Carvajal Diana N, Zambrana Ruth Enid
Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
Department of Women's Studies, University of Maryland, College Park, Maryland.
Health Equity. 2020 Mar 4;4(1):10-16. doi: 10.1089/heq.2019.0107. eCollection 2020.
Reproductive autonomy is associated with educational attainment, advanced employment, and well-being. While U.S. Latinas use contraception to control their own childbearing and have reported a desire to do so, they often use it inconsistently and have the lowest rates of contraceptive use of any group. Reasons previously cited for why Latinas do not use contraception compared with non-Latino white women include lack of access, lack of knowledge, language barriers, emphasis on large families, machismo, and religiosity. These reasons are often overly simplistic and can lead to widespread generalizations about Latinas. Using focus groups and semistructured interviews from November 2014 through June 2015, this study describes the family planning perspectives and experiences of 16 Latinas living in Baltimore and recruited from two federally qualified health centers. A social determinant of health framework was used to guide identification of important concepts and explain findings. Results demonstrated that respondents reported contraceptive agency and claimed autonomy over their bodies; described a sense of responsibility and often expressed caution about having families too large to care for; expressed educational and career aspirations; and perceived contraception as critical for the postponement of childbearing to achieve their goals. The patient/provider encounter should include communication that recognizes all patient preferences and lived experiences to support vulnerable and/or marginalized Latinas in their desires to control their own childbearing and life choices.
生殖自主权与教育程度、高级就业和幸福感相关。虽然美国拉丁裔女性使用避孕措施来控制自己的生育，并表示有这样做的意愿，但她们往往使用得不规律，且在所有群体中避孕使用率最低。与非拉丁裔白人女性相比，此前提到的拉丁裔女性不使用避孕措施的原因包括难以获得避孕服务、缺乏知识、语言障碍、对大家庭的重视、大男子主义和宗教信仰。这些原因往往过于简单化，可能导致对拉丁裔女性的普遍概括。本研究通过2014年11月至2015年6月的焦点小组和半结构化访谈，描述了16名居住在巴尔的摩、从两个联邦合格健康中心招募的拉丁裔女性的计划生育观点和经历。采用健康的社会决定因素框架来指导重要概念的识别并解释研究结果。结果表明，受访者报告了避孕自主权，并声称对自己的身体有自主权；描述了一种责任感，并且经常对家庭规模过大难以照顾表示谨慎；表达了教育和职业抱负；并认为避孕对于推迟生育以实现她们的目标至关重要。医患互动应包括认可所有患者偏好和生活经历的沟通，以支持易受伤害和/或边缘化的拉丁裔女性控制自己生育和生活选择的愿望。
