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Exploring the role of reproductive stigmas in pregnancy decision-making in Alabama

Janet Turan, University of Alabama at Birmingham, 2013

Project abstract

Although premarital sex, using contraception, becoming pregnant unintentionally, parenting out of wedlock, and having an abortion are all common experiences in women’s lives, each may carry significant social stigma in the United States. In the proposed study, we will explore the role these reproductive stigmas play in pregnancy decision-making among young low-income women in Birmingham, Alabama, a socially conservative area in the Deep South with high rates of unintended pregnancy.

The overall goal of this mixed methods research project is to better understand the role of reproductive stigmas in young women’s decision-making when faced with an unintended pregnancy. We will initially conduct six focus group discussions with young (aged 19-24) low-income women attending local health department clinics in Birmingham, to explore their perceptions of how different pregnancy decisions (e.g., single parenthood, adoption, abortion) are viewed by women, partners, family, and others in their community.

Using the focus group findings and our existing validated abortion stigma survey items, we will (a) develop new items that capture other reproductive stigmas, and (b) pre-test these items through cognitive interviews with 10-15 young low-income women. Finally, to assess the reliability and validity of the adapted measures, as well as preliminarily explore associations of reproductive stigmas with women’s pregnancy decisions, we will conduct a self-administered iPad survey of 120 young low-income women with a recent unintended pregnancy recruited from the local health department clinics.

The decisions that women make around pregnancy have lasting health and well-being implications for women and their families. Therefore, understanding how reproductive stigmas influence pregnancy decision-making will have important implications for clinicians, contraceptive and pregnancy counselors, social workers, and others who support pregnant women. In addition, our project will provide tools to measure and assess the contribution of reproductive stigmas to women’s pregnancy decisions, and for the evaluation of stigma-reduction interventions.

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