Contentions and Contradictions in Using Contraceptives: Examining Empowerment, Agency and Womanhood Among Unmarried Young Women in the Philippines

Background and Purpose:  Amidst a backdrop of increased modernization, strongly held belief in women’s rights and deeply rooted Catholicism, the Philippines passed its first comprehensive reproductive health law in 2012 to tackle the rising teenage pregnancy and sexually transmitted infection rates in the country.  The need is evident as one-third (32%) of unmarried Filipinos aged 15-24 years old report sexual activity, 78% of whom indicated that they did not use any form of protection.  This study examined the factors that may influence low contraceptive use among young Filipino women (YFW) and the role religion and gender may play in their contraceptive decisions. 

Methods:  We conducted two focus groups with unmarried YFW (N=19) between the ages of 18-21 years old and five individual interviews with reproductive health providers living in Puerto Princesa, Palawan, which is a small provincial island in the western region of the Philippines.  All sessions followed a semi-structured interview guide where questions were developed in partnership with Filipino young adults.  The qualitative sessions were recorded and transcribed verbatim.  We used Spradley’s ethnosemantic approach to determine salient cultural themes.

Results: Preliminary results suggest that YFW contend with multiple, often conflicting, expectations and feminine ideals relating to their sexuality and eventual contraceptive use.  In our focus groups, sexual agency was closely tied to a YFW’s virginity, a virtue that our participants believed defined a woman’s dignity and respectability.  However, despite this religiously prescribed belief, YFW saw contraceptive use within the confines of a stable loving relationship as acceptable and, for some YFW, a responsible duty.  Additionally, empowerment was described by our focus group participants as forgoing intimate and sexual relationships to pursue one’s educational and professional goals.  Yet the same participants also acknowledged that empowerment can come from using contraceptives as a means to escape poverty and establish financial stability.  Finally, contraception was often expressed in relation to the term “control.”  YFW participants indicated that contraceptives signified a lack of “control” in one’s sexual urges, but such contraceptives can also help “control” one’s life circumstances by preventing an unwanted pregnancy or reducing the risk of infection or disease.  Individual interviews with reproductive health professionals corroborated these findings, indicating that YFW are often caught in between varying societal, familial, and personal expectations, none of which allow them to fully express their sexuality, leading to a lack of attention in YFW’s need for contraception.

Conclusions and Implications:  The intersection of contractive use, religious doctrine, and women’s empowerment is an important area of consideration for health social workers in macro and clinical practice. The study findings can be used to inform macro level practitioners working in international settings as well as those working in local social service and reproductive health agencies that serve newly arrived immigrants and refugees. Specifically, they can help address the systematic and institutional barriers that disempower young women, particularly those from culturally conservative communities, and limit their contraceptive options and choices.