Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability

Wu, Justine; Braunschweig, Yael; Harris, Lisa H.; Horner‐Johnson, Willi; Ernst, Susan; Stevens, Bethany

doi:10.1016/j.contraception.2019.01.006

Cited by 19 publications

(19 citation statements)

References 28 publications

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“…It is incumbent upon clinicians who provide contraceptive care to understand the history of reproductive oppression and to examine the biases that exist in contraceptive services today. Table 1 reviews recent literature analyzing the impact of race/ethnicity [15,16], socioeconomic status (SES) [15,16], age [17], ability [18], and pregnancy history [19] on LARC practices. Transgender men or gender nonbinary individuals who were assigned female at birth often lack access to comprehensive contraceptive services, including LARC, due to provider misconceptions and discomfort with caring for this population [20 ▪▪ ].…”

Section: Coercion and Bias In Long-acting Reversible Contraceptionmentioning

confidence: 99%

Addressing long-acting reversible contraception access, bias, and coercion: supporting adolescent and young adult reproductive autonomy

Bryson

Koyama

Hassan

2021

Current Opinion in Pediatrics

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Purpose of review Long-acting reversible contraception (LARC) is comprised of highly effective methods (the subdermal implant and intrauterine devices) available to adolescents and young adults (AYAs). Professional medical societies endorse LARC use in AYAs and, more recently, have emphasized the importance of using a reproductive justice framework when providing LARC. This article reviews reproductive justice, discusses contraceptive coercion, examines bias, and highlights interventions that promote equitable reproductive healthcare. Recent findings Research indicates that both bias and patient characteristics influence provider LARC practices. AYA access to comprehensive LARC services is limited, as counseling, provision, management, and removal are not offered at all sites providing reproductive healthcare to AYAs. Interventions aimed at addressing provider bias and knowledge, clinic policies, confidentiality concerns, insurance reimbursement, and systems of oppression can improve AYA access to equitable, comprehensive contraceptive care. Additionally, the COVID-19 pandemic has exacerbated inequities in reproductive healthcare, as well as provided unique innovations to decrease barriers, including telemedicine LARC services. Summary Clinicians who care for AYAs should honor reproductive autonomy by approaching contraceptive services with a reproductive justice lens. This includes implementing patient-centered contraceptive counseling, increasing access to LARC, eliminating barriers to LARC removal, and committing to systemic changes to address healthcare inequities.

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Section: Coercion and Bias In Long-acting Reversible Contraceptionmentioning

confidence: 99%

Addressing long-acting reversible contraception access, bias, and coercion: supporting adolescent and young adult reproductive autonomy

Bryson

Koyama

Hassan

2021

Current Opinion in Pediatrics

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“…Australian disability activist Nicole Lee (2019), who uses a wheelchair, writes of how her decision to have an abortion was, in a reversal to the stated norm, interrogated far less than her decision to become a mother. The stigma of disabled parenting can manifest in coercive practices, most notoriously in sterilisation, which women with disabilities continue to experience disproportionately compared to the able-bodied (Wu et al, 2019). Discourses of ablebodiedness also variegate abortion stigma.…”

