True Choice in Reproductive Care: Using Cultural Humility and Explanatory Models to Support Reproductive Justice in Prim
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VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA; 2Stanford University Center for Primary Care and Outcomes Research (PCOR) and Center for Health Policy (CHP), Stanford, CA, USA; 3Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA, USA.
Reproductive justice is the human right to maintain personal bodily autonomy, have children, not have children, and to parent children in safe and sustainable communities. Historically, marginalized individuals have experienced reproductive oppression in multiple forms. This oppression continues in modern times through health policy and patient-clinician communication. To combat this, the framework of reproductive justice outlines four key actions: analyzing power systems, addressing intersecting oppressions, centering the most marginalized, and joining together across issues and identities. Primary care clinicians have a unique role and responsibility to carry out these four key actions in order to provide patient centered reproductive care. To translate reproductive justice into clinical practice, clinicians care can use reflective practice, the framework of cultural humility, and the concepts from the explanatory model of illness. J Gen Intern Med DOI: 10.1007/s11606-020-06245-8 © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2020
INTRODUCTION
Reproductive justice is the human right to maintain personal bodily autonomy, have children, not have children, and to parent children in safe and sustainable communities.1 This term emerged from Black feminist scholars in response to the women’s rights movement, which was largely led by affluent, white women and did not adequately advocate for those marginalized. Today, it is a multi-cultural movement to highlight the critical role of access to reproductive care, calling attention to the fact that without access to information or options there is no “choice.” In addition to services like contraception or abortion, Prior presentations: This manuscript is based on a workshop entitled “Highly effective, respectful, and culturally informed reproductive counseling: overcoming a legacy of racism” which was submitted by all authors of this manuscript and accepted for presentation at National SGIM 2020, canceled due to COVID-19. Received June 2, 2020 Accepted September 11, 2020
reproductive justice highlights access to sex education, sexually transmitted infection prevention and treatment, preconception care, and prenatal care. The reproductive justice framework addresses the intersecting structural barriers to reproductive health, such as intimate partner violence, opportunity gaps, and financial and structural confinement unsafe for individuals. For individuals marginalized by their identities, associations, experiences, and environment,2 reproductive justice has been denied by our medical system. From enslavement to modern day, ther
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