A Systematic Review of the Reproductive Justice Landscape: Assessing the Use of Spatial Data to Explore Reproductive Justice Access

Background and Purpose: Access to maternal and child health (MCH) services is a critical healthcare issue affecting the wellbeing and life expectancy of women and children. Barriers to accessing such services are often heightened in undeserved rural communities and healthcare deserts. Spatial data can add depth and nuance to existing health outcomes research, and help identify unmet healthcare needs. Mapping goes beyond documenting health disparities to explore the specific factors that are causing these disparities for people living in rural areas. Reproductive justice frameworks are infrequently used in conjunction with spatial data approaches to assess healthcare needs and barriers to accessing services. Our overarching research question is “what is the current scope of literature utilizing spatial tools and data to explore reproductive justice healthcare access.” We define reproductive justice as the right to have children, the right to not have children, the right to parent ones’ children (Ross, 2006).

Methods: To assess the use of spatial data in exploring reproductive justice access, we conducted a systematic review of existing scholarship. PRISM guidelines for conducting systematic reviews were followed and our search process was registered with PROSPERO, a prospective register of systematic reviews. Three researchers used the search terms: "reproductive justice" OR "reproductive injustice" AND GIS OR topography OR map* OR spatial* OR "Geographic Information System" OR Geovisualization OR StoryMaps AND "United States” to search the following databases: (1) Google Scholar, (2) PubMed, (3) SAGE, (4) EBSCO, (5) Global Health Archive, (6) CINAHL, (7) JSTOR, (8) Project MUSE, (9) PsycARTICLES, (10) PsycINFO, (11) SocINDEX with full text, and (12) ScienceDirect (Elsevier) between February 2022 and April 2022.

Results: Over 7530 articles were identified using the previously described search terms and databases. After removing duplicates and articles that did not substantively address either reproductive justice/injustice or use spatial data, 42 articles remained. We analyzed articles in terms of a) type of article; (b) study design, measures and outcomes if a research article; (c) article population; (d) role or use of spatial data; (e) article location; and (f) reproductive justice definition/or focus of article.

Conclusions and Implications: These results highlight the unique and powerful role spatial data can play in documenting reproductive justice issues, particularly those related to healthcare access. These findings bring into focus the current limitations in scholarship exploring the use of spatial data to assess and promote reproductive justice, while also offering examples of some best practices and innovative ways these approaches are currently being utilized. In particular, the use of community-based participatory research approaches in conjunction with spatial data offer particular promise for holistically assessing reproductive justice needs and resources and for developing impactful interventions promoting reproductive justice. These findings are currently being used to develop a qualitative assessment of reproductive justice access in rural Montana using StoryMaps.

Ross, L. (2006). Understanding Reproductive Justice: Transforming the Pro-Choice Movement. Off Our Backs, 36(4), 14–19. https://www.jstor.org/stable/20838711