Balancing enhanced contraceptive access with risk of reproductive injustice: A United States comparative case study

Moniz, Michelle H.; Spector‐Bagdady, Kayte; Perritt, Jamila; Heisler, Michele; Loder, Charisse; Wetmore, Marisa; Harris, Lisa H.

doi:10.1016/j.contraception.2022.04.004

Cited by 12 publications

(12 citation statements)

References 41 publications

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“…9,18 Welti et al revealed differences in contraceptive care and family planning dependent on the sociodemographic characteristics of the counseled person, including ethnicity, financial status, sexual orientation, and language proficiency. 10,18 Based on these results, there is a clear need for patient-centered family planning care and contraceptive counseling that primarily focuses on the experiences and preferences of the respective person. 18,19 Patient-centered counseling should also strive to include partners when possible as contractive beliefs, knowledge, and method choice are often heavily influenced by partners, family, and social environments.…”

Section: Inpatient Contraception Care Standardsmentioning

confidence: 99%

“…15 Other national organizations for reproductive justice such as SisterSong and National Women's Health Network also support shared decision-making as the most appropriate framework for contraception counseling. 10 When deployed appropriately, shared decision-making comprises mutual recognition and cross-collaboration between the health care team and the individual. Moreover, incorporating shared decision-making in the inpatient setting enables strong relationship building with the patients.…”

Section: Shared Decision-makingmentioning

confidence: 99%

“…These resources however, do not address the variable quality of contraception counseling and are insufficient to prevent perceived coercion or distrust of clinicians 15 . Other national organizations for reproductive justice such as SisterSong and National Women's Health Network also support shared decision‐making as the most appropriate framework for contraception counseling 10 . When deployed appropriately, shared decision‐making comprises mutual recognition and cross‐collaboration between the health care team and the individual.…”

Section: Shared Decision‐makingmentioning

confidence: 99%

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Providing Inpatient Contraception Care Within a Reproductive Justice Framework

Brennan,

Hotelling,

McInerney

2023

J Midwife Womens Health

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is the fundamental human right to exercise personal autonomy over one's body, to make decisions about having or not having children, and to raise children in communities that are safe. 1 The American College of Nurse Midwives' (ACNM) position statement on comprehensive sexual and reproductive health care services supports the reproductive justice framework and acknowledges it as an essential foundation for comprehensive contraceptive care. 2 Access to comprehensive contraception options are especially important considering that approximately 45% of all pregnancies in the United States are unintended or mistimed. 3 Evidence has shown that short-interval pregnancies are associated with complications such as preterm birth and adverse neonatal outcomes. 3 In addition, laws restricting access to abortion further underscore this fundamental need. 4 The American College of Obstetrics and Gynecology (ACOG) recommends completing contraceptive counseling early in prenatal care to allow time for the individual to determine the appropriate fit for themselves and their family. 3 However, barriers to prenatal care may pose limitations for some individuals. According to the most recent statistics from ACOG, 40% of women do not return for postpartum care. 5 These statistics hamper the efficiency of outpatient prenatal and postpartum contraceptive counseling and impede equity in providing contraceptive care to those who may need it most. 3 Because of these issues, the provision of contraception services as part of inpatient care has become a more widespread practice.Ethical concerns, however, have arisen regarding how this has been implemented and to whom this care is provided. A recent study found that inpatient contraceptive counseling for individuals with similar risk factors was not universal. 6 Young Black non-Hispanic and multiparous individuals were more likely to have inpatient contraception counseling documented. In addition, women with public insurance were also 64.7% more likely to have documented counseling compared with those with private insurance, and 46.2% were

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Section: Inpatient Contraception Care Standardsmentioning

confidence: 99%

Section: Shared Decision-makingmentioning

confidence: 99%

Section: Shared Decision‐makingmentioning

confidence: 99%

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Providing Inpatient Contraception Care Within a Reproductive Justice Framework

Brennan,

Hotelling,

McInerney

2023

J Midwife Womens Health

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“…64 Additionally, data collected from postpartum LARC key-informants suggests that while many aspire to administer patient-centered, autonomy-focused contraceptive care, they still often express biases, including focusing on the healthcare system needs above the individual patient. 65 Clinicians should therefore center conversations around postpartum LARC or permanent contraception on equity and autonomy, ensuring that their patients have informed, full, and free choices when deciding if they want to use contraception and, if so, what method they ultimately adopt. 66,67 Patient and clinician-level factors, like individual preferences or clinician implicit bias, should be carefully considered in the implementation of shared decision-making.…”

Section: Shared Decision-makingmentioning

confidence: 99%

Shared Decision-Making: The Way Forward for Postpartum Contraceptive Counseling

Bullington¹,

Sata²,

Arora³

2022

OAJC

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There are multi-level barriers that impact uptake of postpartum contraception and result in disparities, including clinical barriers such as provider bias. Fortunately, clinicians have direct control over their contraceptive counseling practices, and thus reducing structural barriers is actionable through high quality contraceptive counseling that equips patients with the knowledge and guidance they need to fulfill their reproductive desires. Yet, many commonly employed contraceptive counseling strategies, like One Key Question and WHO tiered contraceptive counseling, are not patient-driven, do not account for the important nuances of contraceptive choices, and are not focused specifically on the postpartum period. Given the history of eugenics and reproductive coercion in the US, supporting patient through their contraceptive decision-making process is especially vital. Additionally, contraceptive preferences vary based on patient-level factors and fluctuate over time and counseling should account for such differences. Shared contraceptive decision-making occurs when patients provide input on their values, desires, and preferences and clinicians share medical knowledge and evidence-based information without judgement. This approach is considered the most ethically sound form of counseling, as it maximizes patient autonomy. Shared decision-making also has clinical benefits, including increased patient satisfaction. In sum, shared contraceptive decision-making should be universally adopted to promote ethical, high-quality care and reproductive autonomy.

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“…Specifically, many voices are concerned that an overemphasis on long-acting reversible contraception (LARC) methods could have resulted in coercive practices and even reduced patient autonomy, in a space where centring patient goals and preferences is essential 7. Evaluation of programmes focusing on LARC uncovered elements of both subtle and overt bias that could have been mitigated by early and robust patient involvement 8. It is noteworthy that it is simply harder to implement LARC-related services in a space where they did not previously exist, as compared with other contraceptive methods.…”

mentioning

confidence: 99%