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\"This book demonstrates that the symbol of maternal sacrifice is the notion that 'proper' women put the welfare of children, whether born, in utero or not conceived, over and above any choices and desires of their own. The idea of maternal sacrifice acts as powerful signifier in judging women's behaviour that goes beyond necessary care for any children. The book traces its presence in various aspects of reproductive health, from contraception to breastfeeding. Pam Lowe shows how although nominally choices are presented to women around reproductive health, maternal sacrifice is used to discipline women into conforming to specific norms, reasserting traditional forms of womenhood. This has significant implications for women's autonomy. Women can resist or reject this disciplinary position when making reproductive decisions, but in doing so they may be positioned as transgressing and/or need to justify their decisions\"-- Back cover.

Background Women’s decision-making power regarding reproductive health and rights (RHR) was the central component to achieve reproductive well-being. Literatures agree that a women having higher domestic decision-making power regarding their health care were more likely to utilize health services. More than 80% of women in Ethiopia reside in rural areas where they considered as the subordinates of their husbands. This would restrict women to fully exercise their RHR. Thus, this study aims to determine the factors influencing the women’s decision-making power regarding RHR in Mettu rural district, South West Ethiopia. Methods A community based cross-sectional study was done among 415 by using randomly selected married women of reproductive age from March to April 2017. Data was entered by using Epi-data manger 1.4 and analyzed by SPSS version 21. Descriptive and multivariate logistic regression analysis was carried out. Result One hundred sixty-eight (41.5%) of the women had greater decision-making power regarding RHR. Woman’s primary education AOR 2.62[95% C. I 1.15, 5.97], secondary (9+) education AOR 3.18[95% C. I 1.16, 8.73] and husband’s primary education AOR 4.0[95% C. I 1.53, 10.42], secondary (9+) education AOR 3.95 [95% C. I 1.38, 11.26], being knowledgeable about RHR AOR 3.57 [95% C. I 1.58, 8.09], marriage duration of more than 10 years AOR 2.95 [95% C. I 1.19, 7.26], access to micro-credit enterprises AOR 4.26[95% C. I 2.06, 8.80], having gender equitable attitude AOR 6.38 [95% C. I 2.52, 12.45] and good qualities of spousal relation AOR 2.95 [95% C. I 1.30, 6.64] were positively influencing women’s decision-making power regarding RHR. Conclusion More than four in ten rural women had greater decision-making power regarding RHR. External pressures (qualities of spousal relation, gender equitable attitude) and knowledge about RHR were found to influence women’s decision-making power. Public health interventions targeting women’s RHR should take into account strengthening rural micro-credit enterprises, qualities of spousal relations and priority should be given to women with no formal education of husband or herself and marriage duration of < 5 years.

In Germany, efforts to reform current legislation governing access to termination of pregnancy (TOP) have recently gained momentum. In 2023, the German Federal Government appointed a ‘Commission on Reproductive Self-Determination and Reproductive Medicine’, which released recommendations to revise legislation of TOP in April 2024. Currently, TOP is unlawful under the German Criminal Code, with exemptions from punishment for TOP performed within the first 12 weeks of pregnancy following mandatory counselling. Additional exemptions exist in case of criminological or medical-social indications.The Commission report recommends the decriminalisation of early-stage TOP and potential abolition of the mandatory counselling requirement. It further recommends a revision of the medical-social indication, due to a lack of clarity in its interpretation. This indication allows for TOP beyond 12 weeks of pregnancy, where there is danger to the pregnant woman’s life or health.This paper provides an overview of Germany’s current TOP regulation and the Commission’s recommendations, with a particular focus on the ethical and legal challenges posed by the application of the current medical-social indication in cases of fetal anomalies. We argue that while legislative clarity is important, maintaining a broad interpretation of the medical-social indication is crucial to prevent undue restrictions on TOP access at later gestations.The Commission report represents a promising step forward in changes for TOP legislation in Germany, and we welcome its call for legal reform. However, given the outcome of the recent federal election in February 2025, it is unlikely that the revision of TOP legislation will be part of the new government’s agenda.

[...]empowerment measures still need to be critically evaluated [10, 11] and to encompass a range of potential empowerment domains – psychological, social, political, economic and legal [8, 9, 12, 13]. The 12 studies included in this special issue apply methodologies from different disciplines – anthropology, sociology, law, demography, and public health – to provide empirical data on an aspect of women’s empowerment during a critical period of the reproductive life-course. [...]the authors provided specific recommendations for how providers and clinics can deliver appropriate care to transgender men during the pre-transition, pre-conception, prenatal, and postpartum periods. [...]improving women’s empowerment could potentially prevent prematurity, but definitive proof is still lacking.

