Factors that influence contraceptive decision-making in African American women, an intergenerational perspective

Abstract

African American women represent a unique group of women in the United States and have a long history of lack of reproductive freedom. Slavery and forced procreation, sterilization abuses, the Eugenics movement, and federally mandated contraception have all impacted on African American women’s independence in contraceptive decision-making. Given this population’s history, it is important for healthcare providers to understand African American women’s contraceptive decision-making, as women often seek their guidance. The purpose of this dissertation research was to discover the intergenerational influences on African American women’s contraceptive decision-making. The specific aims of this study were to: 1) develop an understanding of African American women’s contraceptive decision-making process; 2) identify the factors that influence their decision-making; and 3) develop knowledge that can be used to influence nursing practice. Included in this exploration were questions on the role of mothers and grandmothers in adolescents’ decision-making, familial beliefs about contraceptive choices and whether societal and social factors continue to influence contraceptive decisionmaking in the 21st Century. For this work, I used a qualitative descriptive approach to develop an understanding of the phenomenon from the participants’ worldview. I recruited a purposive sample of 7 triads from a metropolitan community in the northeast United States. I conducted an individual interview, using a semi-structured guide, with each participant. Six themes emerged from the data: 1) southern influences; 2) a worldview of relationships; 3) communication: key to preparedness; 4) seeking information from Mom; 5) "I got caught up in the game"; and 6) contraceptive use and beliefs. African American women's contraceptive decision making is influenced by a variety of factors including familial beliefs, attitudes, culture, and ethnicity. These patterns are transferred to each succeeding generation. Nurses have a significant role to play in providing appropriate contraceptive information and education in a culturally competent context that will meet the needs of these women and their families.