Nikolajski Cara, Miller Elizabeth, McCauley Heather L, Akers Aletha, Schwarz Eleanor Bimla, Freedman Lori, Steinberg Julia, Ibrahim Said, Borrero Sonya
Department of Medicine, University of Pittsburgh Center for Research on Health Care, Pittsburgh, Pennsylvania.
Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, Pennsylvania.
Womens Health Issues. 2015 May-Jun;25(3):216-23. doi: 10.1016/j.whi.2014.12.004. Epub 2015 Mar 5.
Unintended pregnancy is common and disproportionately occurs among low-income and African-American (AA) women. Male partners may influence women's risk of unintended pregnancy through reproductive coercion, although studies have not assessed whether racial differences in reproductive coercion impact AA women's disparate risk for unintended pregnancy. We sought to describe women's experiences with pregnancy-promoting behaviors by male partners and explore differences in such experiences by race.
Semistructured interviews were conducted with low-income, AA and White women aged 18 to 45 years recruited from reproductive health clinics in Western Pennsylvania to explore contextual factors that shape women's contraceptive behaviors. Narratives were analyzed using content analysis and the constant comparison method.
Among the 66 participants (36 AA and 30 White), 25 (38%) described experiences with male partner reproductive coercion. Narratives provided accounts of contraceptive sabotage, verbal pressure to promote pregnancy and specific pregnancy outcomes, and potential motives behind these behaviors. AA women in the sample reported experiences of reproductive coercion more often than White women (53% and 20%, respectively). AA women were also more likely than White women to attribute a current or prior pregnancy to reproductive coercion. AA women identified relationship transiency and impending incarceration as potential motivations for men to secure a connection with a female partner via pregnancy.
Our findings suggest that reproductive coercion may be a factor contributing to disparities in unintended pregnancy. More research, including population-level studies, is needed to determine the impact of reproductive coercion on unintended pregnancy and to understand the social and structural factors associated with pregnancy-promoting behaviors.
意外怀孕很常见，且在低收入和非裔美国（AA）女性中发生率过高。男性伴侣可能通过生殖胁迫影响女性意外怀孕的风险，尽管研究尚未评估生殖胁迫方面的种族差异是否会影响AA女性意外怀孕的不同风险。我们试图描述女性在男性伴侣促进怀孕行为方面的经历，并探讨此类经历在种族上的差异。
对从宾夕法尼亚西部生殖健康诊所招募的18至45岁的低收入AA和白人女性进行了半结构化访谈，以探讨影响女性避孕行为的背景因素。使用内容分析和持续比较法对访谈内容进行分析。
在66名参与者（36名AA女性和30名白人女性）中，25人（38%）描述了男性伴侣生殖胁迫的经历。访谈内容讲述了避孕破坏行为、促使怀孕的言语压力和特定的怀孕结果，以及这些行为背后的潜在动机。样本中的AA女性比白人女性更常报告生殖胁迫经历（分别为53%和20%）。AA女性也比白人女性更有可能将当前或之前的怀孕归因于生殖胁迫。AA女性认为关系短暂和即将入狱是男性通过怀孕与女性伴侣建立联系的潜在动机。
我们的研究结果表明，生殖胁迫可能是导致意外怀孕差异的一个因素。需要更多的研究，包括人群水平的研究，来确定生殖胁迫对意外怀孕的影响，并了解与促进怀孕行为相关的社会和结构因素。
