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Moving Beyond the Individual in Reproductive Health: Exploring the Social Determinants of Unintended Pregnancy

Kavanaugh, Megan Lynn (2008) Moving Beyond the Individual in Reproductive Health: Exploring the Social Determinants of Unintended Pregnancy. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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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 women's reproductive health is heavily reliant on the biomedical paradigm to document and explain existing health trends related to women's 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 women's 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 women's health literature, the first manuscript argues for the adoption of a broadened perspective that focuses on external factors that impact women's 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 women's pregnancy intentions prior to pregnancy testing is feasible and may provide a more accurate portrayal of women's 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 women's 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 women's 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.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kavanaugh, Megan
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDocumet, Patriciapdocumet@pitt.eduPDOCUMET
Committee CoChairTerry, Martha Annmaterry@pitt.eduMATERRY
Committee MemberMarx, Johnjmarx@pitt.eduJMARX
Committee MemberJaros, Kennethkjaros@pitt.eduKJAROS
Date: 28 September 2008
Date Type: Completion
Defense Date: 18 June 2008
Approval Date: 28 September 2008
Submission Date: 4 June 2008
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: DrPH - Doctor of Public Health
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: prospective assessment; social determinants of health; structural factors; unintended pregnancy; social justice; women's sexual and reproductive health
Other ID:, etd-06042008-150308
Date Deposited: 10 Nov 2011 19:46
Last Modified: 15 Nov 2016 13:44


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