"I Didn't Think That I Was Going to Get Pregnant" an Analysis of Racial Differences in Contraceptive Nonuse Among Women

Background and Purpose: The unintended pregnancy (UIP) rate in the United States is declining, but racial disparities in the UIP rate still exist. Scholars have found that black women have the highest rates of UIP that end in abortion. Access to a full range of contraceptives and a thorough understanding of how to use those contraceptives can reduce a woman’s chances of experiencing a UIP. The purpose of this study is to highlight the need for better contraceptive education and access that transcends racial boundaries.

Methods:  The current study is a part of a larger project. Data for the project consisted of responses from 132 pregnant women who were seeking abortion services at the time of enrollment. In the current study, mixed methods were used to explore the relationship between race and birth control nonuse. Two chi-square analyses were run and a thematic analysis was done on the qualitative data which was coded independently by two coders. For the chi-square analyses, race was transformed into a dichotomous variable so that women of color (48%) could be compared to white women (51%).

Results: The self-identified race of participants was 51.1% White­­­, 41.67% Black, 1.5% Asian, 0.8% American Indian/Alaskan Native, 0.8% other, and 3% identified as multiracial. There was a statistically significant relationship between race and whether the women believe their current pregnancy to be a result of birth control failure (χ²(1) =  5.59, p < .05). A second chi-square analysis was conducted to examine the association between race and whether or not the women considered using emergency contraception (EC) after unprotected intercourse, but it was not statistically significant (χ²(1) =  .013, p > .05). The women who did not use EC after unprotected intercourse were asked to explain why. There were 76 responses to this question and exactly half of the responses fell into the category of not thinking they would or could get pregnant. Examples of responses in this category included:

• “I didn’t think that I was going to get pregnant.” (Black woman)
• "Partner pulled out" (White woman)
• “I am bixsexual and this was my first time being with a man. The man who I got pregnant with is my first boyfriend. I didn't think that I could get pregnant.” (Black woman)

Conclusions and Implications: Findings illustrate the need for more education on correct and consistent contraceptive use for women of all racial backgrounds. Over half (51%) of the pregnant women seeking abortion services in the study were not using birth control in the six months prior to becoming pregnant. Also, 74% of the women in the study expressed the preference for an abortion rather than carrying to term and raising a child. This shows the discrepancy between not using contraceptives but at the same time, not wanting to become pregnant. Implications of these findings will be examined using a critical race theory framework and the role that social workers can play to reduce the racial disparities in the UIP rate will be discussed.