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Disparities in family planning

      Prominent racial/ethnic and socioeconomic disparities in rates of unintended pregnancy, abortion, and unintended births exist in the United States. These disparities can contribute to the cycle of disadvantage experienced by specific demographic groups when women are unable to control their fertility as desired. In this review we consider 3 factors that contribute to disparities in family planning outcomes: patient preferences and behaviors, health care system factors, and provider-related factors. Through addressing barriers to access to family planning services, including abortion and contraception, and working to ensure that all women receive patient-centered reproductive health care, health care providers and policy makers can substantially improve the ability of women from all racial/ethnic and socioeconomic backgrounds to make informed decisions about their fertility.

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      References

        • Wulf D.
        • Donovan P.
        Women and societies benefit when childbearing is planned: issues in brief.
        The Alan Guttmacher Institute, New York, NY2002
        • Kost K.
        • Landry D.J.
        • Darroch J.E.
        Predicting maternal behaviors during pregnancy: does intention status matter?.
        Fam Plann Perspect. 1998; 30: 79-88
        • Hook K.
        Refused abortion: a follow-up study of 249 women whose applications were refused by the National Board of Health in Sweden.
        Acta Psychiatr Scand Suppl. 1963; 39: 1-156
        • Najman J.M.
        • Morrison J.
        • Williams G.
        • Andersen M.
        • Keeping J.D.
        The mental health of women 6 months after they give birth to an unwanted baby: a longitudinal study.
        Soc Sci Med. 1991; 32: 241-247
        • Cheng D.
        • Schwarz E.B.
        • Douglas E.
        • Horon I.
        Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors.
        Contraception. 2009; 79: 194-198
        • Gipson J.D.
        • Koenig M.A.
        • Hindin M.J.
        The effects of unintended pregnancy on infant, child, and parental health: a review of the literature.
        Stud Fam Plann. 2008; 39: 18-38
        • Kost K.
        • Landry D.J.
        • Darroch J.E.
        The effects of pregnancy planning status on birth outcomes and infant care.
        Fam Plann Perspect. 1998; 30: 223-230
        • Baydar N.
        Consequences for children of their birth planning status.
        Fam Plann Perspect. 1995; 27 (45): 228-234
        • Klepinger D.H.
        • Lundberg S.
        • Plotnick R.D.
        Adolescent fertility and the educational attainment of young women.
        Fam Plann Perspect. 1995; 27: 23-28
        • Chen X.K.
        • Wen S.W.
        • Fleming N.
        • Demissie K.
        • Rhoads G.G.
        • Walker M.
        Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study.
        Int J Epidemiol. 2007; 36: 368-373
        • Moore K.A.
        • Myers D.E.
        • Morrison D.R.
        • Nord C.W.
        • Brown B.
        • Edmonston B.
        Age at first childbirth and later poverty.
        J Res Adolesc. 1993; 3: 393-422
        • Boden J.M.
        • Fergusson D.M.
        • John Horwood L.
        Early motherhood and subsequent life outcomes.
        J Child Psychol Psychiatry. 2008; 49: 151-160
        • Olausson P.O.
        • Haglund B.
        • Weitoft G.R.
        • Cnattingius S.
        Teenage childbearing and long-term socioeconomic consequences: a case study in Sweden.
        Fam Plann Perspect. 2001; 33: 70-74
        • Stern A.M.
        Sterilized in the name of public health: race, immigration, and reproductive control in modern California.
        Am J Public Health. 2005; 95: 1128-1138
        • Shapiro T.M.
        • Fisher W.
        • Diana A.
        Family planning and female sterilization in the United States.
        Soc Sci Med. 1983; 17: 1847-1855
        • Roberts D.
        The pill at 40–a new look at a familiar method: black women and the pill.
        Fam Plann Perspect. 2000; 32: 92-93
        • Morgan M.
        The payment of drug addicts to increase their sterilization rate is morally unjustified and not simply ‘a fine balance’.
        J Obstet Gynaecol. 2004; 24: 119-123
        • Malat J.
        Racial differences in Norplant use in the United States.
        Soc Sci Med. 2000; 50: 1297-1308
        • Boonstra H.
