Hopkins Kristine, White Kari, Linkin Fran, Hubert Celia, Grossman Daniel, Potter Joseph E
Population Research Center, University of Texas at Austin.
Department of Health Care Organization and Policy, University of Alabama at Birmingham.
Perspect Sex Reprod Health. 2015 Jun;47(2):63-70. doi: 10.1363/47e2815. Epub 2015 Jan 30.
Little is known about low-income women's and teenagers' experiences accessing publicly funded family planning services, particularly after policy changes are made that affect the cost of and access to such services.
Eleven focus groups were conducted with 92 adult women and 15 teenagers in nine Texas metropolitan areas in July-October 2012, a year after legislation that reduced access to subsidized family planning was enacted. Participants were recruited through organizations that serve low-income populations. At least two researchers independently coded the transcripts of the discussions and identified main themes.
Although most women were not aware of the legislative changes, they reported that in the past year, they had had to pay more for previously free or low-cost services, use less effective contraceptive methods or forgo care. They also indicated that accessing affordable family planning services had long been difficult, that applying and qualifying for programs was a challenge and that obtaining family planning care was harder than obtaining pregnancy-related care. As a result of an inadequate reproductive health safety net, women experienced unplanned pregnancies and were unable to access screening services and follow-up care. Teenagers experienced an additional barrier, the need to obtain parental consent. Some women preferred to receive family planning services from specialized providers, while others preferred more comprehensive care.
Women in Texas have long faced challenges in obtaining subsidized family planning services. Legislation that reduced access to family planning services for low-income women and teenagers appears to have added to those challenges.
对于低收入女性和青少年获取公共资助的计划生育服务的经历，我们知之甚少，尤其是在政策发生变化影响此类服务的成本和可及性之后。
2012年7月至10月，在德克萨斯州的九个大都市地区，针对92名成年女性和15名青少年开展了11个焦点小组访谈。这是在一项减少了获得补贴计划生育服务机会的立法颁布一年之后。参与者通过为低收入人群服务的组织招募。至少两名研究人员对讨论记录进行独立编码，并确定主要主题。
尽管大多数女性并未意识到立法变化，但她们报告称，在过去一年里，她们不得不为以前免费或低成本的服务支付更多费用，使用效果较差的避孕方法或放弃护理。她们还表示，长期以来，获得负担得起的计划生育服务一直很困难，申请和符合项目资格是一项挑战，而且获得计划生育护理比获得与怀孕相关的护理更难。由于生殖健康安全网不足，女性经历了意外怀孕，并且无法获得筛查服务和后续护理。青少年还面临额外的障碍，即需要获得父母同意。一些女性更喜欢从专业提供者那里获得计划生育服务，而另一些女性则更喜欢更全面的护理。
德克萨斯州的女性长期以来在获得补贴的计划生育服务方面面临挑战。减少低收入女性和青少年获得计划生育服务机会的立法似乎加剧了这些挑战。
