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Women’s Reproductive Decision-Making Process and Providers’ Participation
Donna B. Barnes, PhD
California State University, Hayward
[email protected]
RESULTS
AIMS
• How do women with HIV/AIDS make reproductive decisions?
• How do providers assist women with HIV/AIDS make
reproductive decisions?
METHODS
• Women
(n=80)
• Providers (n=62)
• Face-to-face interviews between 1995 and 2003
• Women recruited from social service & medical agencies
o Oakland, California (n=30)
o Chicago, Illinois
(n=20)
o Rochester, New York (n=30)
• Providers recruited from women & providers
o Oakland, California (n=33)
o Rochester, New York (n=29)
Women’s Reproductive Decisions
are Relational
Influenced by Relationship to:
CHILDREN
“I didn’t have a chance with my other kids, I really thought that
maybe this one would give me a chance no matter if it came to
HIV or not” (Caucasian mother of 1 child).
FAMILY/CULTURE
“Before I found out that I was HIV positive, I was saying I’m
not having no baby. I have a boy and a girl. He [fiancé] talked
and we talked and I was like, all right. I really do want another
baby. I guess he hoped that maybe I would have his son”
RESULTS
GOD
“My mother and sister were asking, ‘Do you really think you
can handle this?’ My sister was saying, ‘I’m the one who’s
going to end up having to raise him.’ So like I said, I just put it
in the hands of the Lord, and said, ‘Well, you’re going to have
to keep me here because, as you can see, they don’t want him’”
(African American mother of 1 child).
Race/Ethnicity
Women (n=80)
61
50
Providers (n=62)
47
40
20
25
13 11
6
2
0
Black
White
Latino
PERCENTAGE
Other
RESULTS
ONE OF FEW STABLE RELATIONSHIPS
“A lot of these patients, they don’t have nobody. The
only person they have sometimes is the HIV case
manager. Because a lotta these patients, they haven’t
told their families, nobody knows, it’s you, the one that
they come to for practically for everything”
Provider's Occupation
16
16
12
12
10
9
8
9
(Latina case manager).
6
4
0
SW/CM
Peer
MD/PA
NP/RN
Management
Therapist
(African American mother of 3 children and youngest is HIV+).
• Community and social workers recruited women
• $20 honorarium offered
• Data analyzed utilizing grounded theory qualitative methods
75
RESULTS
Mean Age
Women = 35
Providers = 46
PROVIDERS - INFORMATION
“It was like she [nurse practitioner] was really stressing the
issue that I should have an abortion, that I should bring no
baby into the world. And I was like, if it’s a 35% chance, I
mean, that’s giving my baby at least a chance that it won’t be
born with the virus” (African American mother of 3 children).
“The physician told me that there are people who have had
planned pregnancy, that were HIV positive. So that’s why I
know he’s somebody I can talk to” (Caucasian mother of one child).
FRUSTRATIONS
“I’m trying to stay as non-judgmental as possible, but
what frustrates me the most is when you do things to
get medications for a client, to get a client to another
service, or try and help this client get some degree of
quality into their lives and then not to have them
participate on a full level, to even be aware of what
kind of work has gone on behind the scenes”
(African American female nurse).
Providers’ Participation
NON-JUDGMENTAL
“I got more supportive of women having pregnancies and it was
spurred on by more and more women coming to me to talk
about it. And realizing that they had very little opportunities to
even raise the question. And they often raised it with me and
got coached to then raise it with their physicians”
(Caucasian female medical social worker).
PROVIDE INFORMATION
“As a clinician, I offer, I can educate, but the decision rests
totally with the patient” (African American male physician).
WOMEN MAKE THEIR OWN CHOICES
“I have become more resigned to the fact that people need to
and do make their own choices and I don’t own that”
(Caucasian female nurse practitioner).
This research is funded by:
National Institute of Health - Grant 3 S06 GM/A14135-04S1
University of Illinois at Chicago Fellowship, Center for Research on Women and Gender - Funded by John D. and Catherine T. MacArthur Foundation
California State University, Hayward - Research Grant
CONCLUSIONS
• Women’s reproductive decision-making processes
were often based more on relationships and
reproductive experiences than scientific information.
• Information about MTCT can influence women’s
decisions, but usually was not the central focus.
ACKNOWLEGEMENTS
Sheigla Murphy, PhD - Susan Taylor-Brown, PhD - Diane Beeson, PhD
Beatrice Morris, MDiv - Monica Bill Barnes, MFA - Lyn Blackburn, MSW
Craig Sellers, MS - Tim Smith, BS
The Women and the Providers