BACKGROUND:
Since the 1994 Cairo Conference, sexual and reproductive rights have been recognized as fundamental human rights. Reproductive autonomy includes deciding freely on contraception, number and timing of children, without coercion. In Latin America, structural inequalities continue to hinder women’s ability to exercise this right fully.

OBJECTIVES:
To assess reproductive autonomy in contraceptive and family planning decision-making among cisgender women aged 18 to 49 in five Latin American countries.

METHODS:
This mixed-methods study combined an online survey and focus groups. The Reproductive Autonomy Scale (Spanish version) was used in the quantitative phase. As of June 2025, 2,026 responses were registered; 1,996 fulfilled the inclusion criteria, 1,029 completed informed consent, and 850 participants finalized the survey. The study included respondents from Argentina, Chile, El Salvador, Peru, and Uruguay.

RESULTS:
Among 850 respondents, 51.41% were single, 92.47% resided in urban areas, 49.53% were employed, and 30.24% were students. Modern contraceptive use was reported by 72.82%, with 79.19% consulting a healthcare provider (midwives, gynecologist, doctors) prior to initiation. Although 24.49% indicated that the provider selected the method, 66.47% made the decision independently, and 28.71% shared it with their partner. Regarding fertility decisions, 49.41% chose motherhood independently and 48% jointly. Reports of reproductive coercion were low: over 74% strongly disagreed with being forced to use contraception, and 78.35% with being pressured to conceive. Over 90% reported partner support and ease in discussing sexual and reproductive health.

CONCLUSIONS:
Findings suggest a high level of reproductive autonomy among respondents, characterized by significant use of contraceptives, informed and consensual decision-making, low coercion, and strong communication within relationships.

KEY MESSAGE:
The preliminary results show a high level of reproductive autonomy among the surveyed women, who have a profile of high employability and education. The full sample may reveal greater diversity. The healthcare providers are still important in the contraceptive decision. Spanish - SRHR (including three-minute presentation competition)