title: Reconciling religious identity and reproductive practices: the Church and contraception in Poland.
abstract: OBJECTIVE
  After the fall of state socialism in Poland in 1989, a Catholic-nationalist government assumed power. The new political power of the Catholic Church resulted in severe restrictions on family planning (FP) services. Yet, Poland's fertility rate declined sharply, suggesting that women are controlling their fertility despite restrictions. This study examined the Church's influence on women's contraceptive decisions, and how women reconcile religious teachings with their contraceptive use.
  
  
  METHODS
  We conducted a mixed-methods study, including a cross-sectional survey and qualitative interviews, in Gdańsk, Poland with sexually active women aged 18-40. The quantitative sample included 418 respondents; the qualitative sample included 49 respondents.
  
  
  RESULTS
  Despite restrictions on FP services, modern contraceptive use among our sample was 56%, up from 19% in 1991. Catholicism played a relatively small role in respondents' contraceptive decisions; though 94.2% of respondents were Catholic, 79% reported that the Church had little or no influence on reproductive decisions. Women's explanations for how they reconcile their reproductive practices with Catholicism included using elements of religion to support contraceptive use, prioritising responsibility for family and financial considerations over the Church's prohibitions, and challenging the Church's credibility in FP matters.
  
  
  CONCLUSIONS
  Our findings underscore women's struggles under post-socialist reproductive policies that limit FP access. Despite religious, political, and economic obstacles, contraceptive use has increased dramatically, indicating that FP is a high priority for women in Poland. Policies should respond to women's needs. Comprehensive, state-sponsored FP and sex education are urgently needed and the state should legitimise such services.
authors.affiliation: University of Central Florida, Department of Anthropology, Orlando, Florida 32816, USA. jmishtal@mail.ucf.edu
authors.forename: Joanna
authors.initials: J
authors.lastname: Mishtal
authors.forename: Rachel
authors.initials: R
authors.lastname: Dannefer
mesh_terms: D000293:Adolescent; D000328:Adult; D002410:Catholicism / Q000523:psychology; D003267:Contraception / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D011044:Poland; D012068:Religion and Medicine; D043762:Reproductive Behavior; D014932:Women's Health Services / Q000706:statistics & numerical data*; D055815:Young Adult