Racism is associated with undesired pregnancy, but no studies examine how experiencing
discrimination might shape pregnancy preferences or contraceptive use.
We recruited n=1,790 non-pregnant individuals, with the capacity for pregnancy, aged
15–34 from 20 health facilities in West Texas, Nevada, Arizona, New Mexico, and Southern
California and followed them for a year (2019–2022). At baseline, participants completed
the everyday discrimination measure (poor daily treatment based on race/ethnicity,
sometimes/often vs. rarely/never). At baseline and at quarterly intervals, they completed
the Desire to Avoid Pregnancy (DAP) scale (range: 0–4, higher score=greater desire
to avoid pregnancy) and reported contraceptive method use. Using adjusted multivariable
mixed-effects models, we examined associations between discrimination, pregnancy preferences,
contraceptive method, and method satisfaction over one year.
Of the sample (55% Latinx, 22% White, 14% multiracial/other, 8% Black), 25% reported
sometimes or often experiencing discrimination. Discrimination was more common among
Black (50%), multiracial/other (30%) and Latinx (25%) participants (vs. 11% White;
adjusted ORs (aORs), 8.5, 3.5 and 3.1, respectively). Those who reported discrimination
had higher preference to avoid pregnancy, on average, adjusting for race/ethnicity
and covariables (marginal mean, 2.51 vs. 2.30; adjusted Coefficient=0.20 [0.10, 0.32]).
Contrary to hypotheses, among those preferring to avoid pregnancy, discrimination
was positively associated with condom (aOR, 1.83 [1.31, 2.57]) and prescription method
use (aOR, 1.66 [1.26, 2.20]) vs. no method, but marginally negatively associated with
method satisfaction (aOR, 0.74 [0.52, 1.04]).
Experiencing discrimination may influence feelings about becoming pregnant and method
satisfaction. Women's pregnancy preferences and contraceptive choices are not immune
from the impact of racism or xenophobia.