Assessing unmet reproductive health needs for women in shelters

Background: There is growing interest in the intersection between intimate partner violence and reproductive health. Women seeking shelter have reproductive needs, but access to reproductive services is severely limited. Taking control of one's reproductive destiny can be a first step to taking back control from an abuser.

Objective: Assess clients' unmet needs and barriers to services; shelter staffs' understanding of women's needs and staffs' own professional development needs.

Methods: In-person semi-structured interviews with rural and urban women using shelter services (16) and shelter staff (10). Interviews were transcribed verbatim, and entered in NVIVO, a textual data management system. Transcripts were coded, with comparative cross-analyses to find common themes, present a narrative of women's experiences, and look for divergence and agreement from the perspectives of women and shelter staff.

Results: Acute needs identified by women included unplanned pregnancies, exposure to STIs, reproductive coercion, lack of information, but these needs were not being consistently addressed. Staff felt asking about these issues would be intrusive, other needs were more pressing and that they did not have the knowledge necessary to address these needs or make referrals. There were varying levels of comfort with discussing contraceptives or pregnancy options.

Conclusion: Shelters are missing an opportunity to address reproductive health; many women will return to their abuser or start new relationships and could be better equipped with strategies to control their fertility and avoid STIs. Options for fertility control are a key part of a woman's autonomy and overall health, yet are often being ignored.