Abstract:
Traditional family planning research has excluded Black and Latinx leaders, and little is known about medication abortion (MA) among racial/ethnic minorities, although it is an increasingly vital reproductive health service, particularly after the fall of Roe v. Wade. Reproductive justice (RJ) community-based organisation (CBO) SisterLove led a study on Black and Latinx women\'s MA perceptions and experiences in Georgia. From April 2019 to December 2020, we conducted key informant interviews with 20 abortion providers and CBO leaders and 32 in-depth interviews and 6 focus groups (n = 30) with Black and Latinx women. We analysed data thematically using a team-based, iterative approach of coding, memo-ing, and discussion. Participants described multilevel barriers to and strategies for MA access, wishing that \"the process had a bit more humanity … [it] should be more holistic.\" Barriers included (1) sociocultural factors (intersectional oppression, intersectional stigma, and medical experimentation); (2) national and state policies; (3) clinic- and provider-related factors (lack of diverse clinic staff, long waiting times); and (4) individual-level factors (lack of knowledge and social support). Suggested solutions included (1) social media campaigns and story-sharing; (2) RJ-based policy advocacy; (3) diversifying clinic staff, offering flexible scheduling and fees, community integration of abortion, and RJ abortion funds; and (4) social support (including abortion doulas) and comprehensive sex education. Findings suggest that equitable MA access for Black and Latinx communities in the post-Roe era will require multi-level intervention, informed by community-led evidence production; holistic, de-medicalised, and human rights-based care models; and intersectional RJ policy advocacy.
摘要:
传统的计划生育研究排除了黑人和拉丁裔领导人,对种族/族裔少数群体中的药物流产(MA)知之甚少,尽管它是一项日益重要的生殖健康服务,尤其是在罗伊诉韦德案落空之后.生殖正义(RJ)社区组织(CBO)SisterLove领导了一项关于佐治亚州黑人和拉丁裔妇女的MA观念和经历的研究。从2019年4月到2020年12月,我们对20名堕胎提供者和CBO领导人进行了重要的线人访谈,对黑人和拉丁裔妇女进行了32次深入访谈和6个焦点小组(n=30)。我们使用基于团队的主题分析数据,迭代编码方法,memo-ing,和讨论。与会者描述了获取MA的多层次障碍和策略,希望“这个过程更人性化……[它]应该更全面。障碍包括(1)社会文化因素(交叉压迫,交叉柱头,和医学实验);(2)国家和国家政策;(3)与临床和提供者相关的因素(缺乏多样化的诊所工作人员,等待时间长);和(4)个人层面的因素(缺乏知识和社会支持)。建议的解决方案包括(1)社交媒体活动和故事分享;(2)基于RJ的政策宣传;(3)使诊所工作人员多样化,提供灵活的日程安排和费用,社区融合堕胎,和RJ堕胎基金;(4)社会支持(包括堕胎doulas)和全面的性教育。研究结果表明,在后Roe时代,黑人和拉丁裔社区的公平获取将需要多层次的干预,由社区主导的证据制作提供信息;整体,去医疗化,和基于人权的护理模式;以及交叉的RJ政策倡导。