John Hopkins University School of Nursing, Baltimore, Maryland. Dr. Grace is currently at the Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Johns Hopkins University School of Nursing, Baltimore, Maryland.
J Midwifery Womens Health. 2020 Mar;65(2):248-256. doi: 10.1111/jmwh.13061. Epub 2020 Jan 29.
Latina women disproportionately report experiencing reproductive coercion (RC), a set of behaviors that interfere with autonomous reproductive decision making. Given RC's associations with intimate partner violence (IPV) and unintended pregnancy, it is critical to identify and address RC to assist women to achieve safety, autonomy, and reproductive life plans. The purpose of this study was to describe and understand the context of RC and the use of RC safety strategies among Latina women receiving services at an urban clinic, through listening to the experiences of the women in their own words.
Qualitative descriptive methodology was used. Semistructured interviews were conducted with a purposive sample of 13 Latina women recruited from a Federally Qualified Health Center in the Washington, DC, area.
Data were organized into 3 a priori categories: (1) RC behaviors, (2) co-occurrence of RC and IPV, and (3) RC harm reduction strategies. New RC behaviors emerged, and immigration status was used as a method of coercive control. From these a priori categories emerged 4 themes: impact of immigrant and citizenship status, machismo, strength and bravery, and importance of family. Harm reduction strategies included less detectable contraception; some sought community services, but others resorted to deception and stalling as the only tools available to them.
Less detectable methods of contraception remained useful harm reduction strategies for women experiencing RC. Midwives should inquire about method fit and be mindful of honoring the request when patients ask to change methods. Women's strength and resilience emerged as a vital source of power and endurance. This diverse sample and the powerful voices of the women who participated make a significant contribution to the understanding of RC experienced by Latina women in the United States.
拉丁裔女性不成比例地报告经历生殖胁迫(RC),这是一组干扰自主生殖决策的行为。鉴于 RC 与亲密伴侣暴力(IPV)和意外怀孕的关联,识别和解决 RC 以帮助女性实现安全、自主和生殖生活计划至关重要。本研究的目的是通过倾听女性自己的经验,描述和理解接受城市诊所服务的拉丁裔女性中 RC 的背景和 RC 安全策略的使用。
采用定性描述性方法。从华盛顿特区地区的一家合格的联邦健康中心,通过有目的的抽样,对 13 名拉丁裔女性进行了半结构式访谈。
数据被组织成 3 个预先确定的类别:(1)RC 行为,(2)RC 和 IPV 的共同发生,以及(3)RC 减少伤害策略。出现了新的 RC 行为,移民身份被用作强制性控制的一种手段。从这些预先确定的类别中出现了 4 个主题:移民和公民身份状况的影响、大男子主义、力量和勇气,以及家庭的重要性。减少伤害的策略包括使用不太容易被察觉的避孕方法;一些人寻求社区服务,但其他人只能通过欺骗和拖延作为唯一的手段。
对于经历 RC 的女性来说,更不容易被察觉的避孕方法仍然是减少伤害的有效策略。助产士应询问方法是否合适,并在患者要求更换方法时注意尊重请求。女性的力量和韧性是一种重要的权力和耐力来源。这个多样化的样本和参与的女性的有力声音,为理解美国拉丁裔女性经历的 RC 做出了重要贡献。