Female autonomy in debate: hormonal implants, adolescent pregnancy, and the limits of prevention in Ceará

Abstract

This article critically analyzes the expansion of the subdermal contraceptive implant (etonogestrel) within municipal policies in Ceará, Brazil, particularly in Eusébio, Caucaia, and Fortaleza, examining its effects on female autonomy in the prevention of teenage pregnancy. The study adopts a qualitative bibliographic and documentary approach, articulating specialized literature, HIV/AIDS epidemiological reports (2024–2025), municipal administrative acts, and international human rights frameworks, including the Cairo Conference (1994), the Beijing Platform for Action (1995), and the 2030 Agenda (SDG 5). The central hypothesis argues that although expanding access to long-acting reversible contraception represents progress in reproductive rights, its centrality may shift the burden of pregnancy prevention onto adolescent girls, without addressing structural gender inequalities and the persistence of sexually transmitted infections. Drawing on Foucauldian biopolitics and Saffioti’s critique of patriarchy, the article contends that such policies may function simultaneously as instruments of autonomy and mechanisms of bodily regulation. It concludes that substantive autonomy requires the integration of contraception, evidence-based sexuality education, combined STI prevention strategies, and shared gender responsibility.