Reproductive Autonomy in Fertility Research in Sub-Saharan Africa: A Scoping Review.

Abstract

Fertility research in sub-Saharan Africa regularly indicates the need to increase women's reproductive autonomy. However, individual, female-focused conceptualizations of reproductive autonomy tend to neglect the power dynamics both internal and external to couples and other intimate relationships that shape a woman's reproductive autonomy. Furthermore, they disregard the reproductive autonomy of men and other subpopulations and partners in intimate relationships. To identify gaps and evaluate the applicability of the concept, this scoping review clarifies how reproductive autonomy has been assessed and applied in fertility research in sub-Saharan Africa. Eligible for inclusion were empirical peer-reviewed publications, including quantitative, qualitative, and mixed-methods research, published since 1994. Out of 1568 articles screened, 18 met the inclusion criteria. Most publications were quantitative in nature and focused mainly on the reproductive autonomy of women. Our key finding is that the reproductive autonomy of partners in intimate relationships, and of women in particular, is restricted at the community level in order to preserve the status quo of social power structures in society. In line with a reproductive justice approach, more research should focus on the reproductive autonomy of vulnerable and understudied populations as well as on the interpersonal and contextual dynamics that suppress reproductive autonomy in communal settings.