Situating Oneself in the Intersectional Hierarchy: Racially Diverse, Low-Income Women Discuss Having Little Agency in Vasectomy Decisions

Neighborhood‐level racialized socioeconomic deprivation and contraceptive use in the United States, 2011–2019

“…Research has found that while women with low incomes report agency over their own sterilization, they felt less ability to influence their male partner's vasectomies, attributing this to gender and cultural norms. 52 In addition, it was surprising that the interactive effect of Medicaid and neighborhood privilege was associated with higher predicted use of permanent methods, considering that some Black and Latina women with Medicaid have reported difficulty accessing desired postpartum sterilization compared to white women. 53 Further research should continue to examine what structural factors contribute to higher rates of female sterilization in neighborhoods of greater deprivation, as well as how the interactive effect of insurance type and neighborhood might contribute.…”

“…Finally, while we did not see a difference in the predicted probability of permanent methods by neighborhood deprivation, this may be the result of the analytical decision to collapse male sterilization and female sterilization into one category. Research has found that while women with low incomes report agency over their own sterilization, they felt less ability to influence their male partner's vasectomies, attributing this to gender and cultural norms 52 . In addition, it was surprising that the interactive effect of Medicaid and neighborhood privilege was associated with higher predicted use of permanent methods, considering that some Black and Latina women with Medicaid have reported difficulty accessing desired postpartum sterilization compared to white women 53 .…”