{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:12:07Z","timestamp":1778515927664,"version":"3.51.4"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>While data on the factors associated with the sexual and reproductive health of Black women is growing, few studies have applied a reproductive justice framework to their analyses, and few have assessed the role social realities play on reproductive decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data collected from a community-based participatory study, conducted between May 2019 and January 2020. The parent study aimed to get an understanding of the reproductive health experiences and concerns of Black women living in two southern states, Georgia and North Carolina. For this paper, we used a thematic analysis to identify themes from codes within the categories: healthcare utilization, pregnancy, and family life. We applied a reproductive justice framework lens to assess pregnancy intentions, pregnancy decision-making, and family planning agency across the full spectrum of family planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, six focus group discussions, with 8\u201310 participants each, and 25 in-depth interviews were completed. Participants ranged in age, economic, and educational background. We found that social and cultural factors played an important role in pregnancy intentions and decision-making. Community and social norms worked to diminish positive feelings around Black pregnancy and non-childbearing, leading some to feel stigmatized and avoid pregnancy. Factors within the legal, economic, and health systems impacted family planning agency\u2014limiting the ability to access desired family planning services such as abortion and infertility treatments. Participants offered strategies they believed could help counter the impact of these factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings highlight that Black women\u2019s pregnancy intentions, pregnancy decision-making, and family planning agency are influenced by their social realities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1799483","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:36:49Z","timestamp":1777351009000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond choice: social realities shaping pregnancy decisions and family planning agency among Black women in the south"],"prefix":"10.3389","volume":"14","author":[{"given":"Terri-Ann","family":"Thompson","sequence":"first","affiliation":[{"name":"Ibis Reproductive Health","place":["Cambridge, MA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves-Yvette","family":"Evans","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Oakland","place":["CA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Simpson","sequence":"additional","affiliation":[{"name":"SisterSong Women of Color Reproductive Justice Collective","place":["Atlanta, GA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriaku","family":"Njoku Rivera","sequence":"additional","affiliation":[{"name":"Access Reproductive Care-Southeast, Atlanta","place":["GA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Public Health Studies, Elon University","place":["Elon, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref1","volume-title":"Research on Factors that Determine Women\u2019s Ability to Make Decisions about Sexual and Reproductive Health and Rights","year":"2019"},{"key":"ref2","author":"Ranji","year":"2019"},{"key":"ref3","volume-title":"The Surgeon General\u2019s Call to Action to Promote Sexual Health and Responsible Sexual Behavior","year":"2001"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/09541440440000159","article-title":"Weighing the past and the future in decision making","volume":"17","author":"Juliusson","year":"2005","journal-title":"Eur J Cogn Psychol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1037\/0022-3514.94.4.672","article-title":"On the relative independence of thinking biases and cognitive ability","volume":"94","author":"Stanovich","year":"2008","journal-title":"J Pers Soc Psychol"},{"key":"ref6","first-page":"35","article-title":"Understanding medical mistrust in black women at risk of BRCA 1\/2 mutations","volume":"12","author":"Sutton","year":"2019","journal-title":"J Health Dispar Res Pract"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1177\/0021934711415243","article-title":"\u2018It just kind of like falls in your hands\u2019: factors that influence black aunts\u2019 decisions to parent their nieces and nephews","volume":"43","author":"Davis-Sowers","year":"2012","journal-title":"J Black Stud"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/jomf.12618","article-title":"Pathways to parenthood in social and family contexts: decade in review, 2020","volume":"82","author":"Guzzo","year":"2020","journal-title":"J Marriage Fam"},{"key":"ref9","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-137-12103-5_9","article-title":"Black women and motherhood","volume-title":"Motherhood and Space","author":"Collins","year":"2005"},{"key":"ref10","first-page":"694","volume-title":"Qual Health Res.","author":"Leath","year":"2022"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40615-025-02459-w","article-title":"The impact of structural determinants on pregnancy intention and reproductive decision-making among African American women","author":"Strickland Denson","year":"2025","journal-title":"J Racial and Ethnic Health Disparities"},{"key":"ref12","year":"2020"},{"key":"ref13","first-page":"9","volume-title":"The State of Black Women and Reproductive Justice Report","author":"Flint","year":"2017"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1215\/03616878-8802186","article-title":"Affordable but inaccessible? 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