In Malawi, Women’s Fear of Abandonment May Outweigh Desire for Pregnancy Prevention

In “Sexual Pleasure, Partner Dynamics and Contraceptive Use in Malawi,” by Neetu A. John, of Johns Hopkins University, et al., focus group discussions with married men and married women indicate that whether they adopt a contraceptive method, which one they choose and whether they continue using it are all affected by how the method is perceived to affect sexual pleasure, especially male pleasure. This influence is strengthened by the societal norm that assigns women the role of providing pleasure in sexual relationships. Because their spouse may abandon them or take another wife if his sexual needs are not met, women in Malawi must weigh the benefits of method use against how it might affect his sexual pleasure and, thus, the dynamics of their relationship. In this context, the authors say, women’s decision making on contraceptive use is a complex calculation that goes beyond such issues as method access, method effectiveness and desire to prevent pregnancy.