Reproductive Decision Making with Vulnerable Populations: Educating Social Workers to Empower Clients

Overview: A call to action was made for CSWE and social work programs to ensure client reproductive autonomy as part of professional preparation. However, many social workers report lack of necessary knowledge or skills. This paper will focus on increasing the self-efficacy of social workers in empowering clients in reproductive decisionsProposal text: Over forty years ago social workers, along with nurses and doctors, were identified as one of the primary gatekeepers of family planning (Werley, Ager, Rosen, & Shea, 1973). The National Association of Social Workers continues to support the notion that social workers have a professional role in empowering clients with their reproductive decision making (RDM) (National Association of Social Workers, 2018), as do the national goals of Healthy People (Office of Disease Prevention and Health Promotion, n.d.) and numerous social service programs, which aim to help reduce instances of unintended pregnancy. However, the silence of CSWE around reproductive issues has been identified as problematic in supporting social work education and advocacy for client self-determination in RDM (Younes, Hyatt, Witt, and Franklin, 2021).

Roughly 45% of pregnancies in the United States are unplanned, which is substantially higher than rates in Westernized European countries. Furthermore, poor, Black, and Latinx people continue to have much higher rates of unintended pregnancy than do whites and those with higher incomes (Finer and Zolna, 2016). RDM is an economic, social, family, and community issue that can be better addressed through ongoing consideration of community-level engagement and the person in their environment (Hock‐Long, Whittaker, and Herceg‐Baron, 2010). Given that reproductive justice is an NASW goal and is congruent with our code of ethics, quality RDM services are necessary for client self-determination and empowerment. Research also has found that social work professionals and students are interested in addressing unintended pregnancy and other reproductive justice issues within client populations. However, many report not having the knowledge, tools, or strategies to address the multiple dimensions of RDM (Bell, 2015), which require basic knowledge of the social and biological dimensions of this complex concept. In addition, policies that are hostile to reproductive rights have interfered with reproductive health information being disseminated appropriately (Charo, 2017).

This paper will present why RDM matters in social work education, a model based on the Theory of Planned Behavior (TPB) to understand the unique needs of clients, strategies to ensure client-centered care, and tools that social workers can use with their clients. The TPB model prompts professionals to meet the client where they are to center client attitudes, beliefs, environment, and personal traits in determining their reproductive intention and behavior. Guided questions and listening to the client are prioritized at each step along with providing factual information. Electronic tools, such as apps and online decision-making tools, available without a cost from reputable sources, will be demonstrated for use with clients. Participants will be able to approach clients about their RDM intentions, understand their needs and beliefs, and use tools and techniques to assist clients in advancing their ability to make informed reproductive decisions. In addition, social worker partnerships with other experts in fields such as medicine will be discussed with a focus on client-centered care. Finally, the need for social workers to advocate for reproductive justice, and resources for doing so, will be emphasized within the context of the TPB.