title: Perceptions of coercion, discrimination and other negative experiences in postpartum contraceptive counseling for low-income minority women.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Negative experiences with contraceptive counseling may affect contraception utilization. Contraceptive education should respect each individual's autonomy, culture, and values.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Yee
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Simon
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D002641:Chicago; D003068:Coercion; D003267:Contraception; D003268:Contraception Behavior / Q000208:ethnology; D003376:Counseling; D003430:Cross-Sectional Studies; D004192:Discrimination, Psychological; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008484:Medicaid; D010465:Perception; D049590:Postpartum Period; D011203:Poverty / Q000208:ethnology; D011247:Pregnancy; D036301:Qualitative Research; D014481:United States; D014505:Urban Population; D055815:Young Adult