Graduation Semester and Year
Summer 2025
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Social Work
Department
Social Work
First Advisor
Genevieve Graaf
Second Advisor
Poco D Kernsmith
Third Advisor
Vijayan K Pillai
Fourth Advisor
Sophia Fantus
Fifth Advisor
Anindita Bhattacharya
Abstract
Unintended pregnancies have been linked to adverse outcomes such as pre-term births and low infant birthweight (Harron et al., 2020), psychological distress(Abbasi et al., 2013; Barton et al., 2017; Gauthreaux et al., 2017; Mercier et al., 2013), relationship strain (Barton et al., 2017; Moseson et al., 2019), intimate partner violence (IPV) and reproductive coercion (K. T. Grace & Anderson, 2018), and economic strain from unanticipated medical costs despite insurance coverage (Trussell, 2007). Unintended pregnancy outcomes offer crucial insights into the complexities of women's reproductive desires and intentions (CDC, 2023; Rossen et al., 2023). These outcomes inform public health interventions to reduce the prevalence of mistimed and unwanted pregnancy outcomes) in the United States (Birgisson et al., 2015; DiCenso, 2002; Trussell, 2007).
Foreign-born/Foreign-born immigrant (FB/FBI) women of reproductive age face unique barriers such as immigration status, acculturation challenges, language barriers, cultural stigma, and limited health literacy (HL) in accessing family-planning care and contraception (Anderson et al., 2014; Caal et al., 2013; Caballero et al., 2022; Hodgson et al., 2013; Smith, 2017). These challenges can be compounded by experiences of partner abuse, pregnancy coercion, and birth control sabotage leading to unintended pregnancies (Avery et al., 2020). While variations in pregnancy outcomes such as unwanted and mistimed pregnancies have been disaggregated across factors such race, income, and education (Aztlan-James et al., 2017; Finer & Zolna, 2011, 2014; S. Kim, 2011) consideration must be given to how nativity or birth-status interacts with income to influence these disparities among low-income FB/FBI women, a population that is vulnerable to serious health disparities (Kreps & Sparks, 2008). This study applies the National Institutes of Minorities Health and Disparities Research Framework (NIMHD) to identify and interpret multilevel determinants across biological, sociocultural, healthcare domains that shape disparities in pregnancy desire defined as an individual’s retrospective report of whether their most recent pregnancy was mistimed (occurred earlier or later than desired) and unwanted (not desired at any time) and contraceptive counseling among low-income FB/FBI populations. Using pooled data from the 2013-2019 National Survey of Family Growth (NSFG), first this study quantitatively examines differences in pregnancy desire. This study addresses a key gap in the literature pertaining to current data on unintended pregnancy outcomes among FB/FBI populations. Given that immigrant populations particularly those that are newly arrived or have had a shorter length of stay and have low English proficiency (LEP) face significant HL challenges navigating a complex reproductive healthcare landscape in the U.S (Moore & Cordero, 2019). This study examines the receipt of contraceptive counseling, a key HL intervention in clinical care setting FB/FBI women with a focus on key predictors such as nativity (born in the U.S vs born outside the U.S) and an income of < 300% FPL. Findings are interpreted using a health-literacy lens to identify population-level gaps in family-planning service use. Implications for policy and practice to improve the SRH outcomes among low-income and immigrant women are discussed.
Keywords
Unintended pregnancy; immigrant women; reproductive health disparities; health literacy; contraceptive counseling
Disciplines
Demography, Population, and Ecology | Inequality and Stratification | Social Justice | Social Statistics | Social Work
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Chakraborty, Priyanjali, "UNMET FAMILY PLANNING CARE AND HEALTH-LITERACY NEEDS AMONG LOW-INCOME IMMIGRANT WOMEN IN THE UNITED STATES" (2025). Social Work Dissertations. 195.
https://mavmatrix.uta.edu/socialwork_dissertations/195
Included in
Demography, Population, and Ecology Commons, Inequality and Stratification Commons, Social Justice Commons, Social Statistics Commons, Social Work Commons