Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.
INTRODUCTION: In recent years, legislation restricting abortion has become commonplace. Recent studies have identified that one third of women seeking abortion services have experienced intimate partner violence (IPV). The purpose of this study is to gather opinions and experiences of women who have experienced IPV on pregnancy and recent legislative trends restricting abortion. METHODS: Qualitative, semi-structured interviews were conducted with women seeking services for IPV at the Women's Center and Shelter in Pittsburgh. Interviews gathered information regarding feelings on pregnancy and specific abortion restrictions. After transcription, two independent reviewers identified themes from each interview. RESULTS: Nine interviews were conducted and coded. Participants described the occurrence of reproductive coercion in their relationships and influence of the partner in decision-making regarding pregnancy. The women voice concerns regarding policies requiring spousal notification of abortion and described such policies as a violation of the woman's privacy and autonomy. The 24-hour waiting period had mixed views: some participants viewed the waiting period as a time for reflection; others argued partners would have more control if women had to wait to get an abortion. While many argued that state-mandated counseling would be helpful, some participants felt that it would not change the person's mind and could add additional trauma to the situation. CONCLUSION: Women experiencing IPV are particularly vulnerable to recent policies and restrictions on abortion. Spousal notification requirements risk potential danger and further disempowerment. Varied perceptions of mandated waiting periods and counseling may be related to difference in the context or type of IPV experiences.
INTRODUCTION: Targeted Regulations of Abortion Providers (TRAP laws) create variable abortion accessibility by state. We explored how TRAP laws affect where physicians choose to receive family planning training and practice. METHODS: We conducted semi-structured telephone interviews with 25 physicians who provide abortion care across the United States and asked them about their experiences providing care in the recent political climate. Using an iterative qualitative coding process, we detected themes around how political climate and state laws around abortion affected personal preference in location of family planning training and practice. RESULTS: State laws surrounding abortion provision often influenced where providers chose to receive family planning training and practice. Reasons for choosing to train in liberal areas with few TRAP laws include a higher patient load and more opportunity to gain procedural skills. Some providers chose to train in restrictive areas for experience in navigating state laws that limit abortion access. When choosing location of practice, those that chose a hostile environment cited a greater need for abortion providers in restrictive areas. Those who practice in liberal areas often had personal reasons, including safety concern for themselves and their families as well as a desire to work in an environment where state laws do not force providers into practicing substandard care. CONCLUSION: Understanding how state TRAP laws affect location of training and practice of abortion providers creates an opportunity to further analyze what training, supports, and resources can be provided to encourage physicians to practice in underserved areas with restrictive abortion policies.
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