Improving Reproductive Health Communication Between Providers and Women Affected by Homelessness and Substance Use in San Francisco: Results from a Community-Informed Workshop

Objectives Many cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive choices and supporting reproductive decisions of these women poses barriers to reproductive healthcare access. Methods W...

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Bibliographic Details
Published in:Maternal and child health journal 2023-12, Vol.27 (Suppl 1), p.143-152
Main Authors: Wingo, Erin E., Newmann, Sara J., Borne, Deborah E., Shapiro, Brad J., Seidman, Dominika L.
Format: Article
Language:English
Subjects:
Birth control
Childbirth & labor
Cisgender
Communication
Confidence
Counseling
Drug use
Empathy
Experience
Female
Gynecology
Health behavior
Health care access
Health Communication
Health services
Homeless people
Homelessness
Housing
Humans
Ill-Housed Persons
Maternal and Child Health
Medicine
Medicine & Public Health
Mental disorders
Mental health services
Parents & parenting
Patients
Pediatrics
Population Economics
Pregnancy
Public Health
Reproductive Health
Research methods
San Francisco
Social services
Sociology
Stigma
Substance abuse
Substance use
Substance-Related Disorders
Trauma
Women
Womens health
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Summary:Objectives Many cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive choices and supporting reproductive decisions of these women poses barriers to reproductive healthcare access. Methods We used participatory research methods to develop a half-day workshop for San Francisco-based medical and social service providers to improve reproductive counseling of women experiencing homelessness and/or who use substances. Guided by a stakeholder group comprising cisgender women with lived experience and providers, goals of the workshop included increasing provider empathy, advancing patient-centered reproductive health communication, and eliminating extraneous questions in care settings that perpetuate stigma. We used pre/post surveys to evaluate acceptability and effects of the workshop on participants’ attitudes and confidence in providing reproductive health counseling. We repeated surveys one month post-event to investigate lasting effects. Results Forty-two San Francisco-based medical and social service providers participated in the workshop. Compared to pre-test, post-test scores indicated reduced biases about: childbearing among unhoused women ( p  
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-023-03671-y