        • Duran V.
        • Northington Gamble V.
        • Blumenthal P.
        • Dominguez L.
        • Pies C.
        The “boom and bust phenomenon”: the hopes, dreams, and broken promises of the contraceptive revolution.
        Contraception. 2000; 61: 9-25
        • Barrett G.
        • Smith S.C.
        • Wellings K.
        Conceptualization, development, and evaluation of a measure of unplanned pregnancy.
        J Epidemiol Community Health. 2004; 58: 426-433
        • Kendall C.
        • Afable-Munsuz A.
        • Speizer I.
        • Avery A.
        • Schmidt N.
        • Santelli J.
        Understanding pregnancy in a population of inner-city women in New Orleans–results of qualitative research.
        Soc Sci Med. 2005; 60: 297-311
        • Lifflander A.
        • Gaydos L.M.
        • Hogue C.J.
        Circumstances of pregnancy: low income women in Georgia describe the difference between planned and unplanned pregnancies.
        Matern Child Health J. 2007; 11: 81-89
        • Finer L.B.
        • Henshaw S.K.
        Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.
        Perspect Sex Reprod Health. 2006; 38: 90-96
        • Mosher W.D.
        • Martinez G.M.
        • Chandra A.
        • Abma J.C.
        • Willson S.J.
        Use of contraception and use of family planning services in the United States: 1982-2002.
        Adv Data. 2004; 350: 1-36
        • Jones R.K.
        • Darroch J.E.
        • Henshaw S.K.
        Patterns in the socioeconomic characteristics of women obtaining abortions in 2000-2001.
        Perspect Sex Reprod Health. 2002; 34: 226-235
        • Centers for Disease Control and Prevention
        Births: preliminary data for 2005.
        (Accessed March 13, 2009)
        • Dehlendorf C.
        • Marchi K.
        • Vittinghoff E.
        • Braveman P.
        Sociocultural determinants of teenage childbearing among Latinas in California.
        Matern Child Health J. 2009 Jan 27; ([Epub ahead of print])
        • Xie H.
        • Cairns B.D.
        • Cairns R.B.
        Predicting teen motherhood and teen fatherhood: individual characteristics and peer affiliations.
        Soc Dev. 2001; 10: 488-511
        • Carvajal S.C.
        • Parcel G.S.
        • Banspach S.W.
        • et al.
        Psychosocial predictors of delay of first sexual intercourse by adolescents.
        Health Psychol. 1999; 18: 443-452
        • Hogan D.P.
        • Kitagawa E.M.
        The impact of social status, family structure, and neighborhood on the fertility of black adolescents.
        Am J Sociol. 1985; 90: 825-855
        • Hayward M.D.
        • Grady W.
        • Bill J.O.G.
        The influence of socioeconomic status on adolescent pregnancy.
        Soc Sci Q. 1992; 73: 750-772
        • Rose A.
        • Koo H.P.
        • Bhaskar B.
        • Anderson K.
        • White G.
        • Jenkins R.R.
        The influence of primary caregivers on the sexual behavior of early adolescents.
        J Adolesc Health. 2005; 37: 135-144
        • Santelli J.S.
        • Lowry R.
        • Brener N.D.
        • Robin L.
        The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents.
        Am J Public Health. 2000; 90: 1582-1588
        • Frost J.J.
        • Darroch J.E.
        Factors associated with contraceptive choice and inconsistent method use, United States, 2004.
        Perspect Sex Reprod Health. 2008; 40: 94-104
        • Krings K.M.
        • Matteson K.A.
        • Allsworth J.E.
        • Mathias E.
        • Peipert J.F.
        Contraceptive choice: how do oral contraceptive users differ from condom users and women who use no contraception?.
        Am J Obstet Gynecol. 2008; 198: e46-e47
        • Foster D.G.
        • Bley J.
        • Mikanda J.
        • et al.
        Contraceptive use and risk of unintended pregnancy in California.
        Contraception. 2004; 70: 31-39
        • Ranjit N.
        • Bankole A.
        • Darroch J.E.
        • Singh S.
