Introduction:
Family planning is a fundamental human right and central to achieving several Sustainable Development Goals (SDGs). Women with migration histories often experience greater reproductive health needs and face multiple barriers to care. This study explored family planning needs, including barriers and facilitators to rights-based reproductive healthcare among women with migration histories in Germany.
Methods:
We conducted an emergent sequential exploratory study in Berlin among 29 women with migration histories who had accessed reproductive healthcare within the past two years. Interviews were conducted in participants’ preferred languages using multilingual recruitment strategies. Data were analysed thematically and descriptively, and barriers and facilitators were interpreted using the Education, Training, and Research (ETR) Health Equity Framework.
Findings:
Participants (mean age 33.76 years) originated from diverse low- and middle-income countries, and most (89.7%) had at least one child. Contraceptive use varied: barrier methods (27.6%) and mixed approaches (24.1%) were most common, while 20.7% reported no contraceptive use and 17.2% relied on traditional methods. Hormonal methods were used less frequently, largely due to concerns about side effects and financial constraints. Women emphasized the need for affordable and continuous access to contraception, linguistically accessible information, and respectful, shared decision-making. Unmet needs were shaped by four interrelated themes: psychological factors, individual factors, systems of power, and relationships and networks.
Conclusion:
These findings highlight intersecting psychological, social, and structural barriers and underscore the need for culturally sensitive, trauma-informed services and strengthened communication to support equitable reproductive healthcare. Improved financial and administrative accessibility across the life course, aligned with universal health coverage, may serve as important facilitators.
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