Abstract:
Jasmine is an 18-year-old Black female bringing her infant to the pediatrician for a newborn weight check. She asks her pediatrician\'s opinion about hormonal contraceptive injections, sharing that they were strongly recommended after she gave birth. The recommending health care provider told her, \"We don\'t want you to end up back here any time soon.\" Rosita, a 16-year-old Latina female, visits her pediatrician for a well check. She reports a history of vaginal sex with 2 male partners and agrees to have a hormonal subcutaneous implant placed to avoid pregnancy. After 4 months of bothersome spotting, Rosita returns to have the implant removed. Rosita\'s provider strongly counsels against removal. Jasmine and Rosita are members of populations that have been systematically marginalized throughout American history. Their stories are derived from real cases and reveal how structural racism impacts modern contraceptive care. Specifically, their cases are examples of statistical discrimination, wherein the tendency to disproportionately recommend long-acting reversible contraception to historically marginalized communities does not follow the central tenants of sexual and reproductive justice, including acknowledging historical harms in health care and honoring bodily autonomy for all people. By sharing Jasmine and Rosita\'s stories, we use a reproductive justice lens to (1) examine the historical roots of disproportional prescription of long-acting reversible contraception to historically marginalized individuals, (2) discuss provider bias related to sexual and reproductive health care, and (3) illustrate how trauma-informed care with a recognition of historical trauma and the use of individuation can facilitate positive and equitable health outcomes.
摘要:
Jasmine是一名18岁的黑人女性,她将婴儿带到儿科医生那里进行新生儿体重检查。她问她的儿科医生关于荷尔蒙避孕注射的意见,分享他们在她分娩后被强烈推荐。推荐的医疗保健提供者告诉她,“我们不想让你很快回到这里。\"Rosita,一名16岁的拉丁裔女性,去看她的儿科医生做体检.她报告有2名男性伴侣的阴道性行为史,并同意放置荷尔蒙皮下植入物以避免怀孕。经过4个月的麻烦发现,Rosita返回以移除植入物。Rosita的提供者强烈反对删除。茉莉和罗西塔是在美国历史上被系统地边缘化的人群。他们的故事来自真实案例,揭示了结构性种族主义如何影响现代避孕护理。具体来说,他们的案件是统计歧视的例子,其中不成比例地向历史上边缘化的社区推荐长效可逆避孕的趋势并不遵循性和生殖正义的中心租户,包括承认医疗保健的历史危害,并尊重所有人的身体自主权。通过分享茉莉和罗西塔的故事,我们使用生殖正义的镜头来(1)研究长期可逆避孕的不成比例处方的历史根源,以历史边缘化的个人,(2)讨论与性和生殖保健相关的提供者偏见,和(3)说明如何创伤知情护理与历史创伤的承认和个性化的使用可以促进积极和公平的健康结果。