Perceived norms, personal agency, and postpartum family planning intentions among first-time mothers age 15–24 years in Kinshasa: A cross-sectional analysis
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The study underscores that perceived social expectations and norms—especially those from the broader community—are powerful influencers of PPFP behavior. When young mothers believe that their peers use contraception or that their community supports it, their intention to do so increases. Conversely, perceived disapproval suppresses these intentions. Effective PPFP programs must challenge harmful myths, reinforce positive peer examples, and build individual agency while engaging with ethnic and cultural nuances.
Objectives This study examined how social norms and personal agency shape postpartum family planning (PPFP) intentions among first-time mothers (FTMs) aged 15–24 in Kinshasa, Democratic Republic of Congo. A secondary objective was to test the influence of normative expectations on PPFP intentions. Additional objectives were to determine whether norms exerted the same degree of influence on PPFP intentions across ethnic groups and to better understand the simultaneous influences of injunctive norms and social sanctions for PPFP use by modeling the interactions between them.
Methods Data came from the 2018 Momentum Project baseline survey, involving 2,418 pregnant FTMs. Researchers conducted exploratory factor analysis and two multivariable linear regression models, guided by the Integrated Behavioral Model (IBM). Key measures included attitudes toward family planning, injunctive norms (referent approval), descriptive norms (perceived peer behavior), normative expectations, perceived control over PPFP use, self-efficacy, and autonomy.
Results PPFP intentions were generally low: only 10–13% of women reported being very likely to discuss or use contraception postpartum. However, women who perceived societal approval, believed many peers used PPFP, and had high self-efficacy and autonomy, reported stronger intentions. Normative expectations and self-efficacy explained two-thirds of the variation in PPFP intentions. Injunctive norms were less predictive than broader community norms. The influence of norms varied by ethnicity, with stronger effects among the Bakongo group.
Conclusions The results suggested that understanding different normative influences may be important to motivate women to use contraception in the immediate postpartum period. In addition to addressing institutional, individual, and social determinants of PPFP, programs should consider integrating norm-based and empowerment strategies.
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