ReviewWomen's empowerment and fertility: A review of the literature
Introduction
Over the last two decades, women's empowerment has become a focus for development efforts worldwide. In 2000, 189 countries signed on to the eight Millennium Development Goals, which included a commitment to promoting gender equality and empowering women (MDG3) (United Nations, 2000).
Since then, several scholars have attempted to synthesize existing knowledge on women's empowerment and international development. In the only review that focused on reproductive-related outcomes, published over a decade ago, Blanc (2001) synthesized the research examining the role of gender-based power in sexual relationships and its impact on reproductive health. Malhotra et al. (2002) summarized the most promising methods to measure and analyze women's empowerment and provided a review of empirical studies from the fields of economics, sociology, anthropology, and demography. In 2008, Kishor and Subaiya (2008) provided data on the distribution and correlates of women's empowerment in 23 countries documenting the wide variation in levels of decision-making power and gender-equitable attitudes.
Recently, the World Bank devoted the World Development Report (2012) to the theme of Gender Equality and Development. The report argues that the success of global development efforts hinges on gender equality and recommends public policies that promote gender equity as a means of ensuring economic growth.
At the same time that these efforts aimed to improve the status of women globally, support for family planning—an integral component in transforming women's lives—waned (Cleland et al., 2006, Crossette, 2005). The recent London Summit on Family Planning brought renewed attention to the importance of family planning as a means of reducing fertility and expanding the options available to women beyond reproduction (Carr et al., 2012).
This literature review builds on previous reviews of women's empowerment, by focusing specifically on research that examines its associations with fertility. To guide our work we use a definition and conceptualization of women's empowerment based on Kabeer, 1999, Kabeer, 2001: “the expansion of people's ability to make strategic life choices in a context where this ability was previously denied to them.” Within this definition, two central components of empowerment are the agency and the resources needed to exercise life choices. This definition allows a broader conceptualization than interpersonal sexual relationship power.
Section snippets
Methods
We conducted literature searches using PubMed, POPLINE, and Web of Science search engines in May 2013. Searches were conducted by using the following individual and combined keywords (and MeSH terms in PubMed): fertility, family size, ideal family size, birth intervals, birth/birth spacing, induced abortion, reproductive health, unplanned pregnancy, unintended pregnancy, parturition, birth, pregnancy, pregnancy spacing/intervals, and childbearing, published from January 1990 to December 2012.
Measures of women's empowerment
We identified 19 domains of women's empowerment in the reviewed studies and for each, provided specific examples of how the studies operationalized empowerment (Table 1). While the majority of the 60 studies assessed empowerment across multiple domains, 4 studies examined only one domain. In over two-thirds (n = 47) of the studies, multidimensionality was determined through the use of composite or sum scores, indices, factor analysis and multi-item scales, while the remaining 17 studies used
Summary of findings
Overall, empowerment was inversely associated with number of children in the majority of studies, although many studies also found no association between some indicators of women's empowerment and number of children. Studies that used multiple and multidimensional measures of empowerment were more likely to find consistent associations, highlighting the importance of choosing appropriate measures that better approximate women's empowerment.
Empowerment was also demonstrated to be positively
Conclusion
Improvements in the status and empowerment of women is central to progress in global development efforts and, perhaps more importantly, to the achievement of equitable treatment and representation of the 3.5 billion women in the world. Understanding individual women's experience of empowerment and its effects is a crucial early step in making major advances in gender equity at the society level, and in achieving the Millennium Development Goal of promoting gender equality and empowering women.
Acknowledgments
This research was supported by the University of California Global Health Institute (UCGHI) Women's Health and Empowerment Center of Expertise. U. Upadhyay's participation was supported by the Advancing New Standards in Reproductive Health (ANSIRH) program at University of California, San Francisco (UCSF). J. Gipson's participation was supported by NIH Grant #1K01HD067677. A. Fraser and N. Prata's participation was supported by the Bixby Center for Population, Health and Sustainability,
References (86)
Women's autonomy and its impact on fertility
World Dev.
(1996)Toward empowerment
World Dev.
(1989)- et al.
Giving women the power to plan their families
Lancet
(2012) - et al.
