Patient Experiences with Pregnancy Planning and Perspectives on Reproductive Care in Community Health Centers: A Qualitative Study of African American Women in Chicago

Abstract

IntroductionGiven the potential benefits of preventive reproductive health care for both women and children, it is important that clinicians routinely offer preconception and contraceptive counseling in ways that are responsive to patients’ wishes. The goal of this study is to gain knowledge about the components of preventive reproductive health care that patients at Federally Qualified Health Centers value, and to elicit patient perspectives on how best to deliver this care. MethodsWe conducted three focus groups with African American women (n = 21) at two Federally Qualified Health Centers in Chicago. The groups were facilitated using an open-ended, semistructured interview guide. We asked women to reflect on past experiences, advice they would give their teenage daughters, and how to design an ideal clinic. All groups were recorded and transcribed verbatim. Transcripts were coded and analyzed using an inductive approach with ATLAS.ti software. ResultsAlthough participants wanted comprehensive information about sex and pregnancy, they reported receiving no information at all, or many negative messages. The idea of timing and spacing pregnancies was generally embraced by participants. They described an ideal clinic as having a patient population diverse in income, trusting relationships with providers, comprehensive services, and educational opportunities. ConclusionsThe women in our study expressed a desire for more information and comprehensive care in the setting of an equitable clinic where they feel respected as individuals. Our findings support the idea behind the patient-centered medical home and challenge prior literature, which suggests the concept of pregnancy planning does not resonate with low-income African American women.