Graduation Year

2013

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Community and Family Health

Major Professor

Ellen Daley

Keywords

Ecological, Hispanic, Qualitative, Unplanned Pregnancy, Young Adults

Abstract

In the United States, prominent racial/ethnic and socioeconomic disparities in rates of unintended pregnancy, abortion, and unintended births exist. Recent analysis suggests that Latinas are three times more likely to experience an unintended pregnancy than non-Latina white women. More than half of pregnancies among Latinas (53%) in the United States are unintended and have higher unintended births as they are less likely than black women to have an abortion. In addition, in 2006 the unintended pregnancy rate was highest among women aged 20-24. Little research has 0been conducted to understand unintended pregnancy particularly among young adult Latina women.

The purpose of the study is to determine and understand the meaning of unintended pregnancy among Latina subpopulations and examine the perceived consequences and management of unintended pregnancy among Latina subpopulations. Between May 2012 and October 2012, twenty in-depth-interviews were conducted with U. S. born- Latinas between 18-25 years of age seeking a confirmation pregnancy test at clinics in which some provided abortion services.

Latinas in the study's meaning of pregnancy came from their complicated life situations, and were facilitated by Latino cultural beliefs, such as fatalism, religiosity and familismo. Many held favorable and positive meanings of their unintended pregnancy, particularly those who continued their pregnancies to term. Consistent with several other studies, the act of deliberately trying to plan a pregnancy was foreign to many of these women, particularly because a pregnancy was something that should was not in their control and left up to God. Most of the Latinas in the study felt that women should not plan their pregnancies and doing so was going against fate and natural life course.

Public health research overwhelmingly highlights the negative maternal and child health consequences of unintended, while many women in this study perceived the negative consequences of unintended pregnancy to be primarily emotional and social. The inquiry found stigma surrounding unintended pregnancy among Latinas in this study. More than half of the women in the study resorted to termination of their pregnancy and cited fears of family reaction, fears their partner would deny paternity or responsibility, and/or desires to continue schooling, community and societal attitudes toward an unintended pregnancy and religiosity, as influencing this decision. In addition, contributing to the stigma were the stereotypes of Latinas.

Latinas decision to continue their pregnancies to term or have an abortion was provoked by diverse and interrelated factors. Although a few Latinas in the study stated their partner's had an influence on the pregnancy resolution decision, all Latina stated that ultimately they were in control over their pregnancy resolution decision. Even when Latinas partners did not agree with their decision, women still performed their intended pregnancy resolution decision. .

Family planning services might benefit from intervention designs with the following features that address the cultural needs of this population; a) highlight/stress the importance and benefits of delaying a pregnancy, not discuss pregnancy planning which was found to be irrelevant to these women, b) incorporate and address cultural constructs such as familismo and fatalism as protective factors rather than risk factors, and c) link and discuss issues such as poverty, education, insurance, stigma, and mental health issues. Many women reported these factors as perceived consequences and influencing the management of an unintended pregnancy. Interventions may be aimed at improving provider communication with Latinas about prevention of unintended pregnancy as well their pregnancy resolution options. Future public health campaigns might benefit from incorporating promotores de salud who had similar experiences in curriculums already discussing reproductive health. Support groups and mental health counseling was suggested as needed among participants that terminated their pregnancies. Future research should continue to focus on the multiple levels of influence and the contribution they make on the meaning and consequences of unintended pregnancy. In addition, the role of cultural protective factors in strengthening families and communities merits further exploration.

This study increased our understanding of what unintended pregnancy means in the Latino community, and explored it from a comprehensive, multi-dimensional, and structural perspective. Understanding these factors are important and first steps to addressing an issue that affects Latinas, their families, communities, and the nation-at large.

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