Provider Advice to Women May Vary by Women’s Social Class and Ethnicity

Abstract

Low-income black and Latina women surveyed in the Los Angeles area were more likely than middle-class whites to say that during a current or recent pregnancy a health care professional had advised them to limit their childbearing. In a multivariate analysis of the survey results ethnicity and social class were the only characteristics associated with the odds that women had received this kind of advice. Low-income Latinas (along with women who had large families and unmarried women) also had elevated odds of saying that their doctor or someone else had discouraged them from having children. The survey sample consisted of 193 low income and 146 middle-class women who were pregnant or had given birth in the previous five years. Women were considered low income if they were on welfare had health coverage through Medi-Cal (Californias Medicaid program) or were uninsured; low income participants were recruited at offices of the Special Supplementary Food Program for Women Infants and Children. Women were classified as middle-class if they had a college or graduate degree and had health insurance other than Medi-Cal; these women were recruited at a variety of locations in middle-class neighborhoods and through electronic mailing lists. (excerpt)