Racial/Ethnic Differences in Pregnancy Intention, Reproductive Coercion, and Partner Violence among Family Planning Clients: A Qualitative Exploration

Charvonne N. Holliday, Elizabeth Miller, Michele R. Decker, Jessica G. Burke, Patricia I. Documet, Sonya B. Borrero, Jay G. Silverman, Daniel J. Tancredi, Edmund Ricci, Heather L. McCauley

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC. Study Design: Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania. Results: Interviews with 10 Black women and 34 White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women. Conclusions: Racial/ethnic differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status.

Original languageEnglish (US)
JournalWomen's Health Issues
DOIs
StateAccepted/In press - Jan 1 2018

ASJC Scopus subject areas

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery

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    Holliday, C. N., Miller, E., Decker, M. R., Burke, J. G., Documet, P. I., Borrero, S. B., Silverman, J. G., Tancredi, D. J., Ricci, E., & McCauley, H. L. (Accepted/In press). Racial/Ethnic Differences in Pregnancy Intention, Reproductive Coercion, and Partner Violence among Family Planning Clients: A Qualitative Exploration. Women's Health Issues. https://doi.org/10.1016/j.whi.2018.02.003