Abortion rates among racial and ethnic minorities, especially blacks and Hispanics, are higher than rates among white women and are directly related to their higher rates of unintended pregnancy, according to a new Guttmacher policy analysis.
The findings run counter to claims by antiabortion activists that high abortion rates among minorities are the result of supposed aggressive marketing by abortion providers to minority communities. Instead, disproportionately high rates of both unintended pregnancy and abortion are just one symptom of broader health disparities ranging from sexually transmitted infections to diabetes and heart disease.
"There really is no need to resort to far-flung conspiracy theories. Behind virtually every abortion is an unintended pregnancy. And because women of color are much more likely to experience unintended pregnancies than any other group, they are also more likely to seek and obtain abortions than any other group," says Susan A. Cohen, author of the new analysis. "Fundamentally, the question policymakers should be asking is not why women of color have high abortion rates, but rather what can be done to help them have fewer unintended pregnancies and achieve better health outcomes more generally."
Guttmacher research shows that many women of color, who are also disproportionately low-income, are unable to afford prescription birth control methods, such as the IUD, that are highly effective over extended time periods but have high up-front costs. Unstable life situations, in which consistent use of contraceptives is a lower priority than simply getting by, can also be a factor. Beyond access to affordable contraceptives, however, dissatisfaction with the quality of services and the methods themselves may be at least as much an impediment to their consistent and correct use.
"Minority women are among the most likely to experience frequent life changes and to be dissatisfied with their contraceptive method," notes Cohen. "Either of these factors can result in women’s skipping pills or not using a condom every time. Some women are also dissatisfied with their provider, a problem often made worse by cultural or linguistic barriers that can lead to frustration and poor follow-through on contraceptive use."
Narrowing the gaps in access, quality and health outcomes is essential and a priority in the public health community, according to Cohen. Barriers to access to health care, including financial and geographic hurdles, remain a significant issue, particularly among minority communities. But, according to Cohen, there is increasing recognition that the quality of care plays a major role in health-seeking behavior and health outcomes.
"One thing is for sure," says Cohen. "Antiabortion activists in minority communities who are trying to protect African American women and Latinas from themselves by restricting access to safe and legal abortion have it backward. They should instead focus their efforts on reducing the disparities in access to quality health care and in health outcomes more broadly. And if they are most concerned about the disproportionately high abortion rates, they should begin by advocating for improved access to high-quality contraceptive services to reduce the disproportionately high rates of unintended pregnancy in these communities."
Click here to read "Abortion and Women of Color: The Bigger Picture," by Susan A. Cohen, in the Summer 2008 issue of the Guttmacher Policy Review.
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