Likelihood of Emergency Contraception Use Among African-American Women at Risk of Adverse Birth Outcomes

Abstract

Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with a prior adverse birth outcome who either do not use contraception consistently or whose contraception fails is emergency contraception (EC). The purpose of our study was to understand willingness to use EC among African-American women who recently had an adverse birth outcome. The Healthy Births Healthy Communities (HBHC) Interconceptional Care Project (ICCP) targeted high-risk African-American women from two low-income Chicago neighborhoods who recently had an adverse birth outcome. The aim of HBHC ICCP was to improve participants' future birth outcomes by providing medical and social services and helping women to clarify their reproductive life goals. Information about participants' pregnancy intentions and willingness to use EC was measured in an interview shortly after enrollment into the study. Over 90% of the 131 women in our study either did not want to become pregnant or did not know if they wanted to become pregnant within the next 2 years. These women had 4.4 times higher odds of reporting willingness to use EC as compared to women who reported a desire to become pregnant within the next 2 years (75.6 vs. 50.0%, respectively; AOR: 4.4; 95% CI 1.1, 17.6). EC is an essential part of the reproductive toolkit for women at high risk of adverse birth outcomes who are not intending pregnancy, along with reproductive life planning and use of effective contraception.

Scoping Review of Access to Emergency Contraception for Sexual Assault Victims in Emergency Departments in the United States

“…Juxtaposing such results to reported physician practices and the targeted reach of specific policies would be an important component to capturing a more holistic perspective on EC in survivor care. Studies also should continue to explore differences in accessibility to EC based on factors of socioeconomic class, race, insurance status, medical literacy, cultural acceptability of unintended pregnancy, or knowledge of when or where to seek help (Bryant, Nakagawa, Gregorich, & Kuppermann, 2010; Elibiary & Youmans, 2007; Jackson, Schwarz, Freedman, & Darney, 2000; Lind, Godfrey, Rankin, & Handler, 2014; Ward, Roncancio, & Berenson, 2010) and aim to be inclusive of the experiences of gender nonconforming and trans patients who present to the ED who also may be at risk of pregnancy from sexual assault.…”

Reproductive Life Planning: A Concept Analysis

“…This fifth attribute, flexibility, allows individuals to take life circumstances into consideration. Medical and social services are needed to help clarify the reproductive life goals of an individual, especially in cases in which the individual is high risk for poor pregnancy outcomes (Lind, Godfrey, Rankin, & Handler, ). An individual's life circumstances are unique, and as such the reproductive life plan is personalized for each individual or couple.…”

Razões do não uso da anticoncepção de emergência quando indicada

“…No estudo realizado em Edimburgo, na Escócia, as mulheres que estavam em uma gravidez ambivalente também relataram menor uso da AE do que as mulheres com gravidez não planejada (Lakha, Glasier, 2006), indicando que a intenção de engravidar é um aspecto importante na decisão de usar ou não a AE. Ainda, mulheres negras americanas, que relataram não querer engravidar, foram quatro vezes mais propensas a relatar que usariam a AE caso percebessem a necessidade, em comparação com as que tinham a intenção de engravidar (Lind et al, 2013).…”