In Matters of Choice, Iris Lopez presents a comprehensive analysis of the dichotomous views that have portrayed sterilization either as part of a coercive program of population control or as a means of voluntary, even liberating, fertility control by individual women. Drawing upon her twenty-five years of research on sterilized Puerto Rican women from five different families in Brooklyn, Lopez untangles the interplay between how women make fertility decisions and their social, economic, cultural, and historical constraints.

There is a body of theoretical work, and some empirical research, which suggests that non-disabled people assume people with physical disabilities are not suitable romantic partners, do not have sexual drives or desires, or are not sexually active. It has also been proposed that people with physical disabilities face barriers to sexual healthcare access which are structural as well as social. The present paper explores non-disabled South Africans' beliefs concerning the degree to which non-disabled respondents enjoy sexual and reproductive rights, and benefit from sexual and reproductive healthcare, compared to people without disability. Using a survey, we asked 1989 South Africans to estimate the degree to which people with physical disabilities and people without disability have sexual rights, and benefit from sexual and reproductive healthcare services, respectively. Respondents were more likely to support the idea that the population without disability were deserving of sexual rights compared to people with physical disabilities. Respondents were more likely to rate the degree to which people with physical disability benefit from sexual and reproductive healthcare as less than that for people without physical disabilities. These findings provide some of the first empirical support that non-disabled people perceive people with physical disabilities as having fewer sexual and reproductive rights, and deriving less benefit from sexual and reproductive health services, than the population without disability. To have diminished sexual rights, and benefit less from sexual and reproductive healthcare, we suggest, evinces a negation of the sexual and reproductive needs and capacity of people with physical disabilities.

This article discusses political setbacks related to sexual and reproductive health and rights that have occurred in Brazil in the last 5 years (2014-2018) resulting from the significant role played by Christian (Evangelical and Catholic) parliamentarians in the legislative branch. Political initiatives aimed at prohibiting the affirmation of sexual and reproductive rights, while also curtailing debate about sexuality and gender in schools and universities, have raised \"moral panic\" within some elements of Brazilian society. The discursive strategies used around so-called \"gender ideology\" stimulated the formation of civil organisations which promote morality based on right-wing political positions. For this study, we looked at official documents and bibliographic material to examine how issues related to abortion rights, health care in cases of sexual violence, the prevention of sexually transmitted infections and homosexual citizenship are currently being suppressed, compromising the defence and advancement of the sexual and reproductive rights of women and the LGBTI+ population. The results point to the steady weakening of public policies that had become law in the 1980s, a time of Brazilian re-democratisation after two decades of military dictatorship. A wide range of civil, political and social rights, which saw significant growth and consolidation over the last 20 years, were rolled back after the resurgence of the extreme right wing in the federal legislature, culminating in the election of the current president in October 2018. However, social movements have increased in strength in the last few decades, especially the black feminist and LGBTI+ rights movements. These movements continue to provide political resistance, striving to affirm and protect all sexual and reproductive rights achieved to date.

WHO's normative guidance on self-care interventions for sexual and reproductive health and rights (SRHR) promotes comprehensive, integrated and people-centred approaches to health service delivery. Implementation of self-care interventions within the context of human rights, gender equality, and a life course approach, offers an underused opportunity to improve universal health coverage (UHC) for all. Results from an online global values and preferences survey provided lay persons' and healthcare providers' perspectives on access, acceptability, and implementation considerations. This analysis examines 326 qualitative responses to open-ended questions from healthcare providers (n = 242) and lay persons (n = 70) from 77 countries. Participants were mostly women (66.9%) and were from the Africa (34.5%), America (32.5%), South-East Asia (5.6%), European (19.8%), Eastern Mediterranean (4.8%), and Western Pacific regions (2.8%). Participants perceived multiple benefits of self-care interventions for SRHR, including: reduced exposure to stigma, discrimination and access barriers, increased confidentiality, empowerment, self-confidence, and informed decision-making. Concerns include insufficient knowledge, affordability, and possible side-effects. Implementation considerations highlighted the innovative approaches to linkages with health services. Introduction of self-care interventions is a paradigm shift in health care delivery bridging people and communities through primary health care to reach UHC. Self-care interventions can be leveraged by countries as gateways for reaching more people with quality, accessible and equitable services that is critical for achieving UHC. The survey results underscored the urgent need to reduce stigma and discrimination, increase access to and improve knowledge of self-care interventions for SRHR for laypersons and healthcare providers to advance SRHR.

