Health Services Research & Development

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Hamm M, Evans M, Miller E, Browne M, Bell D, Borrero S. "It's her body": low-income men's perceptions of limited reproductive agency. Contraception. 2019 Feb 1; 99(2):111-117.
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Abstract: OBJECTIVES: While some attention has been paid to men's contraceptive use and attitudes in international contexts, relatively little is known about the attitudes towards contraception and pregnancy of low-income, urban men in the U.S. STUDY DESIGN: We conducted semi-structured interviews with 58 low-income men in Pittsburgh, PA, to explore their perspectives on contraception, pregnancy, fatherhood, and relationships. We analyzed the interviews using a combination of content analysis, the constant comparison method, and thematic analysis. RESULTS: Men who we interviewed frequently described feeling that they lacked agency regarding when pregnancies occurred and whether or not they became fathers. Several factors contributed to their sense of low agency, including the belief that women should control contraception and reproduction, a reluctance to have conversations about contraception in some contexts, a lack of acceptable male-controlled contraceptive methods, experiences with pregnancy-promoting behaviors by women, and fatalistic attitudes towards pregnancy occurrence. CONCLUSIONS: Many men in our study described perceptions of limited reproductive agency. In describing their lack of agency, men reinforced contemporary gender norms in which the "work" of pregnancy prevention is a woman's responsibility. Responses to men's perceived limited reproductive agency should work towards deconstructing gendered norms in the work of pregnancy prevention and promote shared and mutual gender responsibility over reproduction while also supporting women's reproductive autonomy. IMPLICATIONS: This study identifies several factors that contribute to low-income men's sense of low reproductive agency and highlights the complexity of acknowledging men's feelings and perceptions about reproductive control in the broader context of gender and power.