Manzer Jamie L, Bell Ann V
University of Delaware, Newark, Delaware, USA.
Qual Health Res. 2022 Jan;32(1):80-94. doi: 10.1177/10497323211004081. Epub 2021 Apr 17.
In the United States, unintended pregnancy is medicalized, having been labeled a health problem and "treated" with contraception. Scholars find women's access to contraception is simultaneously facilitated and constrained by health care system actors and its structure. Yet, beyond these barriers, less research centers women's experiences making contraceptive decisions as they encounter such barriers. Through in-depth, semi-structured interviews with 86 diverse, self-identified women, this study explores how the medicalization of unintended pregnancy has influenced women's contraceptive access and decision-making. We highlight the breadth of such influence across multiple contraceptive types and health care contexts; namely, we find the two most salient forces shaping women's contraceptive decisions to be their insurance coverage and providers' contraceptive counseling. Within these two categories, we offer crucial nuance to demonstrate these oft-cited barriers implicitly and explicitly influence women's decisions. Paradoxically, it is the health care system, itself, that both offers yet constrains women's contraceptive decisions.
在美国，意外怀孕被医学化了，被贴上了健康问题的标签并通过避孕措施进行“治疗”。学者们发现，医疗保健系统的参与者及其结构在促进女性获得避孕措施的同时也对其进行了限制。然而，除了这些障碍之外，很少有研究关注女性在遇到这些障碍时做出避孕决策的经历。通过对86名身份各异、自我认同的女性进行深入的半结构化访谈，本研究探讨了意外怀孕的医学化如何影响女性获得避孕措施和决策过程。我们强调了这种影响在多种避孕方式和医疗保健环境中的广度；也就是说，我们发现影响女性避孕决策的两个最突出因素是她们的保险覆盖范围和提供者的避孕咨询。在这两个类别中，我们提供了关键的细微差别，以表明这些经常被提及的障碍以隐性和显性的方式影响着女性的决策。矛盾的是，正是医疗保健系统本身既为女性提供了避孕决策的机会，又对其进行了限制。
