Evaluation of the psychometric properties of the Reproductive Autonomy Scale for use in the UK

BMJ Sex Reprod Health. 2023 Jul;49(3):151-157. doi: 10.1136/bmjsrh-2022-201685. Epub 2023 Jan 19.


Background: Reproductive autonomy-control over outcomes including contraceptive use and childbearing-is a human right and vital to women's empowerment. Those whose reproductive autonomy is threatened by the structures and relationships in their lives are at risk of coercion and unplanned pregnancy and could benefit from additional services. The Reproductive Autonomy Scale (RAS) was developed in the USA to assess women's reproductive autonomy; this study evaluates the RAS for use in the UK.

Methods: After testing, the RAS was incorporated into an online survey of women of reproductive age. Those who were sexually active were asked to complete the RAS, which was evaluated according to classical test theory. Reliability was assessed via internal consistency and a 3-month test-retest. Construct validity was assessed using hypothesis testing and confirmatory factor analysis.

Results: For 826 women the RAS was highly acceptable, with a response rate of >97.7%. Almost the whole range of reproductive autonomy scores were captured. Internal consistency was good, with a Cronbach's α of 0.75. Test-retest reliability was fair-good with an intraclass correlation coefficient of 0.67. Construct validity analysis found the scale to be valid based on our hypothesis that among women who want to avoid pregnancy, those with higher reproductive autonomy will be more likely to use contraception. The three-factor structure of the scale was confirmed on confirmatory factor analysis.

Conclusion: The RAS is valid and reliable for use in the UK. This tool holds potential utility across research, clinical practice, health interventions and policy development.

Keywords: contraception behavior; family planning services; patient advocacy; reproductive behavior; reproductive health services; surveys and questionnaires.

MeSH terms

  • Contraception*
  • Contraceptive Agents*
  • Female
  • Humans
  • Pregnancy
  • Psychometrics
  • Reproducibility of Results
  • United Kingdom


  • Contraceptive Agents