A Guide to Ensuring Unbiased Care in Women's Reproductive Health

Implicit bias in reproductive health care
The field of reproductive health care suffers with clear and documented health disparities. In fact, in a country with a history of supporting eugenics programs and forced sterilizations, reproductive health care is perhaps one of the areas in which bias has been most troubling. It was just two decades ago when recipients of state welfare benefits were given cash bonuses for getting Norplant, a 5-year contraceptive implant, and one decade ago when inmates in California were coerced into sterilization. - Dr. Baltrushes-Hughes
​Physicians, physicians assistants, nurses, and anyone else who has direct contact with patients, plays a key role in shaping the state of women’s health. Therefore, it is crucial that they have a full understanding of past and present disparities that continue to impact reproductive health care.

The United States has long and tragic history of reproductive oppression among women. In response to the experience of many women of color and marginalized communities throughout the years, a Reproductive Justice Framework was created with an aim to eliminate inequalities and other factors that limit women’s ability to control these rights.

These disparities, although already harmful in nature, pose an even greater threat when reinforced by providers. Whether this reinforcement is explicit or implicit, obtaining an awareness about these disparities is the first step to achieving equality. Disparities in the practices of administering birth control, emergency contraception, and abortion are a just a few of the important topics analyzed in this guide. 

This guide aims to address the latter by providing tools and examples that allow one to analyze his or her own role in health care as it applies to Reproductive Justice.

Each topic is presented with historical context, case studies, and self reflection tools in order to allow one to think critically about his or her own patients and become mindful of the ways in which he or she practices.

Assessing Unconscious Bias

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  • Understanding the underlying biases that manifest in health care settings is critical to addressing the disparities in women’s health outcomes in Wisconsin.
  • In 2003, The Institute of Medicine concluded that unconscious bias against certain groups may jeopardize the communication or quality of care provided to those patients.
  • Therefore, in order to mitigate these impacts, health care professionals have an obligation to evaluate the care they provide through exploration of their own implicit biases.
  • Researchers at Harvard University, The University of Washington, and University of Virginia developed the Implicit Association Test, which is one of the most well known and widely accepted utilities for assessing unconscious bias.​

Topic Guides

Women's Reproductive Health Topics
Please feel free to share some of your own experiences, as well as any comments or suggestions. 

Tips for Communication

  • Honest, non-judgmental conversation can help create mutual understanding between patients and physicians
  • Refer to a woman in a singular context as opposed to referring to groups of “women," the singular title personalizes the issue and avoids the use of stereotypes
  • When discussing divisive issues, using the word “decision” is better than “choice” because it connotes the thoughtfulness with which it is made
  • When discussing abortion with a patient, use the terms “safe and legal” to present abortion in a neutral light
  • Be in tune with patients' lives outside of the medical environment in order to provide health care plans that are realistic and comprehensive
  • Incorporate language that is culturally and gender sensitive
  • When recommending birth control, provide a comprehensive list of options
  • Avoid using "I think" statements