Online Program

Beyond a legacy of coercion: Long-acting reversible contraception (LARC) and social justice

Monday, November 2, 2015 : 1:30 p.m. - 1:50 p.m.

Stephanie Meier, Department of Communication, College of Charleston, Greenville, SC
Beth Sundstrom, Ph.D., M.P.H., Department of Communication, College of Charleston, Charleston, SC
Andrea DeMaria, PhD, MS, Department of Health and Human Performance, College of Charleston, Charleston, SC
Background: Half of all pregnancies in the United States are unintended. The American College of Obstetricians and Gynecologists recommends long-acting reversible contraception (LARC), including the intrauterine device (IUD) and the subdermal implant, as first-line pregnancy prevention for all women and adolescents. Continued reproductive coercion in the United States, especially among underserved populations, problematizes the promotion of LARC methods without considering underlying social and economic issues. Previous research demonstrates ethnicity and socioeconomic status impact health care providers’ recommendations of LARC methods; however, limited research examines the legacy of coercion on LARC method choice.

Methods: This qualitative study examined the impact of reproductive coercion on women’s standpoint and perspectives of LARC methods. Researchers conducted 6 focus groups (n=61) and 18 interviews with women, ages 18-44 years, as part of a larger study about contraceptive choice. Data analyses were completed using HyperRESEARCH 3.5.2. Feminist standpoint theory provided the conceptual lens for data analysis.

Results: The history of reproductive coercion, especially forced sterilization of women of color, emerged in participants’ perspectives of LARC methods. Findings suggest the importance of identity in women’s making meaning of LARC methods. Identifying with women who use LARC methods influenced participants’ understanding of contraceptive choice. Participants indicated that lack of information provided by health care providers served as a barrier to adequate knowledge about LARC methods.

Discussion: Findings from this study offer theoretical and practical opportunities to guide health care practitioners and health communication campaigns aimed at decreasing the burden of unintended pregnancy while maintaining reproductive justice.

Learning Areas:

Diversity and culture
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the impact that past reproductive coercion has on women’s perception of long-acting reversible contraception (LARC) methods. Explain how distinct standpoints shape participants’ understanding of who uses LARC. Design health messages that address the burden of unintended pregnancy while maintaining social justice.

Keyword(s): Social Justice, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as a member of the Women's Health Research Team at College of Charleston for a year. I aided in the collection and interpretation of data for the larger women's health research study concerning contraceptive choice as well as the research for this study. I completed grant funded research for this study over the summer at the College of Charleston.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.