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APHA Scientific Session and Event Listing

Recorded presentation

Roberta Downing, PhD, Kellogg Community Health Scholars Program, Johns Hopkins University, Bloomberg School of Public Health, 624 N. Broadway, HH 337, Baltimore, MD 21205, 443-287-4289, rdowning@jhsph.edu, Heather E. Bullock, Psychology Department, University of California, Santa Cruz, 277 Social Sciences II, Santa Cruz, CA 95062, and Thomas A. LaVeist, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, 441, Baltimore, MD 21215.

Low-income women's childbearing is frequently stigmatized in the media and in policy realms. Poor women who access welfare are often perceived to be adding to state welfare costs when they have children and welfare policy contains provisions that seek to limit low-income women's reproduction (e.g., family caps, “illegitimacy” bonuses). Many of these policy measures reflect negative attitudes toward low-income women's childbearing. Given stereotypes about poor women's reproduction, the discrimination poor women experience in various parts of their lives, as well as policy directives aimed at their childbearing, it is likely that low-income women experience discriminatory treatment in reproductive healthcare. To examine this issue, this study investigated how ethnicity and social class intersect to impact the reproductive health care women receive. Of particular interest was whether providers give poor women, particularly women of color, advice to limit their childbearing and to what extent low-income women are discouraged from having children by providers. Low-income (n=192) and middle class women (n=146) in Los Angeles completed a questionnaire about their experiences in health care. Multiple regression revealed that low-income women, regardless of ethnicity, were more often given advice from providers to limit their childbearing during their pregnancy compared to middle class white women. A separate multiple regression demonstrated that low-income Latinas were most often discouraged from having children during their pregnancy compared to middle class white women. This research has implications for how policy attitudes impact the care women receive as well as questions of what groups are perceived as deserving of having children.

Learning Objectives: