UCLA

Kenya has had a history of promoting both family planning and efforts against gender-based violence. However, intimate partner violence (IPV) remains a significant factor in women’s lives. Although experience of IPV has been shown to create a significant burden on reproductive health outcomes, less work has focused on the impact of IPV on women’s contraceptive use particularly in Kenya. Using the data from the 2003, 2008-09, and 2014 Kenya Demographic and Health Surveys (Kenya National Bureau of Statistics (KNBS) & ICF Macro 2004, 2010, 2015) this dissertation focused on the association between IPV, fertility intentions, women’s autonomy, and contraceptive use. I integrate the theory of gender and power and the social-ecological model to examine the association between IPV and contraceptive use.

In the first study I focus on the impact of IPV on women’s fertility intentions. IPV experience increases the likelihood women would want to limit their childbearing as compared to wanting to space births or have children soon. This indicates that women would be less likely to want to raise children in an environment they are unsure is safe or supportive, a concept I call the uncertain futures hypothesis.

The second study examines whether exposure to IPV reduced contraceptive use. I find that IPV did not uniformly reduce contraceptive use. Instead, IPV exposure decreased the likelihood of traditional contraceptive use but increased the likelihood of modern contraceptive use. This lends further credence to the possibility that women are making planful contraceptive decisions in IPV situations.

In the final study I examine whether healthcare decision making, representing a facet of women’s autonomy, mediates the relationship between intimate partner violence and recent modern contraceptive use. This study found that there no mediated effect of healthcare decision making. However, healthcare decision-making remained significant in all models underscoring the need to consider ability to make healthcare decisions as a possible barrier to contraceptive access for women in abusive partnerships.

This dissertation improves the evidence that IPV may facilitate women’s greater use of modern contraceptives in African contexts. It also underscores the need to consider IPV experiences when advising women on family planning.