misread this
Do not read the high average autonomy score as proof that pandemic restrictions did not harm access, or that counselling improves autonomy. This was a cross-sectional online survey of a mostly educated, capital-city sample, and it did not test an intervention.