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Unintended pregnancy and African American women: an examination of the residual effects of trauma, depression and discrimination on reproductive decision-making

Jill Denson, MSW, University of Wisconsin, Milwaukee

Unintended pregnancy is a public health concern. Nearly half of all pregnancies in the United States are unintended, with African American women experiencing the most unintended pregnancies. In Wisconsin, 65% of pregnancies resulting in live births to Black mothers are unintended, compared to 38% of pregnancies overall. Several state and federally funded preconception interventions have been developed to increase self-efficacy in reproductive decision-making, reduce unintended pregnancies and improve maternal and infant health outcomes. However, there is a dearth of knowledge in the literature that examines how African American women's intersecting identities, compounded with a history of racism and sexism, have resulted in higher rates of psychological trauma, chronic stress and discrimination, all of which affect African American women disparately. The residual effects have resulted in statistically higher rates of ambivalence about contraceptives, a lack of reproductive decision-making and an increase in unintended pregnancy. This project intends to study African American women's lived experiences accessing reproductive care and making reproductive decisions and to further explore how historical events and racial bias and discrimination in the healthcare system have shaped their social identities and experiences. This project will be grounded in constructs from Critical Race Theory (CRT) and Reproductive Justice (RJ) using the micro, mezzo and macro systems of the Social Ecological Model (SEM). Both CRT and RJ's theoretical frameworks reinforce the constructs of participant voice and action-oriented research. Therefore, a participatory approach will be used to capture the voices of African American women across social class through Group Concept Mapping.


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