Section: Reproductive Justicementioning

confidence: 99%

Abortion at the edges: Politics, practices, performances

Baird

Millar

2020

Women's Studies International Forum

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This article provides a brief overview of the state of discourse, politics and provision of abortion in the Anglophone West, including developments in the wake of the COVID-19 pandemic. It then surveys three promising directions for feminist abortion scholarship. The first is work inspired by the Reproductive Justice Movement, that points to the intersectional axes of inequality that shape abortion discourse and position us in relation to reproductive choice and access issues. The second is work that examines the particularity of the constitution of the aborting body, reflecting the particularity of the pregnant body. This is a specific body, with a specific history; abortion discourse draws from and makes a significant contribution to the meaning and lived experience of this body. The third area of scholarship we highlight is that which seeks to amplify the meaning of abortion as a social good. Much abortion scholarship is attuned to a critique of negative aspects of abortion-from its representation in popular culture to restrictive law and access issues. This is critical work but/and the performative nature of abortion scholarship, like all discourse, means that it can amplify the association of negativity with abortion. The article concludes by introducing the articles contained in the special section of Women's Studies International Forum, 'Abortion at the edges: Politics, practices, performances'. In the context of the 'constantly changing space' of abortion and reproductive issues more broadly (Berer & Hoggart, 2019: 79), feminist scholarship about abortion remains a site of ongoing interest and hard work from scholars across diverse institutional and disciplinary locations. This is related to and necessary for the equally diverse range of non-academic feminist and related campaigns and activist movements that work locally, nationally and globally to improve access to safe abortion care and normalise the experience of abortion. There is no sign that this work, or the need for it, is abating. As we write, responses to the COVID-19 pandemic are creating new challenges for women who seek abortions and those who provide them, and intensifying the pace of change in this space. The International Campaign for Women's Right to Safe Abortion has issued an international call to action. 'Every country could and should move most abortions out of hospitals and clinics by ensuring women can get abortion pills and self-manage their abortions up to 10-12 weeks at home, with a number to call for advice and backup care if needed' (International Campaign for Women's Right to Safe Abortion, 2020). National and regional responses are diverse. Abortion scholars and others will continue to watch how this global social and public health crisis will affect access to abortion services, discourse about abortion, and laws that regulate abortion in both the short and long term. The focus of this article, and the special issue for which it is an introduction, is abortion in the Anglophone West. After a brief overview of the state of dis...

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“…Population-based surveys have documented higher rates of tubal sterilization among people with any disability, 37 physical or sensory, 10 or cognitive disability 11,13 compared with people without any disability. These findings have raised concerns that long-standing discrimination of people with disabilities, including eugenic compulsory sterilization of thousands throughout the 20th century, 38 continues to influence rates of tubal sterilization today. In this analysis, we did not observe any difference in tubal sterilization based on deaf or hard-of-hearing status.…”

Section: Discussionmentioning

confidence: 99%

Contraceptive Provision and Quality Care Measures for Insured Individuals in Massachusetts Who Are Deaf or Hard of Hearing

Zhang

McKee

et al. 2021

Obstetrics &Amp; Gynecology

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OBJECTIVE: To evaluate contraceptive provision and contraceptive care quality measures for individuals who are deaf or hard of hearing and compare these outcomes to those individuals who are not. METHODS: We conducted a claims analysis with data from the 2014 Massachusetts All-Payer Claims Database. Among premenopausal enrollees aged 15–44, we determined provision of any contraception (yes or no) and provision by contraception type: prescription contraception (pills, patch, ring, injectables, or diaphragm), long-acting reversible contraceptive (LARC) devices, and permanent contraception (tubal sterilization). We compared these outcomes by deaf or hard-of-hearing status (yes or no). The odds of contraceptive provision were calculated with regression models adjusted for age, Medicaid insurance, a preventive health visit, and deaf or hard-of-hearing status. We calculated contraceptive care quality measures, per the U.S. Office of Population Health, as the percentage of enrollees who used: 1) LARC methods or 2) most effective or moderately effective methods (tubal sterilization, pills, patch, ring, injectables, or diaphragm). RESULTS: We identified 1,171,838 enrollees at risk for pregnancy; 13,400 (1.1%) were deaf or hard of hearing. Among individuals who were deaf or hard of hearing, 31.4% were provided contraception (23.5% prescription contraception, 5.4% LARC, 0.7% tubal sterilization). Individuals who were deaf or hard of hearing were less likely to receive prescription contraception (adjusted odds ratio 0.92, 95% CI 0.88–0.96) than individuals who were not deaf or hard of hearing. The percentage of individuals who were deaf or hard of hearing who received most effective or moderately effective methods was less than that for individuals who were not (24.2% vs 26.3%, P<.001). There were no differences in provision of LARC or permanent contraception by deaf and hard-of-hearing status. CONCLUSION: Individuals who were deaf or hard of hearing were less likely to receive prescription contraception than individuals who were not; factors underlying this pattern need to be examined. Provision of LARC or permanent contraception did not differ by deaf or hard-of-hearing status. These findings should be monitored and compared with data from states with different requirements for contraceptive coverage.

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Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability

Cited by 19 publications

References 28 publications

Addressing long-acting reversible contraception access, bias, and coercion: supporting adolescent and young adult reproductive autonomy

Addressing long-acting reversible contraception access, bias, and coercion: supporting adolescent and young adult reproductive autonomy

Abortion at the edges: Politics, practices, performances

Contraceptive Provision and Quality Care Measures for Insured Individuals in Massachusetts Who Are Deaf or Hard of Hearing

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