A lack of power, misconceptions, fear and embarrassment stop young Cambodian women using contraceptives

Misconceptions arising from poor sexual and reproductive health knowledge, the fear of side effects, embarrassment, and having little power in relationships are stopping young women in Cambodia from using contraceptives.

The findings, based on interviews with 30 women aged 16-27, suggest that young women would benefit from education and empowerment initiatives that would support them to make informed decisions about their sexual and reproductive health.

The study took place between January and April 2019 in Cambodia’s capital city Phnom Penh and urban areas of Siem Reap Province. Of the 30 participants, 22 were sexually active (12 married and 10 unmarried) and 8 were not.

The women described having little choice about which contraceptives they used. More than half the sexually active participants used the withdrawal method because their partner preferred it. Information about the withdrawal method mostly came from their partner, who received their knowledge from friends and colleagues rather than healthcare professionals.

Five participants had switched from the withdrawal method to the contraceptive pill after getting pregnant unintentionally. All had learnt about the contraceptive pill from healthcare staff during antenatal visits.

Many women did not know where to get accurate information about contraceptives and were too shy to ask health providers about them.

As a result, many had misconceptions about contraceptives. Some believed the coil could cause internal injuries, others believed the contraceptive pill or injection would make them infertile.

Women were also concerned about side effects, including headaches, vomiting and weight gain and heavy menstrual bleeding.

None of the women had received any sexual and reproductive health education at school or university, nor had they got this information from health centres or a family member. Women with a higher level of education (at least Year 10-12 of high school) used the internet to find out information about contraception.

Around half (17) had moved from rural areas in search of better work and study opportunities. Many of these women reported having limited access to nearby sexual and reproductive health services.

Cultural barriers also played a significant role in limiting women’s access to contraceptives. All the unmarried, sexually active participants said they were too shy or embarrassed to ask for contraceptives at health centres, shops or pharmacies. The short-term nature of sexual relationships was also a reason for not wanting to take the contraceptive pill or have an injection.

Nine women said they would like to use contraceptive implants but these were unavailable in health centres. In general, women felt health centres offered a limited choice of contraceptive methods.

Despite its small size, this study provides further evidence of the severe lack of sexual and reproductive health services for young women in Cambodia.

To address this, the study’s authors recommend that the Cambodian government introduces a national education programme on sexual and reproductive health for young men and women, focusing on promoting the rights of young women to make informed decisions about their bodies.