        Contraceptive failure in the first two years of use: differences across socioeconomic subgroups.
        Fam Plann Perspect. 2001; 33: 19-27
        • Trussell J.
        • Vaughan B.
        Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 national survey of family growth.
        Fam Plann Perspect. 1999; 31 (93): 64-72
        • Fu H.
        • Darroch J.E.
        • Haas T.
        • Ranjit N.
        Contraceptive failure rates: new estimates from the 1995 national survey of family growth.
        Fam Plann Perspect. 1999; 31: 56-63
        • Vaughan B.
        • Trussell J.
        • Kost K.
        • Singh S.
        • Jones R.
        Discontinuation and resumption of contraceptive use: results from the 2002 national survey of family growth.
        Contraception. 2008; 78: 271-283
        • Kilbourne A.M.
        • Switzer G.
        • Hyman K.
        • Crowley-Matoka M.
        • Fine M.J.
        Advancing health disparities research within the health care system: a conceptual framework.
        Am J Public Health. 2006; 96: 2113-2121
        • Scott C.S.
        • Shifman L.
        • Orr L.
        • Owen R.G.
        • Fawcett N.
        Hispanic and black American adolescents' beliefs relating to sexuality and contraception.
        Adolescence. 1988; 23: 667-688
        • Guendelman S.
        • Denny C.
        • Mauldon J.
        • Chetkovich C.
        Perceptions of hormonal contraceptive safety and side effects among low-income Latina and non-Latina women.
        Matern Child Health J. 2000; 4: 233-239
        • Gilliam M.L.
        • Warden M.
        • Goldstein C.
        • Tapia B.
        Concerns about contraceptive side effects among young Latinas: a focus-group approach.
        Contraception. 2004; 70: 299-305
        • Thorburn S.
        • Bogart L.M.
        Conspiracy beliefs about birth control: barriers to pregnancy prevention among African Americans of reproductive age.
        Health Educ Behav. 2005; 32: 474-487
        • Bird S.T.
        • Bogart L.M.
        Birth control conspiracy beliefs, perceived discrimination, and contraception among African Americans: an exploratory study.
        J Health Psychology. 2003; 8: 263-276
        • Kuiper H.
        • Miller S.
        • Martinez E.
        • Loeb L.
        • Darney P.
        Urban adolescent females' views on the implant and contraceptive decision-making: a double paradox.
        Fam Plann Perspect. 1997; 29: 167-172
        • Clark L.R.
        Will the pill make me sterile?.
        J Pediatr Adolesc Gynecol. 2001; 14: 153-162
        • Silverman J.
        • Torres A.
        • Forrest J.D.
        Barriers to contraceptive services.
        Fam Plann Perspect. 1987; 19 (101-2): 94-97
        • Rivera C.P.
        • Mendez C.B.
        • Gueye N.A.
        • Bachmann G.A.
        Family planning attitudes of medically underserved Latinas.
        J Womens Health (Larchmt). 2007; 16: 879-882
        • Clark L.R.
        • Barnes-Harper K.T.
        • Ginsburg K.R.
        • Holmes W.C.
        • Schwarz D.F.
        Menstrual irregularity from hormonal contraception: a cause of reproductive health concerns in minority adolescent young women.
        Contraception. 2006; 74: 214-219
        • Garces-Palacio I.C.
        • Altarac M.
        • Scarinci I.C.
        Contraceptive knowledge and use among low-income Hispanic immigrant women and non-Hispanic women.
        Contraception. 2008; 77: 270-275
        • Baldwin S.B.
        • Solorio R.
        • Washington D.L.
        • Yu H.
        • Huang Y.C.
        • Brown E.R.
        Who is using emergency contraception?.
        Womens Health Issues. 2008; 18: 360-368
        • Foster D.G.
        • Ralph L.J.
        • Arons A.
        • Brindis C.D.
        • Harper C.C.
        Trends in knowledge of emergency contraception among women in California, 1999-2004.
        Womens Health Issues. 2007; 17: 22-28
        • Murphy P.
        • Kirkman A.
        • Hale R.W.
        A national survey of women's attitudes toward oral contraception and other forms of birth control.
