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J Health Care Poor Underserved. 2011 Nov;22(4):1387-400. doi: 10.1353/hpu.2011.0144.

Perceptions of coercion, discrimination and other negative experiences in postpartum contraceptive counseling for low-income minority women.

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  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.



Using in-depth qualitative methods, we investigated negative contraception counseling experiences, including those felt to be coercive or discriminatory, in a population of postpartum urban minority women.


Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women who had received care at a Medicaid-funded obstetrics clinic. In-person one-on-one interviews were then reviewed for themes using an iterative process of qualitative analysis.


In this sample of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. Features of negative counseling experiences included having insufficient, non-physician-directed and impersonal counseling. Most women had experienced episodes of poor communication with providers; 10 described feeling coerced or perceiving racially-based discrimination in counseling.


Negative experiences with contraceptive counseling may affect contraception utilization. Contraceptive education should respect each individual's autonomy, culture, and values.

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