Covert contraceptive use: Prevalence, motivations, and consequences

This article examines women's covert use of contraceptives, that is, their use of a method without their husbands' knowledge. Three questions are addr essed: (1) How is covert rise measured? (2) How prevalent is it? and (3) Wh at are the factors underlying covert use? Existing studies are used togethe r with survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and their husbands. Women's covert use of contra ceptives is estimated to account for 6 to 20 percent of all current contrac eptive use, and it is more widespread when contraceptive prevalence is low. The multivariate analysis indicates that difficult spousal communication a bout contraception is the strongest determinant of covert tree. Husbands' d isapproval of contraception works through spousal communication rather than as a direct influence on covert use. Husbands' pronatalism had no signific ant effect. The article concludes with implications of covert use for repro ductive health and family planning programs, especially women's (and men's) needs for confidential services.