Who Decides? Reproductive Autonomy Among Married Rural Women in India: Evidence from 11 Villages

Abstract

Reproductive autonomy is central to women’s health, rights, and gender equality, yet many married  women in rural India continue to have limited authority over decisions related to childbearing and healthcare. While prior research has linked women’s autonomy to education, poverty, and social norms, fewer studies have examined how digital access, financial control, and collective participation intersect with structural disadvantage at the village level. This paper investigates the extent of reproductive decision-making autonomy among married rural women and examines its association with education, caste, economic vulnerability, digital use, financial control, and self-help group participation. A cross-sectional survey was conducted among 982 married women aged 18–49 years across 11 purposively selected villages in India. The questionnaire was structured using the Advancing Women’s Empowerment through Systems-Oriented Model Expansion (AWESOME) framework. Descriptive statistics and chi-square tests were used to analyse patterns of decision-making and associations with key socio-demographic and empowerment variables. Only 20.3% of respondents reported sole decision-making authority over childbearing, while 44% reported that husbands or in-laws were the primary decision-makers. Sole authority over healthcare visits was reported by 28.8% of women. Education and self-help group participation were positively associated with reproductive autonomy, while caste and economic vulnerability were associated with lower autonomy. The findings further show that household access to phones, homes, or bank accounts does not necessarily translate into women’s agency when independent control is absent. The paper contributes to gender research by showing that reproductive autonomy is shaped not only by household assets, but by the interaction of structural disadvantage, effective resource control, and collective support. The study argues that gender-transformative interventions must move beyond material provision toward strengthening women’s independent digital and financial control and expanding collective platforms that support negotiation and agency.