Community-led research for reproductive justice: Exploring the SisterLove Georgia Medication Abortion project

Abstract

IntroductionWhile reproductive injustice indicators are improving globally, they are worsening in the United States particularly for Black and other marginalized communities. Eugenics and obstetric violence against low-income and communities of color create well-founded distrust of sexual and reproductive health (SRH). Transformational, reparative ways of conducting SRH research are needed.Proposed principles of community-led research for reproductive justiceDrawing on our collective experience as reproductive justice leaders, SRH researchers, and clinicians, we propose the following principles of community-led research for reproductive justice: 1) Center the marginalized community members most affected by SRH inequities as leaders of research; 2) Facilitate equitable, collaborative partnership through all phases of SRH research; 3) Honor multiple ways of knowing (experiential, cultural, empirical) for knowledge justice and cross-directional learning across the team; 4) Build on strengths (not deficits) within the community; 5) Implement the tenets of reproductive justice including structural-level analysis and the human rights framework; 6) Prioritize disseminating useful findings to community members first then to other audiences; 7) Take action to address social and reproductive injustices.SisterLove's community-led georgia medication abortion projectWe offer the community-led Georgia Medication Abortion (GAMA) Project by reproductive justice organization SisterLove from 2018–2022 as a case study to demonstrate these principles along with the strengths and challenges of reproductive justice research.DiscussionCommunity-led reproductive justice research offers innovative and transformational methods for truly advancing SRH in an era of increasing policy restrictions and decreasing access to care. Yet existing funding, research administrative, and publishing systems will require structural change.

Estimation of Multiyear Consequences for Abortion Access in Georgia Under a Law Limiting Abortion to Early Pregnancy

“…Barriers to abortion care—including poverty, lack of transportation, lack of language equity, medical racism, and immigration enforcement—will be heightened by HB481, particularly for those already experiencing inequitable access to care. Prior to Dobbs v Jackson , clients seeking abortion funding assistance from Georgia’s local abortion fund, Access Reproductive Care–Southeast, predominantly identified as non-Hispanic Black, were 18 to 34 years of age, and had a high school education or less .…”

“…These findings support and extend the existing evidence on unjust social and health consequences of restrictive abortion policies. 17,[32][33][34][35] In an evaluation of HB954, Black patients accessed abortions later in pregnancy and at higher rates than their White counterparts, 17 Barriers to abortion care-including poverty, lack of transportation, lack of language equity, medical racism, and immigration enforcement 36 -will be heightened by HB481, particularly for those already experiencing inequitable access to care. Prior to Dobbs v Jackson, clients seeking abortion funding assistance from Georgia's local abortion fund, Access Reproductive Care-Southeast, predominantly identified as non-Hispanic Black, were 18 to 34 years of age, and had a high school education or less.…”

“I don’t regret it at all. It’s just I wish the process had a bit more humanity to it … a bit more holistic”: a qualitative, community-led medication abortion study with Black and Latinx Women in Georgia, USA

“…Using CBPR and RJ principles, all research activities were conducted with guidance and oversight from the study’s Community Advisory Board, including abortion clinics and advocacy groups, community-based organisations (CBO) serving Black and Latinx communities, faith leaders, and researchers as well as Black and Latinx women from metro-Atlanta. 15 The Community Advisory Board helped develop data collection instruments, advised on recruitment strategies, discussed findings, and participated in dissemination as co-presenters at conferences and co-authors of manuscripts. The study team was majority Black and Latinx and approximately half bilingual (Spanish and English).…”

“…Moreover, abortion research has seldom employed a reproductive justice (RJ) or community-engaged framework to understand and address pertinent questions regarding access to abortion for marginalised groups. 15 This has led to a critical lack of Black and Latinx voices in the existing literature on abortion. Briefly, RJ can be defined as a social theory and community organising framework that promotes the human rights to have children, to not have children, and to parent one’s children with health and dignity free of reproductive oppression and coercion.…”

“…Led by our HIV and RJ organisation, SisterLove, in partnership with researchers from local academic universities, we conducted a community-engaged, qualitative study of MA among Black and Latinx communities in metro-Atlanta, Georgia. 15 , 24 We explored Black and Latinx women’s perceptions of, experiences with, barriers to, and facilitators of MA to address the following research questions: What are their understandings, attitudes, beliefs, and perceptions of MA? How do they describe their MA experiences or experiences they have heard about?…”