Co-principal Investigator, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh. Correspondence:
Co-principal Investigator, The DHS Program, Avenir Health, Rockville, MD, USA.
Sex Reprod Health Matters. 2022;29(2):2097044. doi: 10.1080/26410397.2022.2097044.
Bangladesh is one of the major labour-exporting countries in the world, with large-scale labour migration flows occurring both internationally and domestically. Spousal separation due to migration has the potential to disrupt women's ability to use contraception in line with their reproductive goals. This qualitative study complements the 2014 Bangladesh Demographic and Health Survey (BDHS) data; we conducted in-depth interviews with a sub-sample of 23 BDHS respondents whose husbands stayed elsewhere but returned at least once a year to Barisal Division, Bangladesh. The study explores how husbands' migration patterns influence couples' fertility intentions, contraceptive decision-making and behaviour, and unintended pregnancies. Results showed that contraceptive use was high among the study participants, with nearly all couples using some method to avoid pregnancy - usually pills and condoms. However, the use was episodic and inconsistent, reducing effectiveness. Experiences of side effects were commonplace, which contributed to this pattern of inconsistent use: women used pills only during the duration of their husband's visits. Half of the informants experienced unintended pregnancies either due to the inconsistent use of pills or other method failures. The study findings indicate that women with migrant husbands need family planning education related to their particular circumstances and access to a wider range of family planning choices. Quality counselling should respect women's experiences with side effects and include thorough discussion of viable alternatives.
孟加拉国是世界上主要的劳务输出国之一，存在大规模的国际和国内劳务迁移。由于迁移导致的配偶分离，有可能破坏妇女按照其生殖目标使用避孕措施的能力。这项定性研究补充了 2014 年孟加拉国人口与健康调查（BDHS）的数据；我们对 23 名 BDHS 受访者进行了深入访谈，这些受访者的丈夫在其他地方工作，但每年至少回巴塞尔地区一次。该研究探讨了丈夫的迁移模式如何影响夫妻的生育意愿、避孕决策和行为以及意外怀孕。结果表明，研究参与者的避孕措施使用率很高，几乎所有夫妇都使用某种方法来避免怀孕——通常是药丸和避孕套。然而，这种使用是间歇性的且不一致的，降低了效果。副作用的经历很常见，这导致了这种不一致使用的模式：妇女只在丈夫来访期间使用药丸。一半的受访者因药丸使用不一致或其他方法失败而经历了意外怀孕。研究结果表明，有移民丈夫的妇女需要与她们的特殊情况相关的计划生育教育，并获得更广泛的计划生育选择。优质咨询应尊重妇女的副作用经历，并包括对可行替代方案的彻底讨论。