        Womens Health Issues. 1995; 5: 94-99
        • US Census Bureau
        Educational attainment in the United States 2007.
        (Accessed March 21, 2009)
        • McKee M.D.
        • O'Sullivan L.F.
        • Weber C.M.
        Perspectives on confidential care for adolescent girls.
        Ann Fam Med. 2006; 4: 519-526
        • Fisher T.D.
        Characteristics of mothers and fathers who talk to their adolescent children about sexuality.
        J Psychol Human Sex. 1990; 3: 53-70
        • Meneses L.M.
        • Orrell-Valente J.K.
        • Guendelman S.R.
        • Oman D.
        • Irwin Jr, C.E.
        Racial/ethnic differences in mother-daughter communication about sex.
        J Adolesc Health. 2006; 39: 128-131
        • Lefkowitz E.S.
        • Romo L.F.
        • Corona R.
        • Au T.K.
        • Sigman M.
        How Latino American and European American adolescents discuss conflicts, sexuality, and AIDS with their mothers.
        Dev Psychol. 2000; 36: 315-325
        • Parker R.M.
        • Williams M.V.
        • Baker D.W.
        • Nurss J.R.
        Literacy and contraception: exploring the link.
        Obstet Gynecol. 1996; 88: 72-77S
        • El-Ibiary S.Y.
        • Youmans S.L.
        Health literacy and contraception: a readability evaluation of contraceptive instructions for condoms, spermicides and emergency contraception in the USA.
        Eur J Contracept Reprod Health Care. 2007; 12: 58-62
        • Williams-Deane M.
        • Potter L.S.
        Current oral contraceptive use instructions: an analysis of patient package inserts.
        Fam Plann Perspect. 1992; 24: 111-115
        • Schwarz E.B.
        • Lohr P.A.
        • Gold M.A.
        • Gerbert B.
        Prevalence and correlates of ambivalence towards pregnancy among nonpregnant women.
        Contraception. 2007; 75: 305-310
        • Crosby R.A.
        • Diclemente R.J.
        • Wingood G.M.
        • Davies S.L.
        • Harrington K.
        Adolescents' ambivalence about becoming pregnant predicts infrequent contraceptive use: a prospective analysis of nonpregnant African American females.
        Am J Obstet Gynecol. 2002; 186: 251-252
        • Zabin L.S.
        • Astone N.M.
        • Emerson M.R.
        Do adolescents want babies?.
        J Res Adolesc. 1993; 3: 67-86
        • Schunmann C.
        • Glasier A.
        Measuring pregnancy intention and its relationship with contraceptive use among women undergoing therapeutic abortion.
        Contraception. 2006; 73: 520-524
        • Davies S.L.
        • DiClemente R.J.
        • Wingood G.M.
        • et al.
        Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study.
        J Adolesc Health. 2006; 39: 43-49
        • Jaccard J.
        • Dodge T.
        • Dittus P.
        Do adolescents want to avoid pregnancy?.
        J Adolesc Health. 2003; 33: 79-83
        • Jewell D.
        • Tacchi J.
        • Donovan J.
        Teenage pregnancy: whose problem is it?.
        Fam Pract. 2000; 17: 522-528
        • Afable-Munsuz A.
        • Speizer I.
        • Magnus J.H.
        • Kendall C.
        A positive orientation toward early motherhood is associated with unintended pregnancy among New Orleans youth.
        Matern Child Health J. 2006; 10: 265-276
        • Gold R.
        Next steps for America's family planning program: leveraging the potential of Medicaid and Title X in the evolving health care system.
        Guttmacher Institute, New York, NY2009
        • Guttmacher Institute
        Contracpetive needs and services, 2006.
        (Accessed March 17, 2009)
        • Ebrahim S.H.
        • Anderson J.E.
        • Correa-de-Araujo R.
        • Posner S.F.
        • Atrash H.K.
        Overcoming social and health inequalities among US women of reproductive age–challenges to the nation's health in the 21st century.
        Health Policy. 2008; 2,3: 196-205
        • Culwell K.R.
        • Feinglass J.
        The association of health insurance with use of prescription contraceptives.
