Despite widespread agreement on the importance of a human rights-based approach to contraception programming, a gap exists between the principle of valuing individual choice and what programs are held accountable for in practice. This gap is reflected in the increasingly recognized need for new rights-based measures.

We discuss 6 opportunities for conceptual and measurement innovation and propose a framework for the construct of “contraceptive agency”— the ability of an individual to make and act on decisions related to whether to do something to avoid or delay pregnancy and what, if anything, to do when they are not actively trying to become pregnant.

The contraceptive agency framework can serve as a guide for centering individuals’ ability to make and act on their own contraceptive choices, regardless of what those choices are, in contraception program design and evaluation.

The human right to control one’s own childbearing requires that individuals can both make and act on reproductive decisions.1 Thus, frameworks for ensuring a rights-based approach to contraception emphasize the importance of supporting individuals and couples to make and act on their own choices, regardless of what they choose.2–4 However, a gap exists between the importance of ensuring individuals can make their own contraceptive choices and act on them without interference in principle and what programs are held accountable for in practice, as reflected in a lack of robust rights-based measures and prioritization of contraceptive use focused, rather than rights-based, benchmarks of success.5–9

Several new frameworks and measures related to reproductive empowerment and autonomy have been published in the last decade and represent building momentum toward operationalizing a rights-based approach to supporting people’s reproductive decision-making.10–13 In this commentary, we review these frameworks and measures and argue that there remains a need for innovation in …