The reproductive decisions women make in their lifetimes are very intimate and personal. Decisions about contraception or whether or not to have children can be complicated. Yet those decisions can greatly affect women, their families and ways of life. Researchers are working to better understand reproductive decision-making and how to best support women in their reproductive rights.
Reproductive rights involve a whole spectrum of issues. They include the decision to have children, to family planning and contraception, abortion and assisted reproduction (help from a specialist to become pregnant), just to name a few. Reproductive rights are a part of human rights, says Sonya Borrero, MD, associate professor of medicine, University of Pittsburgh School of Medicine, and director, Pitt’s Center for Women’s Health Research and Innovation.
“We need comprehensive health care to ensure those human rights,” she says. “All individuals have the right to decide if, when and with whom they would like to have children.”
Part of Dr. Borrero’s research has been focused on understanding some of the influences that might shape or complicate pregnancy decision-making, especially when the decisions do not conform to social norms. These influences can include relationship and family dynamics, financial status and many other factors. As a part of her research, Dr. Borrero started collecting stories from women in Pittsburgh about their reproductive decision-making. She realized that pregnancy is not always a yes-or-no decision for some people. The decision can be very complicated.
She says, “As a health care provider, we often have these ideas about how people ‘should’ be reproducing—for example, you should be in a stable financial situation, you should not be a teenager, etc. From a public health perspective, situations like economic instability or pregnancy in teens are associated with poorer outcomes. But these ‘shoulds’ aren’t necessarily a part of how men and women are evaluating reproduction in their own lives. For some folks, having a child even in the midst of job instability may also feel like the right time. As health care providers, our job is to inform women about all their options and any risks and help ensure that they are able to make decisions that line up with their values and priorities. We want to meet women where they are and then work with them to get where they want to be.”