000042364 001__ 42364
000042364 005__ 20240306083854.0
000042364 0247_ $$2doi$$a10.6083/bpxhc42364
000042364 037__ $$aETD
000042364 041__ $$aeng
000042364 245__ $$aMinimizing concern about coercion: a critical discourse analysis of a contraceptive use metric
000042364 260__ $$bOregon Health and Science University
000042364 269__ $$a2023-11-01
000042364 336__ $$aDissertation
000042364 502__ $$bPh.D.
000042364 502__ $$gNursing
000042364 520__ $$aThe field of public health has long named unintended pregnancy a problem concentrated in people of lower social class and associated with negative outcomes. A main strategy to reduce the unintended pregnancy rate is to increase women's use of specific contraceptive methods via contraceptive use metrics. However, scholars have criticized these metrics for a lack of attention to the issue of coercion. This study aimed to critically describe how policymakers constructed a contraceptive use metric targeting women with Medicaid insurance with attention to the discussion of contraceptive coercion. Using Critical Discourse Analysis and Reproductive Justice as guiding frameworks, I analyzed publicly available policy documents including meeting minutes, presentation slides, policy guidance texts, public testimonies, a stakeholder survey, and one audio recording. My analysis revealed healthcare system experts constructed the metric in alignment with mainstream public health discourse naming unintended pregnancy the cause of negative health outcomes and women’s use of specific contraceptive methods, particularly long-acting reversible contraceptives, as the solution. Policymaker discourse reinforced the assumption that women are responsible for pregnancy prevention. Policymakers minimized stakeholder concerns about incentivizing coercion by changing the topic to improving access to contraception and through silence about the issue. Finally, a fertility reduction discourse was present naming certain people as being in no position to have children and children of impoverished people as high-cost children. Study results suggest a eugenic ideology and a mother-blame narrative may underpin contraceptive use metrics. These findings point to a need to focus policy on removing healthcare system barriers to contraceptive access for fertile people of all genders rather than increasing women’s use of specific contraceptives.
000042364 540__ $$fCC BY
000042364 542__ $$fPublic domain
000042364 650__ $$aContraception$$017054
000042364 650__ $$aPublic Health$$024885
000042364 650__ $$aMedicaid$$021932
000042364 650__ $$aCoercion$$016865
000042364 650__ $$aEugenics$$018742
000042364 650__ $$aPregnancy, Unplanned$$036169
000042364 6531_ $$apublic health policy
000042364 691__ $$aSchool of Nursing$$041370
000042364 7001_ $$aCampbell, Molly$$uOregon Health and Science University$$041354$$10000-0001-5674-2298
000042364 789__ $$eIs supplemented by$$whttps://osf.io/bzhct/?view_only= [https://osf.io/static/img/osf-sharing.png]https://osf.io/bzhct/?view_only= Analysis of a Contraceptive Use Metrichttps://osf.io/bzhct/?view_only=$$2URL
000042364 792__ $$aCampbell, M. (2022, June 8). Analysis of a contraceptive use metric. Open Science Framework.
000042364 8564_ $$9db3548a6-95fe-45d4-b458-09650257085f$$s2684590$$uhttps://digitalcollections.ohsu.edu/record/42364/files/Campbell.Molly.2023.pdf
000042364 909CO $$ooai:digitalcollections.ohsu.edu:42364$$pstudent-work
000042364 980__ $$aTheses and Dissertations
000042364 981__ $$aPublished$$b2023-11-30