Disparities in family planning

Abstract

Prominent racial/ethnic and socioeconomic disparities in rates of unintended pregnancy, abortion, and unintended births exist in the United States. These disparities can contribute to the cycle of disadvantage experienced by specific demographic groups when women are unable to control their fertility as desired. In this review we consider three factors which contribute to disparities in family planning outcomes: patient preferences and behaviors, health care system factors, and provider related factors. Through addressing barriers to access to family planning services, including abortion and contraception, and working to ensure that all women receive patient-centered reproductive health care, health care providers and policy makers can substantially improve the ability of women from all racial/ethnic and socioeconomic backgrounds to make informed decisions about their fertility. KeywordsHealth disparities; Unintended Pregnancy; Family Planning; Contraception; Abortion The ability to plan if and when to have children is fundamental to the health of women and critical to the equal functioning of women in society. 1 In the United States, rates of unintended pregnancy (including both mistimed and undesired pregnancies), unintended birth, abortion, and adolescent pregnancy differ across racial, ethnic, and socioeconomic lines. These disparities have profound short-term and long-term consequences for women, their children, and society. Women with unintended pregnancies that are continued to term are more likely to receive inadequate or delayed prenatal care and have poorer health outcomes such as infant low birth weight, infant mortality, and maternal mortality and morbidity. 2-7 Children resulting from unplanned pregnancies have been found to be more likely to experience developmental delay and have poorer relationships with their mother.8 These risks of unintended birth are magnified in adolescent mothers, who experience increased risk for pregnancy complications and are often forced to make compromises in education and employment opportunities that

Happiness About Unintended Pregnancy And Its Relationship to Contraceptive Desires Among a Predominantly Latina Cohort

“…[16][17][18][19] For many women, method choice is limited by financial barriers, such as lack of insurance coverage or inability to afford a copay; logistical barriers, such as inability to find reliable transportation to a clinic or having to lose pay for taking time off to attend; or provider barriers, such as prevailing but outdated clinical practice norms. 20,21 Moreover, many women may find user-dependent methods (e.g., condoms, the pill) difficult to use correctly because they are dissatisfied with certain aspects, 22 such as interference with sexual function, 23 negative side effects 24 or nonacceptance by intimate partners. 25 Thus, for some women, use of less effective contraceptive methods or imperfect contraceptive use may reflect their inability to use the method they truly desire-that is, the one they would use if they could obtain any method they wanted.…”

Social, Reproductive, and Attitudinal Factors Associated with U.S. Women's Disagreement with the Passage of the Affordable Care Act

“…Socially disadvantaged women, those with an unmet need for effective contraception, and nonusers of health services, especially preventive services, disproportionately experience adverse reproductive health outcomes in the United States and are therefore primary target populations of the ACA. [16][17][18][19][20][21][22][23][24][25][26][27][28] Our results may highlight critical gaps in women's understanding and acceptance of the ACA among the very groups who stand to benefit from it the most. Findings may have important implications for whether the women who need health care will actually utilize the services afforded to them under the ACA.…”

Sexual and birth control health practices among female undergraduates: a descriptive study

“…Há evidências de que as mulheres americanas com baixo status socioeconômico apresentam disparidades nos cuidados de planejamento familiar. No acesso aos serviços que prestam estes cuidados foram verificadas importantes desigualdades raciais, étnicas e socioeconômicas (17) . As jovens universitárias estudadas têm acesso ao atendimento ginecológico, sejam nos serviços de saúde públicos ou conveniados aos planos de saúde.…”