Gender imbalances in intimate relationships make it difficult for women to decide when, if at all, to have children.
One out of three Sowetan women between the ages of 18-24 say they have been sexually assaulted by a male partner in the last year, according to a study published in the African Journal of Reproductive Health in March.
The study authors interviewed 90 women while accessing contraception and other sexual and reproductive health services in Soweto.
The researchers concluded that although the women said contraception and other sexual and reproductive health services to prevent HIV infection and unintended pregnancies was available, gender dynamics in their relationships influenced their choices when accessing these services.
Only half of the participants had used a condom the last time they had sex even although almost all of them were aware of this form of
Common factors that influenced whether the participants protected themselves or not against pregnancy or HIV infection included “physical and emotional abuse by partners, pressure from partners to have sex or have a baby (and in one case, from parents to have a baby), and partners not wanting to use protection”.
Issues relating to economic inequality also factored into women’s choices or lack thereof. Said one participant: “Women don’t protect themselves. If you find a man, and let’s say he gives you money and you live with him, once he says he doesn’t want a condom, that’s that.”
According to Vuyiseka Dubula from the gender activist group, Sonke Gender Justice, gender imbalances in intimate relationships make it difficult for women to decide when, if at all, to have children as well as how many they want to have.
Dubula says gender inequality gives men more power over women’s bodies and control over their reproductive rights. “…[S]exual rights of women are compromised in relationships where women do not have power to negotiate safe sex particularly when it comes to prevention of HIV transmission.”
Nataly Woollett from the Wits Reproductive Health and HIV Institute (WRHI), a health research organisation, says women who do not access sexual and reproductive health services may suffer health complications. Complications of unwanted pregnancies from the inaccessibility of fertility control result in poor outcomes such as the risk of exposure to HIV or sexually transmitted infections and maternal deaths, she says.
The 2013 government progress report on the millennium development goal indicated that maternal deaths between the years 2002 and 2010 increased from 133 deaths to 269 deaths per 100 000 live births. The 2012 national HIV antenatal survey conducted with over 34 000 pregnant participants found that nearly 30% of the women between the ages of 15 and 49 were HIV positive.
“Intimate partner violence tends to be high where gender inequality is high,” Woollett says.
Persomé Oliphant is a Bhekisisa fellow sponsored by the United Nations Population Fund.