ABSTRACT Objective: To understand how primary care nurses understand and integrate reproductive rights in the context of family planning. Method: Action research developed between September and November 2023 with five nurses from a Primary Care Health Unit in the central region of Rio Grande do Sul. Data were collected through focus groups and analyzed using the content analysis technique. Results: Nurses highlighted reproductive autonomy, with an increase in the demand for tubal ligations; personalized education on contraception; the socioeconomic impact on access to family planning; and challenges related to male inclusion, with strategies aimed at co-responsibility in planning. Final considerations: Nurses play an essential role in promoting reproductive rights. By respecting individualities and the social context, nurses promote shared responsibility and strengthen female autonomy, which are aligned with the Sustainable Development Goals that aim at gender equality and reducing inequalities. RESUMEN Objetivo: Comprender cómo las enfermeras de atención primaria plantean los derechos reproductivos en el contexto de la planificación familiar. Método: Investigación-acción realizada entre septiembre y noviembre de 2023 con cinco enfermeras de una Unidad Básica de Salud de Río Grande del Sur. Los datos se recogieron a través de grupos focales y se analizaron mediante el análisis de contenido. Resultados: Las enfermeras destacaron la autonomía reproductiva, con aumento de la demanda de ligaduras de trompas; la educación anticonceptiva personalizada; el impacto socioeconómico del acceso a la planificación familiar; y los retos sobre la inclusión masculina, con estrategias dirigidas a la corresponsabilidad en la planificación. Consideraciones finales: Las enfermeras desempeñan un papel esencial en la promoción de los derechos reproductivos, respetando la individualidad. Promueven la responsabilidad compartida y refuerzan la autonomía femenina, alineadas a los objetivos del Desarrollo Sostenible, con miras a la igualdad de género y a la reducción de desigualdades. RESUMO Objetivo: Compreender como enfermeiras da atenção primária compreendem e integram os direitos reprodutivos no contexto do planejamento familiar. Método: Pesquisa-ação desenvolvida entre setembro e novembro de 2023 com cinco enfermeiras de uma Unidade Básica de Saúde da região central do Rio Grande do Sul. Os dados foram coletados por meio de grupos focais e analisados pela técnica da análise de conteúdo. Resultados: As enfermeiras destacaram a autonomia reprodutiva, com aumento na demanda por laqueaduras; a educação personalizada sobre contracepção; o impacto socioeconômico no acesso do planejamento familiar; e desafios relacionados à inclusão masculina, com estratégias voltadas à corresponsabilidade no planejamento. Considerações finais: Enfermeiras desempenham papel essencial na promoção dos direitos reprodutivos. Pelo respeito às individualidades e o contexto social, as enfermeiras promovem a responsabilidade compartilhada e fortalecem a autonomia feminina, as quais estão alinhadas aos Objetivos do Desenvolvimento Sustentável que visam a igualdade de gênero e a redução das desigualdades.

Background Women’s empowerment is a process wherein females are afforded power over their own lives as well as their participation in the communities and larger societies to which they belong. An important aspect of such empowerment is the right to make decisions regarding fertility—an entitlement affected by the social health determinants that contribute to the social conditions under which humans live and work throughout their lives. As one such determinant, psychosocial factors play an essential role in the development of women’s empowerment. Correspondingly, this study conducted a structural equation modeling of these determinants to examine the empowerment of Iranian women in reproductive decision making. Methods This cross-sectional study involved 400 women who were referred to clinical centers of the Shahid Beheshti University of Medical Sciences in Tehran, Iran. Data were collected using six questionnaires, namely, demographic, socioeconomic, and social support questionnaires, the Rosenberg self-esteem scale, a marital satisfaction questionnaire, and an empowerment survey. The data were analyzed using SPSS software version 17, and the structural equation modeling was carried out using EQS software version 6.1. Results The Iranian women had an average level of empowerment with respect to reproductive decision making, and such empowerment was related to all the psychosocial factors examined ( p  = 0.001). The final model appropriately fit the data (comparative fit index = 0.92, root mean square error of approximation = 0.06). The psychosocial factors served as intermediate social determinants of the women’s empowerment in reproductive decision making (β = 0.78, p  = 0.001). This empowerment was indirectly affected by socioeconomic situation as a structural factor (β = 0.44, p  = 0.001). Conclusions Socioeconomic factors, through the mechanism of psychosocial determinants, may significantly affect women’s empowerment in making decisions regarding reproductive health. Conditions associated with these factors should be improved to ensure that women claim and exercise their right to have mastery over their reproductive health.