Promoting healthy couples’ communication to improve reproductive health outcomes

Implement interventions demonstrated to encourage couples to discuss family planning/reproductive health and make equitable, joint decisions to reach fertility intentions.

Couples’ communication is a form of interpersonal communication that entails the exchange or sharing of information, thoughts, ideas, intentions, and feelings between sexual partners. Couples’ communication is influenced by policies, attitudes, values, culture, social and gender norms, and the individual’s immediate environment. There are many forms of interpersonal communication that could result in uptake of modern contraception or improved reproductive health outcomes, e.g., between woman to woman; man to man; parent to child; provider to client; provider to provider; trusted adult to adolescent. This brief focuses on improving healthy couples’ communication to improve reproductive health outcomes.

Since the 1990s, the family planning field has recognized the importance of couples’ communication in the voluntary uptake of modern contraceptive methods.1–3 Several studies show a positive association between couples discussing their fertility intentions with joint decision making on whether or when to have children (Schwandt et al., 2021; Naja-Sharjabad, 2021; Shattuck, 2011).4–6

In the last decade, evidence has emerged on the importance of ensuring interventions promoting healthy couples’ communication, with a focus on improving the quality of those discussions6(p186) and addressing gender inequalities. Supporting healthy couples’ communication can increase the uptake of modern contraceptive use while meeting the HIP principle of “gender equality,” or “endeavor[ing] to be inclusive of women and men by removing barriers to their active engagement and decision-making, recognizing the role of family planning in supporting more equitable power dynamics and health relations.”7 Recently, there has been attention to power related to sexual decision making and healthy sexual relationships (e.g., consent, bodily autonomy, pleasure), with a need to “better support couples in building practical skills to increase intimacy and communication).”8(p5)

Access to modern contraceptive methods and reproductive autonomy are fundamental human rights.9 Individuals must be able to access contraception as their individual right. Involvement of the male partner should not prevent women from choosing contraception free from the influence of a male partner.6 Therefore, while promoting healthy couples’ communication to improve reproductive health outcomes is a proven HIP, it is critical to ensure that “all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children.”