“YOU’RE PLANNING A FAMILY, NOT JUST A PREGNANCY”: THE MEANINGS, EXPERIENCES, AND UNEVEN BURDENS OF FAMILY PLANNING IN WOMEN’S LIVES
Family planning has been a cornerstone of American public health policy for decades because of its potential to reduce unintended pregnancies, decrease related public spending, and improve family stability. Despite this prioritization, nearly fifty percent of pregnancies in the United States (U.S.) remain unplanned, suggesting there may be an unexplored disconnect between family planning as a public health goal and women’s own family formation needs and experiences. However, given the purported benefits of family planning, few policymakers, scholars, and healthcare professionals critically examine the paradigm of family planning, instead focusing policy efforts and resources on simply encouraging women to better time and space their pregnancies in line with public health recommendations. Through the stories of 86 diverse self-identified women, whose lives I follow for five years, I set out to understand how women conceive of family planning and enact its tenets (or not) in their lives. In doing so, I demonstrate that family planning is not simply a set of objective, health-related decisions about when and under what circumstances to become pregnant. Rather, it is a deeply intimate social process of family formation, influenced by gender, race, and class-based ideologies around family, motherhood, and health. Through these findings, I cast a critical light on the paradigm of family planning by challenging the underlying assumptions about its relevance, neutrality, universality, and benefits. Further, by using a Reproductive Justice lens, I emphasize the unequal burdens of family planning as currently conceived on women and families as well as its failure to support and stabilize families. I conclude by offering a new definition of family planning and use it to propose clear directions for future research as well as recommendations for social and public health policies that are both family and woman centered.