Relationship Dynamics and Young Women's Contraceptive Use.

Introduction: Research from sub-Saharan Africa has shown that women's relationships and partners influence their contraceptive use. Most relevant studies focus on relationship status with few considering how the quality of a relationship might influence women's use of contraceptives. This study is the first to examine how both positive and negative relationship dynamics are associated with young women's modern contraceptive use among those who want to postpone pregnancy for at least two years or stop childbearing altogether. Methods: We analyze survey data collected in 2010 and 2011 from 745 young women aged 16-26 in partnerships in southern Malawi. The data include positive relationship dynamics such as expressions of love, communication, and partner support (relationship unity) and negative dynamics including unequal power and intimate partner violence. Results: Logistic regression models show that relationship unity is significantly and positively associated with modern contraceptive use whereas negative relationship dynamics are not associated with contraceptive use among the sample. When stratified by relationship status, model results show the effects are driven by unmarried women. Conclusions: Results suggest that positive relationship dynamics among unmarried couples can facilitate modern contraceptive use among those who want to avoid pregnancy. Policy Implications: Efforts to encourage partner communication and support surrounding the use of contraception, and expanding access to a variety of modern methods, may be beneficial for reducing unintended pregnancies and enhancing unmarried young women's reproductive autonomy to meet their contraceptive and fertility desires.