Title: Factors Influencing Family Planning Decisions in Saudi Arabia
Version: 4 Date: 30 Nov 2024
Reviewer's report:
This is an important study and I enjoyed it. Suggestions are offered to give it greater readability
and impact on readers.
My first concern is about the vagueness of statements throughout the paper referring to 'societal
pressure' (line 123),  'in some cultures' (line 72), 'influence of cultural values: cultural factors
and traditions' (line 244); 'broader cultural context' (line 247); 'impact of family and societal
expectations' (line 256); 'societal norms and familial expectations' (line 259); 'societal influences
(line 261).
'Societal pressure' might refer to friendship circles, extended family, co-workers, employers,
religious or political leaders or cultural discourses in  the media. It would be helpful to know
what aspect of society was responsible for this ‘pressure’. If your data is not able to indicate
this, it might e appropriate to mention it as a limitation of the study, and suggest it as a line of
further inquiry for future qualitative or mixed methods research.
I had hoped to see these vague terms defined with more specificity in the Discussion section,
but it is too if full of similar vague terms.  Some more specific terms you might consider are,
eg. cultural attitudes that assume women's primary role as mothers; hetero-normative cultural
values;  societal influences in the form of pressure on women to bear more children than they
would want; familial expectations of a specific number of children.
I was struck by the repeated mention of husband's attitudes to FP being a factor- it is cited
as the strongest p-value in the logistical regression figures in the abstract (Lines  35-8) and is
mentioned in other places in the article (Lines 65-6; 158-9; ) but without any discussion of the
role of traditional forms of masculinity which would seem pertinent to this finding.
Men were not surveyed for this study, it seems. This needs addressing as one of the limitations
of the study.
There are also seemingly contradictory statements about this in the paper. eg. Line 358 says
'Having a supportive partner is associated with positive family planning decisions', but at
Line 351 you have said 'husband support for the FP decision didn't  seem  to affect women's
contraceptive use'. This needs clarifying.
- The title should be altered to:  Factors Influencing Women’s Family Planning Decisions in
Saudi Arabia, since no men or other parties were surveyed in this study.
-line 28 - in the abstract - 'survey-based survey' (word repetition). Replace with: survey-based
inquiry
-line 53 - this should NOT be a new paragraph since it follows directly from the previous
sentence.
- line 58  -'Now, there is an excellent variety of contraceptive products available '. Replace with:
Currently, there is an excellent variety of contraceptive products available in Saudi Arabia.
line 60 - '...there are many obstacles standing in the way to access and effectively use FR
services'. Replace with: ...there are many obstacles to access and effective use of FP services.
line 72 -the statement here  about cultures where other family members determine women's
choices needs more specificity: In which specific cultures is this so? And is this so in Saudi
Arabia or not?
Line 82 - the year 2023 appears twice in this first clause. Change to: A recent study conducted
in  Saudi Arabia identified a prevalence of contraceptive use among married women aged 15–
49 of  64.9%, measured in 2023 (18)
Line 87 - 'nationwide studies for contraceptive use couldn't be traced'. Change to: no nationwide
studies for contraceptive use were identified.
Line 87 - I think many will find it odd to refer to Saudi Arabia as a 'developing nation' given
it is one of the richest in the world by GDP. The term global South is less burdened with
developmental status and is suggested as an alternative. Replace with this whole clause with:
As in other global South nations, Saudia Arabia is seeing rapid transformation in its socio-
demographic structure.
Lines 90-92 is a sentence with grammatical errors and word choice problems. Replace with:
As a result of this rapid social change, FP has only recently become an essential part of most
women's lives. Our study aims to identify the key factors to assess  current socio-cultural factors
related to FP decisions in Saudi Arabia (SA).
Line 109: this definition of p has colloquial expression in it. Replace with: estimated proportion
of the population that possesses the characteristic studied
Line 115: 'Fertility' should be 'fertility' (no capital letter)
Line 117: 'they reached their desired number .' Replace with: they had reached their desired
number of children.
Line 120: was concerned with the perceived importance of FP in life, and the other was whether
career goals and personal aspirations affected their family planning decisions;. Replace with:
was concerned with the perceived importance of FP in life, and the other was about whether
their career goals and personal aspirations affected their family planning decisions
Line 197: the term 'higher marital status' is ambiguous. Replace with 'longer marriage duration'
Line 259 - typo: 'The data implies that individuals may do to or challenge societal norms '.
Replace with: The data implies that individuals may challenge societal norms.