Barriers to Family Planning Services Among Patients in Drug Treatment Programs

Abstract

In July 1989, family planning services were integrated into 13 drug treatment programs in Philadelphia. To obtain information on the family planning needs of women in drug treatment programs, baseline interviews were conducted with 599 women. Three-quarters of these women had had a sexually transmitted disease, and although they were in a drug treatment program, 41 percent had injected drugs in the previous month. In addition, 62 percent of the women who were sexually active in the previous month had not used a contraceptive. Twelve months into the program, seven focus groups were conducted with 65 women and men to learn more about their opinions and attitudes related to contraceptives and family planning services in general. The discussions revealed that many of the participants were unsure what family planning services included, saw no need for such services or had had prior negative experiences with health care providers. There was also a great deal of misinformation about contraceptives and the effects they have on health.

Perceived Discrimination During Prenatal Care, Labor, and Delivery: An Examination of Data From the Oregon Pregnancy Risk Assessment Monitoring System, 1998–1999, 2000, and 2001

“…5 A few studies have explored women's experiences with discrimination while receiving reproductive health care, 6,[11][12][13] but none has specifically examined women's experiences of discrimination while receiving prenatal or obstetric care. We assessed perceptions of discrimination during prenatal care, labor, and delivery among Oregon women.…”

A Comparison of Opioid Using Women Attending High Risk Prenatal Clinic versus a Regular OB Clinic

“…Their decision is compounded by the finding that physicians are less likely to prescribe a Highly Active Antiretroviral Therapy (HAART) if a woman has an alcohol problem, uses drugs intravenously, or has a mental illness [13] and thus the women are more likely to have high viral loads [14]. Armstrong et al [15] reported that women in focus groups shared that clinicians had called them "junkies" and "crack ladies" and therefore were reluctant to seek treatment at a regular prenatal care. One woman said "In a place like (a High Risk Clinic)…you don't have to live a double life".…”

Offering Incentives to Drug‐using Women to Take Up Contraception: The Ethical and Clinical Issues

“…Other barriers these women face in accessing contraception include a belief that contraception is not needed due to impaired fertility while in drug treatment (e.g. methadone) and misinformation about different methods [4]. As it stands currently, women in specialist drug treatment needing sexual and reproductive health care are usually referred to external services, either to their general practitioners, sexual health clinics or family planning centres.…”

“…For example, integrated care models are more effective in enhancing health-care utilization (e.g. hepatitis B virus vaccination and hepatitis C virus treatment) in drug treatment populations, and we hope to trial an integrated contraceptive service, as suggested by previous work with drug treatment populations in the United States [4].Any discussion of the ethical issues of providing financial or other incentives for women to utilize effective contraception must take into consideration the extent bs_bs_banner Letters to the Editor 1361 …”