An exploration of perceived contraceptive coercion at the time of abortion

Brandi, Kristyn; Woodhams, Elisabeth; White, Katharine O.; Mehta, Pooja

doi:10.1016/j.contraception.2017.12.009

Cited by 87 publications

(55 citation statements)

References 18 publications

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“…However, there is also some concern that this enthusiasm, while often well-meaning, could lead to coercion and a general disregard for women’s informed choice and autonomy [7–9]. In light of past reproductive rights abuses against disadvantaged women in the U.S. [10], the recent documentation of women feeling coerced in their contraceptive decision making after undergoing abortion [11], and the fact that this initiative is specifically targeted to low-income women served by Medicaid, it is important to ensure that women’s choice and reproductive justice are central when developing and implementing these policies.…”

Section: Introductionmentioning

confidence: 99%

Women’s informed choice and satisfaction with immediate postpartum long-acting reversible contraception in Georgia

DeSisto

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Haider

et al. 2018

Contracept Reprod Med

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BackgroundSeveral state Medicaid agencies have recently started reimbursing for long-acting reversible contraception (LARC) placement immediately postpartum. Women’s perspectives are critical for ensuring that this change increases access to LARC while empowering women to choose the method and timing of contraception that best meets their needs. We conducted a pilot study in Georgia, which recently changed its Medicaid reimbursement policy, to assess women’s informed choice and satisfaction with immediate postpartum LARC.MethodsWe sampled all women with a live birth paid for by Georgia Medicaid during November 2015 through February 2017 who received an immediate postpartum LARC. We then used a one-to-one match to sample women who did not receive immediate postpartum LARC. Women were contacted via telephone for a 25–30 min interview regarding their knowledge, attitudes, and behaviors related to immediate postpartum LARC and their satisfaction with postpartum contraception. We calculated descriptive statistics and components of informed choice overall and by receipt of immediate postpartum LARC, using chi-square tests to calculate differences by group.ResultsWe approached 470 women and completed interviews with 51; 25 (49%) received immediate postpartum LARC (24 implants, 1 intrauterine device). Two-thirds reported their provider discussed the option of receiving immediate postpartum LARC during prenatal care, with over 90% reporting they received all the information they needed to make a decision. Most women believed the ideal time to begin using birth control postpartum is in the hospital immediately after delivery, although this differed significantly by women’s receipt of immediate postpartum LARC. Most women who received immediate postpartum LARC reported they are very or extremely happy with their device, although 40% also reported wanting their device removed at some point.ConclusionsWomen on Medicaid in Georgia report making informed choices regarding immediate postpartum LARC. Among those who received immediate postpartum LARC, women report high levels of satisfaction.

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Section: Introductionmentioning

confidence: 99%

Women’s informed choice and satisfaction with immediate postpartum long-acting reversible contraception in Georgia

DeSisto

Handler

Haider

et al. 2018

Contracept Reprod Med

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“…The complex meeting and the importance of respectful counselling at the time of an abortion (studies II and III) highlight the need for PCC [132,138] to improve women's SRHR. Few studies have reported how respectful counselling in the often emotionally charged context of an abortion influences -sceptical -women to make a choice of contraceptive method post-abortion [14,19,64]. Scepticism about contraception, as found in study II, may partly explain why some women discontinue, or never initiate, use of contraceptives post-abortion and are at higher risk of a repeat UP.…”

Section: General Findingsmentioning

confidence: 93%

“…The importance of relational communication seems slightly dominant in the context of an abortion [15,19,64] and stresses need of individualised contraceptive counselling [19,59]. Women's use of contraception varies over time and is related to complex factors such as: sexual relationships [65], intentions in pregnancy [66,67], estimation of fertility [25,68,69] and experiences of side effects [19,65,68,70].…”

Section: Contraceptive Counselling At the Time Of An Abortionmentioning

confidence: 99%

“…Women report feelings of being pushed to choose a more effective method, such as long-acting reversible contraception (LARC), and experiences of stigma at the time of a repeat abortion [90,91]. This may negatively affect their ability to establish trusting relationships [50,64,92], especially at the time of an abortion [64].…”

Section: Informational Communication Concerning Effectiveness and Sidmentioning

confidence: 99%

“…The core message in health promotion and prevention programmes might interfere with people's autonomy and cause resistance to such things as more effective contraceptive methods, such as LARC [92,137]. Women may experience infringement of their reproductive autonomy at the time of contraceptive counselling, even in countries where contraception is promoted, accepted and available [64,92]. This indicates that healthcare services aimed at preventing UPs need to be designed in line with women's autonomy and individual needs.…”

Section: Previous Prevention Programmes Have Reported An Increased Chmentioning

confidence: 99%

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Contraceptive counselling in abortion care

Kilander

2018

Linköping University Medical Dissertations

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Introduction Improving women's knowledge about contraception, and their access to contraceptive methods, is central in order to strengthen their sexual and reproductive rights at the time of an abortion. Contraceptive counselling aims to support women's reproductive control and prevent unintended pregnancies (UPs). It is unclear, however, how to provide contraceptive counselling and how to organise services at the time of an abortion, in order to achieve this.

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The Need for Reproductive Justice in Pediatrics

2021

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As pediatricians, we set the stage for patients' future relationships with health care professionals; nowhere are the stakes higher than sexual and reproductive health care. Listening to young people and respecting their priorities imparts a valuable lesson about self-advocacy within health care. Reproductive health is one of the most important aspects of patients' personal lives, and we should model respectful, compassionate, and evidence-based care. This means integrating reproductive justice into our clinical practice.Reproductive justice asserts that every person has "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities." 1 Developed in 1994 by Women of African Descent for Reproductive Justice, this framework answers the call for a more expansiveunderstandingofreproductiveautonomythanthe individualistic focus of other frameworks developed in response to threats to reproductive freedom. For example, reproductive health addresses the provision of clinical services to an individual, while reproductive rights focus on the legal protection of the right to certain services, including abortion. In contrast, reproductive justice brings a societal and structural lens to "understand and root out reproductive oppression to achieve human rights and social justice." 1 This broader view recognizes that communities that historically have been marginalized bear a disproportionate burden of constraints on reproductive autonomy. These burdens include limited access to contraception and abortion care, as well as forced and coerced sterilization, carried out by medical professional and government institutions in the name of public health and reduction of poverty. 2 As pediatricians, comprehensive contraceptive counseling has become the standard of care, and many clinicians have focused on increasing access to longacting reversible contraception and promoting its use via tiered efficacy counseling. 3,4 Many pediatricians express concern about the age of patients making reproductive choices and, as such, advocate for long-acting reversible contraception in all adolescent patients. While this may be discussed flippantly, real harm is perpetuated by prioritizing public health goals over an individual patient's reproductive goals and bodily autonomy. The paternalistic belief that an adolescent's top priority should be to delay childbearing is fraught with the potential for implicit bias and further entrenchment of stratified reproduction, by which the fertility of certain patients is valued over others.While institutionalized policies of forced sterilization are no longer legal, more subtly coercive attempts to influence contraceptive decision-making still occur by providing financial incentives, pressuring patients to choose specific contraceptive methods, or refusing to remove long-acting reversible contraception until after a trial

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An exploration of perceived contraceptive coercion at the time of abortion

Cited by 87 publications

References 18 publications

Women’s informed choice and satisfaction with immediate postpartum long-acting reversible contraception in Georgia

Women’s informed choice and satisfaction with immediate postpartum long-acting reversible contraception in Georgia

Contraceptive counselling in abortion care

The Need for Reproductive Justice in Pediatrics

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