Family planning: the unfinished agenda
Lancet
(2006) - et al.
Impact of woman's status on fertility and contraceptive use in Bangladesh: evidence from Bangladesh demographic and health survey, 1999–2000
J. Fam. Welf.
(2005) - et al.
Factors affecting the most recent fertility rates in urban-rural Bangladesh
Soc. Sci. Med.
(1997) - et al.
Women's empowerment and fertility decline among the Pare of Kilimanjaro region, Northern Tanzania
Soc. Sci. Med.
(2003) Women's empowerment and reproductive experiences over the lifecourse
Soc. Sci. Med.
(2010)- et al.
Understanding gendered influences on women's reproductive health in Pakistan: moving beyond the autonomy paradigm
Soc. Sci. Med.
(2009) - et al.
Community level effects of gender inequality on intimate partner violence and unintended pregnancy in Colombia: testing the feminist perspective
Soc. Sci. Med.
(2005)
Do higher status and more autonomous women have longer birth intervals? Results from Cebu, Philippines
Soc. Sci. Med.
Women's autonomy and unintended pregnancies in the Philippines
J. Biosoc. Sci.
Position of women in the Ladiya society: demographic perspectives
Coll. Antropol.
Refining the measurement of women's autonomy: an international application of a multi-dimensional construct
Soc. Forces
Status of women and fertility in Iran
J. Comp. Fam. Stud.
The sociocultural context of family size preference, ideal sex composition, and induced abortion in India: findings from India's national family health surveys
Health Care Women Int.
Determinants of women's fertility in Oman
Saudi Med. J.
Women empowerment and marital fertility in Oman
J. Egypt Public Health Assoc.
Women's empowerment and reproductive choices
Pak. Dev. Rev.
Socio-cultural constraints and women's decision-making power regarding reproductive behaviour
Pak. Dev. Rev.
Poor women's participation in credit-based self-employment: the impact on their empowerment, fertility, contraceptive use, and fertility desire in rural Bangladesh
Pak. Dev. Rev.
The effects of status of women on fertility in an urban setting of Tamil Nadu
Indian J. Soc. Work
Individual and community aspects of women's status and fertility in rural Bangladesh
Popul. Stud.
Women's education and the timing of marriage and childbearing in the next generation: evidence from rural Bangladesh
Stud. Fam. Plan.
Determinants of fertility in three north Indian states: caste, female autonomy and economic development
Can. J. Dev. Stud. Rev. Can. d'études Du. dév.
Economic development, gender inequality, and demographic outcomes: evidence from India
Popul. Dev. Rev.
The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence
Stud. Fam. Plann.
Sex roles and the link between fertility and employment
Sex. Roles
Routes to low mortality in poor countries
Popul. Dev. Rev.
The Demographic Transition. The Population Debate: Dimensions and Perspectives
Reproductive health and the millennium development goals: the missing link
Stud. Fam. Plann
Decision-making patterns and contraceptive use: evidence from Uganda
Popul. Res. Policy Rev.
On kinship structure, female autonomy, and demographic behaviour in India
Popul. Dev. Rev.
The path to replacement fertility in Egypt: acceptance, preference, and achievement
Stud. Fam. Plan.
Contraceptive use, birth spacing, and autonomy: an analysis of the Oportunidades program in rural Mexico
Stud. Fam. Plan.
Writing the names: marriage style, living arrangements, and first birth interval in a Nepali society
Demography
'Marriage means having children and forming your family, so what is the need of discussion?' – communication and negotiation of childbearing preferences among Bangladeshi couples
Cult. Health & Sex.
Fertility decline and women's status: a micro data analysis of the role of non-governmental organizations (NGOs) in Bangladesh
Int. NGO J.
Conjugal power in rural Kenya families: its influence on women's decisions about family size and family planning practices
Sex. Roles
Modernisation, status of women and fertility
J. Fam. Welf.
Women's autonomy, women's status and fertility-related behavior in Zimbabwe
Popul. Res. Policy Rev.
Multilevel models of fertility determination in four Southeast Asian countries: 1970 and 1980
Demography
Household organization, women's autonomy, and contraceptive behavior in southern Ethiopia
Stud. Fam. Plan.
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