Women's Education, Spousal Agreement on Future Fertility Intentions, and Contraceptive Use in Pakistan.

Abstract

In less egalitarian countries such as Pakistan, reproductive behaviors are gendered, with couples often disagreeing about their fertility goals. However, the dramatic changes in women's empowerment and messaging around reproductive behaviors in Pakistan in recent years may have affected how women's own characteristics and their concordance with their spouse on fertility goals are linked to contraception. Using matched couple data from two cycles of the Pakistan Demographic Health Survey (1990-1991 and 2017-2018), this paper examines the relative influence of husbands' and wives' fertility preferences, as well as women's education, on contraceptive use using linear probability models. Disagreement between couples declined modestly, by about four percentage points, over time. When disagreement about future fertility intentions occurs, wife's fertility preferences are more strongly related to contraceptive behavior, and this association has not changed over time. Although contraceptive use is positively associated with education, the link between women's education and contraceptive use has weakened over time due to increased use among uneducated women. Pakistani women's own fertility preferences are reflected in their contraceptive behavior, and contraceptive use is increasing among all women, even less educated women. Diffusion processes are likely at play, though more work is needed to identify these processes and potential barriers to contraceptive use.