        Perspect Sex Reprod Health. 2007; 39: 226-230
        • Boonstra H.
        • Sonfield A.
        Revisiting public funding of abortion for poor women: issues brief.
        in: Alan Guttmacher Institute, New York, NY2000: 1-4
        • Finer L.B.
        • Frohwirth L.F.
        • Dauphinee L.A.
        • Singh S.
        • Moore A.M.
        Timing of steps and reasons for delays in obtaining abortions in the United States.
        Contraception. 2006; 74: 334-344
        • Henshaw S.K.
        Factors hindering access to abortion services.
        Fam Plann Perspect. 1995; 27 (87): 54-59
        • Foster D.G.
        • Jackson R.A.
        • Cosby K.
        • Weitz T.A.
        • Darney P.D.
        • Drey E.A.
        Predictors of delay in each step leading to an abortion.
        Contraception. 2008; 77: 289-293
        • Cook P.J.
        • Parnell A.M.
        • Moore M.J.
        • Pagnini D.
        The effects of short-term variation in abortion funding on pregnancy outcomes.
        J Health Econ. 1999; 18: 241-257
        • Jones R.K.
        • Zolna M.R.
        • Henshaw S.K.
        • Finer L.B.
        Abortion in the United States: incidence and access to services, 2005.
        Perspect Sex Reprod Health. 2008; 40: 6-16
        • Rodriguez M.I.
        • Edelman A.
        • Wallace N.
        • Jensen J.T.
        Denying postpartum sterilization to women with Emergency Medicaid does not reduce hospital charges.
        Contraception. 2008; 78: 232-236
        • DuBard C.A.
        • Massing M.W.
        Trends in emergency Medicaid expenditures for recent and undocumented immigrants.
        JAMA. 2007; 297: 1085-1092
        • Johnson R.L.
        • Roter D.
        • Powe N.R.
        • Cooper L.A.
        Patient race/ethnicity and quality of patient-physician communication during medical visits.
        Am J Public Health. 2004; 94: 2084-2090
        • van Ryn M.
        • Fu S.S.
        Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health?.
        Am J Public Health. 2003; 93: 248-255
        • Smedley B.
        • Stith A.
        • Nelson A.
        Unequal treatment: confronting racial and ethnic disparities in healthcare.
        The National Academies Press, Washington, DC2003
        • Sabin J.A.
        • Rivara F.P.
        • Greenwald A.G.
        Physician implicit attitudes and stereotypes about race and quality of medical care.
        Med Care. 2008; 46: 678-685
        • McKinlay J.
        • Link C.
        • Marceau L.
        • et al.
        How do doctors in different countries manage the same patient?.
        Health Serv Res. 2006; 41: 2182-2200
        • McKinlay J.B.
        • Potter D.A.
        • Feldman H.A.
        Non-medical influences on medical decision-making.
        Soc Sci Med. 1996; 42: 769-776
        • Schulman K.A.
        • Berlin J.A.
        • Harless W.
        • et al.
        The effect of race and sex on physicians' recommendations for cardiac catheterization.
        N Engl J Med. 1999; 340: 618-626
        • van Ryn M.
        • Burgess D.
        • Malat J.
        • Griffin J.
        Physicians' perceptions of patients' social and behavioral characteristics and race disparities in treatment recommendations for men with coronary artery disease.
        Am J Public Health. 2006; 96: 351-357
        • Burgess D.J.
        • Crowley-Matoka M.
        • Phelan S.
        • et al.
        Patient race and physicians' decisions to prescribe opioids for chronic low back pain.
        Soc Sci Med. 2008; 67: 1852-1860
        • Hannan E.L.
        • van Ryn M.
        • Burke J.
        • et al.
        Access to coronary artery bypass surgery by race/ethnicity and gender among patients who are appropriate for surgery.
        Med Care. 1999; 37: 68-77
        • Bao Y.
        • Fox S.A.
        • Escarce J.J.
        Socioeconomic and racial/ethnic differences in the discussion of cancer screening: “between-” versus “within-” physician differences.
        Health Serv Res. 2007; 42: 950-970
        • McKinlay J.B.
