Public health has moved away from its original mission to address and promote health on a societal level towards an individually focused, victim-blaming paradigm. In particular, research regarding womens reproductive health is heavily reliant on the biomedical paradigm to document and explain existing health trends related to womens fertility. This research often targets behavior in isolation of its social context. In order to promote the integration of a population health perspective into the current medically dominated realm of womens reproductive health, this dissertation highlights the issue of unintended pregnancy (UIP).
The United States (US) continues to have the highest rate of UIP of all industrialized countries. These UIPs, and their negative health consequences, are disproportionately experienced in the high-risk populations of low-income, young and minority women. In efforts to foster greater understanding of UIP and of these disparities, this dissertation encompasses three distinct manuscripts. Based on a review of public health and womens health literature, the first manuscript argues for the adoption of a broadened perspective that focuses on external factors that impact womens reproductive behavior. Manuscript 2 discusses the first component of a mixed-methods research study involving surveys of women at high-risk for UIP who sought pregnancy tests in Pittsburgh, which reveal that assessing womens pregnancy intentions prior to pregnancy testing is feasible and may provide a more accurate portrayal of womens intentions to become pregnant than existing retrospective measures. The third manuscript, which highlights qualitative interviews with ten women from the above sample, presents evidence for the influence of external factors on womens experience of UIP.
This dissertation challenges current individually focused paradigms for understanding UIP among US women. The public health significance of this dissertation lies in the findings of the research presented, which demonstrate that a reciprocal relationship exists between the social context of womens lives and their UIP experiences and which emphasize the need to broaden the perspective of current UIP research. Future research, programs, and policy should integrate the perspective and findings highlighted in this dissertation in order to reduce negative health consequences of UIP and promote population-level healthy pregnancy outcomes.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-06042008-150308 |
| Date | 28 September 2008 |
| Creators | Kavanaugh, Megan Lynn |
| Contributors | Martha Ann Terry, PhD, John Marx, PhD, Patricia Documet, MD, DrPH, Kenneth Jaros, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-06042008-150308/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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