Women’s Reproductive Decision-Making Process and Providers’ Participation Donna B. Barnes, PhD

1. Women’s Reproductive Decision-Making Process and Providers’ Participation Donna B. Barnes, PhD California State University, Hayward dbarnes@csuhayward.edu RESULTS RESULTS RESULTS AIMS 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” (African American mother of 3 children and youngest is HIV+). 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). 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). 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” (Latina case manager). 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). • 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 • Oakland, California (n=30) • Chicago, Illinois (n=20) • Rochester, New York (n=30) • Providers recruited from women & providers • Oakland, California (n=33) • Rochester, New York (n=29) • Community and social workers recruited women • $20 honorarium offered • Data analyzed utilizing grounded theory qualitative methods 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). CONCLUSIONS RESULTS • 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. Mean Age Women = 35 Providers = 46 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 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