        • Burns R.B.
        • Durante R.
        • et al.
        Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment.
        J Eval Clin Pract. 1997; 3: 23-57
        • Griggs J.J.
        • Culakova E.
        • Sorbero M.E.
        • et al.
        Social and racial differences in selection of breast cancer adjuvant chemotherapy regimens.
        J Clin Oncol. 2007; 25: 2522-2527
        • van Ryn M.
        • Burke J.
        The effect of patient race and socio-economic status on physicians' perceptions of patients.
        Soc Sci Med. 2000; 50: 813-828
        • Woo J.K.
        • Ghorayeb S.H.
        • Lee C.K.
        • Sangha H.
        • Richter S.
        Effect of patient socioeconomic status on perceptions of first- and second-year medical students.
        CMAJ. 2004; 170: 1915-1919
        • Becker D.
        • Tsui A.O.
        Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group differences.
        Perspect Sex Reprod Health. 2008; 40: 202-211
        • Forrest J.D.
        • Frost J.J.
        The family planning attitudes and experiences of low-income women.
        Fam Plann Perspect. 1996; 28 (77): 246-255
        • Harrison D.D.
        • Cooke C.W.
        An elucidation of factors influencing physicians' willingness to perform elective female sterilization.
        Obstet Gynecol. 1988; 72: 565-570
        • Downing R.A.
        • LaVeist T.A.
        • Bullock H.E.
        Intersections of ethnicity and social class in provider advice regarding reproductive health.
        Am J Public Health. 2007; 97: 1803-1807
        • Thorburn S.
        • Bogart L.M.
        African American women and family planning services: perceptions of discrimination.
        Women Health. 2005; 42: 23-39
        • Borrero S.
        • Schwarz E.B.
        • Creinin M.
        • Ibrahim S.
        The impact of race and ethnicity on receipt of family planning services in the United States.
        J Womens Health (Larchmt). 2009; 18: 91-96
        • RamaRao S.
        • Lacuesta M.
        • Costello M.
        • Pangolibay B.
        • Jones H.
        The link between quality of care and contraceptive use.
        Int Fam Plan Perspect. 2003; 29: 76-83
        • Foster D.G.
        • Klaisle C.M.
        • Blum M.
        • Bradsberry M.E.
        • Brindis C.D.
        • Stewart F.H.
        Expanded state-funded family planning services: estimating pregnancies averted by the family PACT program in California, 1997-1998.
        Am J Public Health. 2004; 94: 1341-1346
        • Amaral G.
        • Foster D.G.
        • Biggs M.A.
        • Jasik C.B.
        • Judd S.
        • Brindis C.D.
        Public savings from the prevention of unintended pregnancy: a cost analysis of family planning services in California.
        Health Serv Res. 2007; 42: 1960-1980
        • Frost J.
        • Sonfield A.
        • Gold R.
        Estimating the impact of expanding Medicaid eligibility for family planning services, occasional report.
        Guttmacher Institute, New York, NY2006
        • Evans W.D.
        • McCormack L.
        Applying social marketing in health care: communicating evidence to change consumer behavior.
        Med Decis Making. 2008; 28: 781-792
        • Evans W.D.
        • Blitstein J.
        • Hersey J.C.
        • Renaud J.
        • Yaroch A.L.
        Systematic review of public health branding.
        J Health Commun. 2008; 13: 721-741
        • Bala M.
        • Strzeszynski L.
        • Cahill K.
        Mass media interventions for smoking cessation in adults.
        Cochrane Database Syst Rev. 2008; 1 (CD004704)

      Linked Article

      • Health disparities: definitions and measurements
        American Journal of Obstetrics & GynecologyVol. 202Issue 3
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          An article in this issue of the Journal, titled “Family Planning Disparities,” is the first in a series of 4 articles to address disparities in the area of obstetrics and gynecology. The remaining articles will appear in subsequent issues and will address disparities in reproductive endocrinology and infertility, obstetrics, and gynecology. Because the field of health disparities research is evolving rapidly and is conceptually complex, in this editorial we provide a background of the definitions and current understanding of health disparities to serve as a foundation for understanding this series.
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