How does provider bias impact pregnancy and abortion disparities?




The October 2010 article, Recommendations for intrauterine contraception: a randomized trial of the effects of patients’ race/ethnicity and socioeconomic status (SES) gives great insight to potential provider biases with respect to family planning and contraceptive management. Studies continue to show provider bias based on race/ethnicity when counseling on family-planning while health disparities continue to exist.


The authors investigated the effects of race/ethnicity and SES on recommendations for Mirena intrauterine contraception (IUC), their primary outcome. Based on their findings, the authors call for an awareness of sociodemographic characteristics on contraceptive recommendations. That said, the study’s findings raise an even more important concern. How does provider bias impact disparities in unintended pregnancies and abortion rates? IUC recommendations were lowest in low SES white women and highest among high SES black women ; however, it is widely documented that minority and low SES groups have disproportionately higher unintended pregnancy and abortion rates. An unmet goal of Healthy People 2010 was that at least 70% of pregnancies be intended. What role will gynecologists play in reaching this goal in 2020?


The Healthy People initiative also acknowledges lack of access to care as a major cause of health disparities. Dehlendorf et al compellingly demonstrate that provider bias not only trumps access, but potentially, health equity. Family planning advocates are currently promoting contraception as a required preventive service under health care reform, recognizing that high-risk groups not only need, but deserve, the same family planning opportunities as low-risk groups. By the study’s findings, this requirement will not be enough to eliminate provider bias. Will the findings of this study move us to take proactive measures to eradicate discriminatory behaviors within our profession?

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Jun 5, 2017 | Posted by in GYNECOLOGY | Comments Off on How does provider bias impact pregnancy and abortion disparities?
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