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Mosley EA, Ayala S, Jah Z, Hailstorks T, Hairston I, Rice WS, Hernandez N, Jackson K, Scales M, Gutierrez M, Goode B, Filippa S, Strader S, Umbria M, Watson A, Faruque J, Raji A, Dunkley J, Rogers P, Ellison C, Suarez K, Diallo DD, Hall KS. " I don't regret it at all. It's just I wish the process had a bit more humanity to it … a bit more holistic": a qualitative, community-led medication abortion study with Black and Latinx Women in Georgia, USA. Sex Reprod Health Matters 2022; 30:2129686. [PMID: 36368036 PMCID: PMC9664998 DOI: 10.1080/26410397.2022.2129686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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.
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Affiliation(s)
- Elizabeth A. Mosley
- Affiliated Faculty Member, Center for Reproductive Health Research in the Southeast, Emory University Rollins School of Public Health Atlanta, GA, USA,Assistant Professor, Center for Innovative Research on Gender Health Equity, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Correspondence:
| | - Sequoia Ayala
- Director of Policy and Advocacy, SisterLove, Inc., Atlanta, GA, USA
| | - Zainab Jah
- Research Director, SisterLove, Inc., Atlanta, GA, USA
| | - Tiffany Hailstorks
- Assistant Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Indya Hairston
- Community-Based Research Program Manager, SisterLove, Inc., Atlanta, GA, USA
| | - Whitney S. Rice
- Assistant Professor, Center for Reproductive Health Research in the Southeast, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Kwajelyn Jackson
- Executive Director, Feminist Women’s Health Center, Atlanta, GA, USA
| | - Marieh Scales
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Mariana Gutierrez
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Bria Goode
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Sofia Filippa
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Shani Strader
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Mariana Umbria
- Research Intern, SisterLove, Inc., Atlanta, GA, USA,MPH Student, Georgia State University School of Public Health, Atlanta, GA, USA
| | - Autumn Watson
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Joya Faruque
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Adeola Raji
- Research Intern, SisterLove, Inc., Atlanta, GA, USA,MPH Student, Georgia State University School of Public Health, Atlanta, GA, USA
| | - Janae Dunkley
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Peyton Rogers
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Celeste Ellison
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | - Kheyanna Suarez
- MPH Student, Emory University Rollins School of Public Health, Atlanta, GA, USA,Research Intern, SisterLove, Inc., Atlanta, GA, USA
| | | | - Kelli S. Hall
- Founding Director, Center for Reproductive Health Research in the Southeast, Emory University Rollins School of Public Health, Atlanta, GA, USA,Associate Professor, Columbia University Mailman School of Public Health, New York, NY, USA
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