Ibis Reproductive Health, Cambridge, MA, United States.
National Asian Pacific American Women's Forum, Atlanta, GA, United States.
Front Public Health. 2023 Jan 17;10:982215. doi: 10.3389/fpubh.2022.982215. eCollection 2022.
Culture and community can play a role in views, stigma, and access related to abortion. No research to date has documented the influence of culture and community attitudes on Asian American (AA) experiences accessing abortion care in the United States (US). This paper aims to fill gaps in research and understand how cultural and community views influence medication abortion access and experiences among AAs.
We used a community-based participatory research approach, which included collaboration among experts in public health, advocates, practitioners, and community partners to understand abortion knowledge, attitudes, and experiences among AAs. Using a semi-structured interview guide, we interviewed twenty-nine eligible people of reproductive age over 18 that self-identified as Asian American or mixed race including Asian American, Native Hawaiian, and/or Pacific Islander (AANHPI), and had a medication abortion in the US between January 2016 and March 2021. Interviews were analyzed and coded in NVivo 12 using a modified grounded theory approach.
Participants described various influences of religion negatively impacting acceptability of abortion among their family and community. Lack of openness around sexual and reproductive health (SRH) topics contributed to stigma and influenced most participants' decision not to disclose their abortion to family members, which resulted in participants feeling isolated throughout their abortion experience. When seeking abortion care, participants preferred to seek care with providers of color, especially if they were AANHPI due to past experiences involving stigma and judgment from White providers. Based on their experiences, respondents recommended ways to improve the abortion experience for AAs in the US including, (1) more culturally aware abortion providers from one's community who better understand their needs; (2) clinics providing abortion services located in or near AA communities with signage in local languages; and (3) tailored mental health resources with culturally aware therapists.
This study demonstrates ways in which culture and community opinions toward SRH can influence both the acceptability of abortion and experiences seeking abortion care among AAs. It is important to consider family and community dynamics among AAs to better tailor services and meet the needs of AAs seeking abortion care in the US.
文化和社区在与堕胎相关的观点、耻辱感和获取途径方面可能会产生影响。迄今为止，没有研究记录文化和社区态度对美国亚裔美国人（AA）获取堕胎护理的经历的影响。本文旨在填补研究空白，了解文化和社区观点如何影响 AA 人群获得药物流产的机会和体验。
我们采用了基于社区的参与性研究方法，包括公共卫生专家、倡导者、从业者和社区合作伙伴之间的合作，以了解 AA 人群对堕胎的知识、态度和经历。我们使用半结构化访谈指南，对 29 名符合条件的 18 岁以上的生殖年龄人群进行了访谈，他们自我认同为亚裔美国人或混合种族，包括亚裔美国人、夏威夷原住民和/或太平洋岛民（AANHPI），并在 2016 年 1 月至 2021 年 3 月期间在美国进行了药物流产。访谈使用 NVivo 12 进行分析和编码，并使用改进的扎根理论方法进行编码。
参与者描述了宗教对其家庭和社区中堕胎可接受性的各种负面影响。对性和生殖健康（SRH）话题的开放性不足导致了耻辱感，并影响了大多数参与者决定不向家人透露他们的堕胎经历，这导致参与者在整个堕胎过程中感到孤立。在寻求堕胎护理时，参与者更喜欢寻求有色人种提供者的护理，尤其是如果他们是 AANHPI，因为过去曾经历过来自白人提供者的耻辱感和评判。根据他们的经验，受访者建议了一些改善美国 AA 堕胎体验的方法，包括：（1）更有文化意识的社区内堕胎提供者，他们更了解他们的需求；（2）在 AA 社区内或附近提供堕胎服务的诊所，并提供当地语言的标识；（3）提供具有文化意识的治疗师的定制化心理健康资源。
这项研究表明，文化和社区对 SRH 的看法如何影响 AA 人群对堕胎的接受程度和寻求堕胎护理的体验。考虑到 AA 家庭和社区动态，对于更好地定制服务和满足美国寻求堕胎护理的 AA 人群的需求非常重要。
