“Nobody Ever Asks Me:” A Reproductive Justice Approach to Rural Health Disparities

Abstract

Rural women within the southern United States face complex challenges when attempting to access reproductive health care. A reproductive justice framework provides an intersectional approach to understanding the experiences of women from varying backgrounds. Researchers conducted 52 in-depth interviews with women aged 18–44 years in rural South Carolina to understand perceived reproductive health care barriers through a reproductive justice framework. Interviews were analyzed using a constant-comparative method with qualitative data analysis software HyperRESEARCH 3.7.2. Reproductive justice served as the conceptual lens. Participants noted barriers to reproductive health care including cost, poor quality of care, and long wait times. Participants described confidentiality concerns and lack of facilities. Insufficient access to health care for women in conjunction with racial and cultural norms revealed intersectionality between gender and race. Participants reported limited autonomy over health decisions due to generational habits of not seeking care and predetermined attitudes toward health, influencing social capital and access to care. Findings suggest the need for grassroots organizing to shift the focus from reproductive rights to reproductive justice, facilitating autonomous health decisions and supportive environments to exercise decision making. Robust understandings of women's lived experiences offer insights to addressing health barriers in rural communities.