Implicit Bias in Counseling for Permanent Contraception: Historical Context and Recommendations for Counseling

Kathawa, Cosette A; Arora, Kavita Shah

doi:10.1089/heq.2020.0025

Cited by 41 publications

(48 citation statements)

References 23 publications

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“…Educational strategies regarding HIV-prevention tools with clinicians and also with all sexually active women are warranted. 91 Although HIV screening for sexually active women during gynecology visits is supported without copays, fewer than 20% of sexually active women reported receiving an HIV test during the past year in a recent report. 96 Offering routine HIV screenings should be fully incorporated during obstetrics and gynecology visits; early diagnosis is vital for timely treatment and decreased morbidity and mortality (Fig.…”

Section: Reproductive Health Disparities Access Services and Outcomentioning

confidence: 99%

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

Sutton¹,

Anachebe²,

Lee³

et al. 2021

Obstetrics &Amp; Gynecology

136

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Racial and ethnic disparities in women's health have existed for decades, despite efforts to strengthen women's reproductive health access and utilization. Recent guidance by the American College of Obstetricians and Gynecologists (ACOG) underscores the often unacknowledged and unmeasured role of racial bias and systemic racial injustice in reproductive health disparities and highlights a renewed commitment to eliminating them. Reaching health equity requires an understanding of current racial–ethnic gaps in reproductive health and a concerted effort to develop and implement strategies to close gaps. We summarized national data for several reproductive health measures, such as contraceptive use, Pap tests, mammograms, maternal mortality, and unintended pregnancies, by race–ethnicity to inform health-equity strategies. Studies were retrieved by systematically searching the PubMed (2010–2020) electronic database to identify most recently published national estimates by race–ethnicity (non-Hispanic Black or African American, Hispanic or Latinx, and non-Hispanic White women). Disparities were found in each reproductive health category. We describe relevant components of the Affordable Care Act (ACA) and the Preventing Maternal Deaths Act, which can help to further strengthen reproductive health care, close gaps in services and outcomes, and decrease racial–ethnic reproductive health disparities. Owing to continued diminishment of certain components of the ACA, to optimally reach reproductive health equity, comprehensive health insurance coverage is vital. Strengthening policy-level strategies, along with ACOG's heightened commitment to eliminating racial disparities in women's health by confronting bias and racism, can strengthen actions toward reproductive health equity.

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Section: Reproductive Health Disparities Access Services and Outcomentioning

confidence: 99%

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

Sutton¹,

Anachebe²,

Lee³

et al. 2021

Obstetrics &Amp; Gynecology

136

View full text Add to dashboard Cite

show abstract

“…Although studies have found mixed results regarding whether including training during residency helps with overall IUD insertion [37,38], continuing education for physicians was found to be a strong predictor of LARC insertion [39]. Efforts to improve contraceptive rates need to a) consider ways to address cost, especially for postpartum LARC; b) create strategies to reduce physician bias [40] and misconceptions regarding promoting LARC; and c) provide culturally tailored patient education.…”

Section: Multinomial Logistic Regression Estimating the Odds Of Contraception Usementioning

confidence: 99%

Variations in Receipt of Contraceptives by Insurance Status and Race/Ethnicity

Liu

Taylor

Schuch

et al. 2022

North Carolina Medical Journal

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D espite decreases in unintended pregnancies over the past decade, more than half of pregnancies among US women aged 18-29 are unplanned [1]. At 51%, the US unintended pregnancy rate is substantially higher than that of most European countries [2], with costs estimated at $21 billion in 2010 [3]. Unplanned pregnancies are associated with poorer outcomes including delayed or inadequate prenatal care, increased levels of stress and depression, and decreased rates of breastfeeding among mothers [4-6], and prematurity, low birth weight, and physical and mental health problems among children [1,7]. Black and Hispanic women experience greater burden of unintended pregnancy than White women [1,6,8], for reasons that include lack of education about effective contraceptive methods [9], less access to family planning services [10,11], distrust of the health care system stemming from historical injustices [9], cultural differences, and levels of acculturation [11,12]. The burden of unintended pregnancy among younger women, especially women of color, is generally high in the United States. In North Carolina, 54% of all pregnancies and 70% of pregnancies among women under age 24 were considered unintended in 2015 [13]. Young women of reproductive age (15-34) make up 26.8% of the North Carolina population, with 24% being Black and 11% Hispanic [14]. Therefore, understanding the family planning needs of these women is an important and urgent public health need.Long-acting reversible contraceptives (LARC), includ-ing intrauterine devices (IUDs) and subdermal hormonal implants, are an extremely effective contraception method associated with reducing unintended pregnancies with a failure rate of less than 1% [15]. However, cost as well as patient and provider knowledge and attitudes are key barriers to increased LARC use [16,17]. While some insurance providers cover LARC, they still require an initial copay that can hinder access [18,19]. For example, based on different insurance plans, the birth control shot (also known as Depo-Provera or the Depo shot

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“…Data suggest that women of color are offered LARC more often sometimes owing to implicit biases. 91 Awareness of historical and modern-day racial injustices often contribute to the lower rate of contraceptive use among Black and Hispanic women; there is a distrust by some patients that has yet to be acknowledged by many clinicians. 92 To combat this, patient-centered shared decision making is a vital component of all contraceptive counseling.…”

Section: 72mentioning

confidence: 99%

Section: Human Immunodeficiency Virus Diagnosesmentioning

confidence: 99%

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

Sutton

Anachebe

Lee

et al. 2021

Obstetrical &Amp; Gynecological Survey

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Racial-ethnic disparities in access and outcomes in the context of women's reproductive health continue to be pervasive in the United States. Contraceptive use, sexually transmitted infection care, human papillomavirus vaccination among younger women aged 18 to 25 years, reproductive cancers, preterm deliveries, and low-birth-weight neonates, as well as maternal morbidity and mortality, continue to have documented disparities. Policy-level interventions addressing the removal of social and structural barriers for women of underserved racial and ethnic minorities are necessary to increase utilization of needed 276Obstetrical and Gynecological Survey

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Implicit Bias in Counseling for Permanent Contraception: Historical Context and Recommendations for Counseling

Cited by 41 publications

References 23 publications

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

Variations in Receipt of Contraceptives by Insurance Status and Race/Ethnicity

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020

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